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كتب- نشأت أمين: نظرت محكمة الجنايات قضية إتهام آسيوي وآسيوية بممارسة الزنا، وقد جاء الكشف عن القضية عندما تقدمت السيدة المتهمة وهي في الثالثة والعشرين من العمر ببلاغ إلي رجال الشرطة قالت فيه أنها كانت تمارس الرذيلة منذ فترة مع رئيسها في العمل . | |
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Sunday, December 14, 2008
سيدة تتهم مديرها بإصابتها بالإيدز
محاضرات للوقاية من الأمراض الجنسية والإيدز في تكنولوجية سخنين
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| من أمين بشير مراسل موقع العرب وصحيفة كل العرب |
| * تم عرض مادة علمية وإدارة نقاش وحوار حول انتقال الأمراض الجنسية والايدز, طرق العدوى وسبل الوقاية والحماية منها . ضمن مشروع توعية الأولاد والشبيبة من السلوكيات والظواهر السلبية في مجتمعنا العربي تقوم جمعية الجليل للبحوث والخدمات الصحية – مركز الحقوق الصحية- بتقديم محاضرات وورشات عمل لأبناء الشبيبة وطلاب المدارس في موضوع الوقاية من الأمراض الجنسية ومرض الايدز. حيث تم تمرير ثلاث محاضرات لطلاب الحوادي عشر في مدرسة سخنين الثانوية التكنولوجية.
وفي حديث مع الأستاذ سيف أبو صالح مدير ألمدرسه قال: قالت العرب "درهم وقاية خير من قنطار علاج". ومن هذا المنطلق، فإننا نعمل في المدرسة على تكثيف برامج التوعية المتنوعة (العنف، الكحول، التثقيف المروري، التثقيف الجنسي...الخ) التي تهدف إلى تحصين الطلاب تفاديًا من أي أضرار مستقبلية. أشكر على وجه التخصيص مركزي التربية الاجتماعية على عملهما الدؤوب لما فيه خير للطلاب
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| 2008-12-12 06:55:17 |
جميلة، أنيقة، طالبة... وعاهرة
تقرير: كريمة ادريسي
10-12-2008
أمام الحرم الجامعي، بمدينة طلابية مغربية، تقف طالبة تضم حقيبتها إلى صدرها بشكل متوتر، ويبدو أنها في انتظار أحد ما. تنظر من حين لآخر إلى ساعتها اليدوية، ثم تقف أمامها فجأة سيارة فخمة. يفتح الباب الأمامي. تتلفت حولها وتصعد مسرعة، ثم تنطلق السيارة تاركة خلفها زوبعة من الغبار.
مشهد يتكرر منذ زمن أمام محطات القطار والأزقة المزدحمة... لكن أمام الحرم الجامعي؟ فهذا أمر جديد! ويثير الدهشة والاسي ..
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تكشف ممارسة الدعارة في المغرب عن مفارقات كبيرة، تؤدي إلى طرح إشكاليات، حسب المنظمة الأفريقية لمكافحة الإيدز.
نشرت المنظمة نتائج أول بحث مستقل عن الدعارة في المغرب، تشير فيه إلى أن العاملات في الدعارة بالمغرب مجموعة غير متجانسة، تختلف من الصغيرة للمسنة، ومن الأمية لحاملات الشهادة العليا. وأشار البحث إلى أن "31.5 % من اللاتي شملتهن الدراسة أميات، لكنّ المفارقة أيضا أنّ نسبة 21 % من العاملات في هذا الميدان أيضا دخلن الجامعات وحصل بعضهن على شهادات علمية مرموقة".
أما مجلة نيشان فقد أنجزت قبل ذلك بحثا عن الطالبات اللاتي يمارسن الدعارة، واستطاعت المجلة التوصل إليهن ومحاورتهن.
وفي نفس المجلة تقول سناء العاجي لإذاعة هولندا العالمية: "الخطير في دعارة الطالبات ان المكانيزمات التي توصل الطالبة إلى ممارسة الدعارة ليس الفقر، ولكن غالبا ما تتعاطى الطالبة الدعارة كحل سهل لبلوغ مستوى معيشي أرقى. والأخطر أن الطلب على الطالبات اللاتي يمارسن الدعارة يتزايد بشكل ملفت".
تنافس الطالبات العاهرات المعتادات لدى عينة معينة من الزبائن. رجال أعمال، أطر، أطباء ومهندسون. "يستطيعون توفير مستوى مادي معين، فالطالبة غالية الثمن. وكأي سوق في النهاية يصبح العرض والطلب متقابلين متوازيين". كما تصرح سناء العاجي.
عينة معينة من المجتمع، تبحث عن فتاة تقضي معها وقتا ممتعا وليس من اجل الجنس فقط. طالبة "تشرف" من يصطحبها إلى المجتمعات الراقية، التي تُقدم إليها كصديقة أو عشيقة وليس عاهرة. فهذا المصطلح مرفوض ومهين، ففي بحث نيشان لا تعتبر بعض الطالبات ما يمارسنه دعارة وإنما "قضاء وقت جميل صحبة شخص محترم مقابل هدية ثمينة. تقول إحدى الطالبات منهن: "أنا ارفض المال لكن أتقبل الهدايا الثمينة أو رحلة نهاية أسبوع ممتعة"، لكن هناك من الطالبات من يصرحن بان ما يفعلنه من اجل المال ليس إلا.
وتقول سناء العاجي: " قد يكون لدينا نوع من التعاطف مع نساء تدفعهن الظروف لذلك لامتهان الدعارة، لكن ان تمارس طالبة ذلك يظل أمرا غير مفهوم".
أشارت دراسة المنظمة الأفريقية لمكافحة الإيدز إلى أن "فترة الانتظار بين إكمال الدراسة والحصول على وظيفة تعدّ واحدة من الأسباب بالإضافة أيضا إلى ضعف المنح الجامعية المخصصة للدراسة مما يدفع الطالبات إلى بيع أجسادهن من أجل الحصول على المال الكافي".
هناك في الرباط عمارة الطالبات، قرر صاحبها ان يكتريها للطالبات فقط ليبتعد عن المشاكل، لكن النتيجة كانت عكسية. اكتسبت العمارة الآن سمعة "البورديل" أي وجهة لطالبي المتعة. وتقول سناء العاجي: "وأما طالبات السكن الجامعي، وللتخلص من إجراءات السكن الصارمة التي تحتم عليهن اللجوء إلى غرفهن باكرا، فإنهن يشترين ببعض ما يكسبن، صمت حراس السكن الجامعي".
ومهما كان، يبدو أن نسبة الطالبات اللاتي يمارسن الدعارة محدودة جدا لا تزال. وقد أشار بحث المنظمة الأفريقية لمكافحة الإيدز إلى أنّ "نحو 40% من العاملات في هذا الميدان مطلقات، زيادة على أنّ 4 % متزوجات تمارسن الجنس مقابل المال بسبب غياب الزوج أو عدم قدرته على الإنفاق أو دون علمه".
والجدير بالذكر أن بحث المنظمة شمل 500 امرأة من سبع مدن هي الرباط، أزرو، بني ملال، مكناس، فاس وأغادير.
مفردات البحث: أزرو، أغادير، الايدز، الحرم الجامعي. ، الدعارة، الرباط، المغرب، بني ملال، بورديل، سناء العاجي، طالبات، فأس، مجلة نيشان
تزايد اعداد الشواذ جنسيا في الاردن
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تلفزيون نابلس- فيما أعلنت وزارة الصحة الأردنية عن رصد 20 حالة شذوذ جنسي بين المواطنين في أنحاء البلاد، وذلك بعد تقارير تحدثت عن تنامي ظاهرة الشاذين، حذرت مديرية "الأمراض المنقولة جنسيا" من تنامي أعداد الشاذين مالم تتكاتف الجهود للتصدي لهذا السلوك المنبوذ من المجتمع.
فقد قدر رئيس قسم الأمراض المنقولة جنسيا د. رجاء العزة، أعداد "الشاذين" بحوالي 150 شخصا، معتبرا أن هذه الأعداد "متدنية ولا تشكل ظاهرة في مجتمعنا"، لكنه لم يستبعد أن تتضاعف أعداد المثليين في المجتمع الأردني "المحافظ" وتتجاوز التقديرات المعلنة، في حال لم تتكاتف جهود كل الجهات للتصدي لهذا السلوك "المنبوذ من المجتمع".
وقالت وزارة الصحة إنها تمكنت من رصد 20 حالة شذوذ جنسي بين المواطنين الأردنيين في أنحاء البلاد، وجاء التوضيح الرسمي الأردني، بعد تقارير إعلامية تحدثت عن تنامي ظاهرة الشاذين و تقدير أعدادهم بالآلاف.
ولم يحدد التقرير نوع الشذوذ، ونسب انتشاره بين الشبان والفتيات، إلا أن مديرية الأمراض المنقولة جنسيا في وزارة الصحة، قالت في تقريرها، الذي نشرته صحيفة "الغد" الأردنية الأحد 22-6-2008 إن العدد ربما يرتفع ليصل إلى 150 حالة فقط.
وكانت تقارير تحدثت عن بروز بؤر شبه علنية في بعض أحياء العاصمة عمّان، وأصبحت معروفة أنها أماكن لتجمع الشاذين جنسيا من الشبان، فيما ألمحت تقارير أخرى عن بروز مقاهي وصالات ديسكو، معروف عنها أنها مكان لتجمع الشاذات جنسيا من الفتيات الأردنيات.
وقالت وزارة الصحة في تقريرها، إنها "تقدم المساعدة الإرشادية النفسية للمثليين جنسيا باعتبارهم من الفئات الأكثر تعرضا للإصابة بالأمراض المعدية"، وخصوصا مرض الإيدز. واعتبرت الصحة أن سلوك هؤلاء الشاذين "محفوف بالمخاطر الصحية".
وحذر د. العزة من مدى خطورة هذا السلوك الشاذ من الزاويتين الاجتماعية والصحية، ودعا الأهالي إلى متابعة أبنائهم، ومراقبة سلوكياتهم، ومعرفة أماكن تجمعاتهم.
ويقول د. العزة من خلال تعامله المباشر مع مراجعي القسم من المثليين جنسيا، إنهم "أذكياء ومتعلمون، لكنهم لا يميلون إلى الجنس الآخر"، ومن ثم، فإن "تفاعلهم مع مجتمعهم كأسوياء، سيكون له إيجابيات عديدة"، ويؤكد على أن "علاجهم ليس مستحيلا لكنه صعب".
Tuesday, December 9, 2008
الانخراط القوي للأميرة للا سلمى في محاربة السيدا يحظى بتنويه افريقي
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| 22:41 | 06.12.2008 | الدارالبيضاء: 'المغربية' (و م ع) | المغربية |
| غادرت صاحبة السمو الملكي الأميرة للا سلمى، ليلة الخميس الجمعة، العاصمة السينغالية دكار، بعد مشاركة سموها في أشغال المؤتمر الدولي 15 حول داء فقدان المناعة المكتسبة (السيدا) والأمراض المنقولة جنسيا بإفريقيا. |
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وكانت صاحبة السمو الملكي الأميرة للا سلمى، شاركت بعد ظهر أول أمس الخميس، في الدورة الخاصة للسيدات الأوليات بإفريقيا، المنظمة في إطار المؤتمر الدولي 15 حول مرض فقدان المناعة المكتسبة (السيدا) والأمراض المنقولة جنسيا. وجرى هذا اللقاء بحضور السيدات الأوليات للسينغال ومالي ورواندا، وكذا ممثلي العديد من البلدان والمنظمات الدولية والإفريقية المنخرطة في محاربة السيدا. وبحث اللقاء دور السيدات الأوليات في مجال التحسيس وتعبئة الموارد من أجل الحد من انتشار السيدا في إفريقيا. وكانت صاحبة السمو الملكي الأميرة للا سلمى، شاركت الأربعاء الماضي، في حفل افتتاح هذا المؤتمر، حيث ألقت سموها كلمة باسم المملكة المغربية، دعت فيها إلى تعبئة مستمرة، وإلى قيام تعاون فعال، على الصعيدين الإقليمي والدولي، لمحاربة داء فقدان المناعة المكتسبة (السيدا). وأكدت صاحبة السمو الملكي الأميرة للا سلمى أنه يتعين اعتماد مقاربة دولية، تأخذ بعين الاعتبار مختلف الجوانب المرتبطة بهذا الداء، سواء منها الطبية أو السوسيولوجية أو النفسية أو الثقافية. وخلال حفل افتتاح هذا المؤتمر، الذي شهد حضور حوالي 7000 مشارك حول موضوع "جواب إفريقيا: مواجهة الحقائق"، تسلمت صاحبة السمو الملكي الأميرة للا سلمى جائزة المؤتمر الدولي حول السيدا والأمراض المنقولة جنسيا، اعترافا بانخراط سموها في مجال محاربة السيدا. وتميز مقام صاحبة السمو الملكي الأميرة للا سلمى في دكار بتوشيح سموها من قبل الرئيس السينغالي عبدو اللاي واد، بالحمالة الكبرى للاستحقاق الوطني، التي تعتبر أسمى وسام بجمهورية السينغال. ويضم المؤتمر الدولي 15 حول السيدا والأمراض المنقولة جنسيا حوالي 7000 مشارك يمثلون 130 بلدا، من باحثين وأصحاب قرار سياسي ونساء أوليات ومنظمات غير حكومية وأشخاص حاملين لداء السيدا. وبحث المشاركون في هذا المؤتمر، الذي انعقد حول موضوع "جواب إفريقيا: التصدي للواقع"، على مدى أربعة أيام، سبل تنسيق جهود الحكومات والباحثين والمنظمات غير الحكومية والمجموعات، من أجل الحد من انتشار السيدا بإفريقيا، من خلال ضمان انسجام أكبر على مستوى صياغة ووضع برامج وتظافر جهود مختلف المقاربات العلمية، المشتركة والرائدة. | ||||||||||||
إستشارية تحذر من شفرات الحلاقين المتجولين
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| الرياض 10 ذوالحجة 1429 الموافق 8 ديسمبر 2008 م واس حذرت إستشارية الأمراض المعدية بمستشفى القوات المسلحة بالرياض الدكتورة نسرين الشربيني حجاج بيت الله الحرام من خطورة أدوات الحلاقة التي يستخدمها الحلاقون المتجولون . ولفتت النظر إلى احتمال تلوث تلك الأدوات ببعض الفيروسات الخطرة التي قد تنتقل للحجيج من خلال الدم ومنها التهاب الكبد الفيروسي ( ب ) و( ج ) وفيروس نقص المناعة الأيدز . ونصحت الشربيني بعدم استعمال شفرة حلاقة سبق استخدامها من حاج لأخر في أي مرحلة من مراحل الحلق أو التقصير ومراعاة استخدام شفرة جديدة وضرورة ان يستخدم كل حاج أدوات الحلاقة الخاصة به مع ضرورة غسل يديه بالماء والصابون وتطهير أدوات الحلاقة المستخدمة بالمطهرات المعروفة قبل الحلاقة . وأوصت بضرورة عدم رمي مخلفات الحلاقة مثل الأمواس على الأرض لأنها قد تتسبب في جرح أقدام الحجاج وتلوثها وانتقال الأمراض المعدية بينهم . ودعت الأشخاص المصابين للحفاظ على صحة الغير وعدم إستعمال أدوات الحلاقة الخاصة بالاخرين وإخطار الطبيب في حالة احتياجه لإشراف طبي والآخرين ممن يهتمون بصحته بأنه حامل لفيروس التهاب الكبد الوبائي ( ب ) لأخذ الاحتياطات اللازمة مثل الامتناع عن التبرع بالدم ، إضافة إلى ضرورة تنظيف أي نقطة دم تنزل من جسمه بمطهر ومياه ومسح الجرح بسائل مطهر . // انتهى // 1521 ت م |
Saturday, December 6, 2008
في يوم الإيدز العالمي..67 مصاب أردني جديد
تحتفل وزارة الصحة اليوم في مدينة السلط الثقافية باليوم العالمي للإيدز، تحت شعار "أيها القياديون أوفوا بالعهد وأوقفوا الايدز"، لتعريف المواطنين بمرض الايدز وطرق انتشاره والوقاية منه.
ومن المقرر أن تقدم الوزارة عونا للمتعايشين مع الايدز والتصدي لعدوى فيروس المرض، ودعم البرامج الخاصة للفئات الأكثر عرضة للعدوى.
ويسجل للأردن عالميا انخفاضا في معدلات انتشار مرض الايدز، ووفق آخر إحصائية صدرت عن مديرية مكافحة الايدز فقد رصدت 634 إصابة بين أردنيين ووافدين منذ تاريخ أول إصابة في العام 1986 ولغاية الآن؛ وصل عدد الأردنيين 194 إصابة توفي منهم 103 إصابة، ليسجل هذا العام ارتفاعا وصل إلى 67 حالة جديدة، بحسب مدير البرنامج الوطني لمكافحة الايدز د. بسام الحجاوي.
فيما يبدو أن هناك تضارباً في إحصائيات وزارة الصحة، فالوزير صلاح المواجدة كشف مؤخرا عن أعداد الأردنيين المصابين إلى 350 حالة فقط.
عن المتعايشين مع المرض، فإن تقديرات منظمة الصحة العالمية مقارنة مع ما حصدته وزارة الصحة فإنها تشير إلى أن عددهم "غير دقيق ويجب عدم اعتماد هذه الأرقام".
وفي هذا العام ركزت منظمة الصحة العالمية على دول شرق البحر المتوسط، متخذين من شعار "آن للمرأة أن تقود الركب" خطة لتسليط الضوء على دور القيادات النسائية، ويقول د. بسام الحجاوي: "دور المرأة فاعل وقيادي، بحيث تكون قادرة على خدمة المتعايشين مع مرض الايدز وتقدم لهم الدعم الكامل اجتماعيا ونفسيا وإيصال الدواء لهم".
في الأردن، هناك استراتيجيات وأهداف يتبعها البرنامج الوطني لمكافحة الايدز للحد من انتشار المرض للمحافظة على هذه المعدلات المنخفضة، يوضحها د. الحجاوي "هناك فعاليات كاملة من توعية وتثقيف لفئة الشباب، وتقديم الوقاية والعلاج للمتعايشين في الايدز وتقديم الدعم المالي لهم والتعاون مع منظمات المجتمع المحلي لأنها الأقدر على الوصول للفئات المعرضة للخطر خاصة الذين يتعاملون مع الجنس والذين يتعاملون بسلوكيات خاطئة، ويركز البرنامج على فحوصات دم الوافدين القادمين من الخارج والحاصلين على إقامة، وعندما تثبت إصابتهم يتم التعامل مع بلدانهم".
وفي نفس السياق، يعمل مجلس النواب على صياغة مشروع "قانون دعم مكافحة أمراض نقص المناعة لمكتسبة والسل والملاريا" كما ورد من الحكومة، مخالفين بذلك قرار لجنة الصحة النيابية التي رفضت القانون.
ويفرض مشروع القانون دعم هذه الأمراض دينارا واحدا على كل تذكرة سفر على الدرجة الأولى ودرجة رجال الأعمال، ونصف دينار على التذاكر السياحية، على أن تودع المبالغ المحصلة في حساب أمانات لدى وزارة المالية وان يصدر مجلس الوزراء نظاما لتنفيذ أحكام هذه القانون.
مرض العوز المناعي المكتسب أي نقص المناعة، ينتج عن الإصابة بفيروس متخصص بضرب جهاز المناعة والذي يسمى (سي دي 4) ، وينمو الفيروس في الخلية المصابة ويتكاثر فيها حتى يدمرها لينتقل إلى مجموعة أخرى من الخلايا فيدمرها وهكذا إلى أن يدمر معظم الخلايا ويحرم الجسم من المناعة ويعرضه للإصابة بأمراض مختلفة.
ومرض الايدز من اخطر الأمراض التي عرفتها البشرية؛ وذلك لأنه في بعض الحالات لا تظهر الإصابة بالمرض إلا بعد ستة أشهر من إصابته، ويضيف د. الحجاوي" في بعض الأحيان لا تظهر على المصاب أعراض المرض، والغريب ان هذه الفترة قد تستمر لمدة عشرين عام، ويكون مظهره سليم ويستطيع أن يبث وينشر العدوى دون أي رقابة ووازع ديني أو ضمير".
وتوفر وزارة الصحة الدواء المضاد لفيروس الايدز، هو لا يشفي لكنه يطيل عمر الفرد ويخفف من الأعراض، ويؤجل من ظهورها، بكلفة تقدر بـ 250 دينار شهريا للمصاب الواحد.
ويقوم هذا الدواء بعمل كمون للفيروس ويقلل من تكاثره مما يؤدي إلى تأخير الأعراض، وعندما ظهرت أول حالة في عام 1986 كان من الممكن أن يتوفى هذا الشخص بعد سنة أو سنتين والآن من الممكن أن يعيش 10 سنوات تبعا لحالته الصحية.
ويقدم مركز المشورة والفحص الطوعي النصح والإرشاد للسليمين والمصابين الذي يحملون فيروس المرض ولعائلاتهم وذويهم، لكن من الناحية الإنسانية وحتى لو تم اللجوء إلى القانون والتشريعات فانه لم يتمكنوا من منع المصابين من الزواج والحد من انتشار المرض، لذا الوزارة معنية بالتركيز على السياسات الخاصة بالإرشاد والنصح.
بالمائة من المصابين بالسيدا في المغرب بسبب الزنا 87
وكشفت الدكتورة نادية بزاد أن 87 بالمائة من المصابين بالسيدا في المغرب بسبب العلاقات الجنسية الغيرية، و 3 في المائة في صفوف الشواذ جنسيا، و 1,2 في المائة في صفوف ''عاملات الجنس'' و 2 في المائة بسبب حقن المخدرات.
وتعليقا لها على نسبة المصابين من الشواذ والعاهرات، قالت الدكتورة هذه أرقام خطيرة ينبغي أن ندق عندها ناقوس الخطر.
التجديد
Symptoms or not, everyone should be tested for HIV
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 Copyright (c) 2008 The Daily Star |
| By Dalila Mahdawi Daily Star staff |
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| BEIRUT: Jad (not his real name) thinks he became infected with HIV, the virus that causes AIDS, two years ago, during a one-night stand with someone he met in a nightclub. "We were very drunk and I'm not sure I used a condom," he explained. After hearing about a hospital that provided confidential HIV testing some time later, Jad decided to go. "I wasn't worried that I was infected, but I felt I should have the check anyway, just to be sure." When his tests came back positive, Jad was surprised. "I didn't know much about the illness, and I didn't have any symptoms," he recalled. "I thought you had to have symptoms to be infected. I didn't think getting HIV was something that would happen to me. You never think it's going to be you." For Jad, coming to terms with having HIV hasn't been the only difficulty. Like in many parts of the world, there is much stigma and legally sanctioned discrimination attached to the disease in Lebanon. "I felt I had to tell my parents, who were shocked, but I haven't told any of my friends," he said. "I'm afraid their opinion of me would change. Having to hide this from them is difficult for me and often I feel very sad that I can't tell them." He found his career options were limited, too. "You have to get an HIV test if you want to work abroad," Jad said, staring intently at the floor. "I'll never be allowed to work in the Gulf now," where he had hoped to get a better job. Jad is one of 1,172 people reported to be living with HIV/AIDS virus in Lebanon, although the true figure is likely double that as there are an unknown number of additional cases of people who don't know that they are infected. According to the Ministry of Public Health's National AIDS Program (MOPH-NAP), 116 new cases of infection were reported in 2008 alone. Of all those reported as living with the virus, 81.9 per cent were males, and 51.5 per cent were between the ages of 31 and 50. More than half of those infected were identified as heterosexual and 67.6% were infected with HIV through sexual intercourse. All are entitled to free medication from the Lebanese government. Marking Worlds AIDS Day on Monday, MOPH-NAP, in collaboration with UN agencies and 15 Lebanese nongovernmental organizations, held a health exhibition at the Cultural Center in Sin al-Fil. According to Mustafa al-Nakib, manager of the MOPH-NAP, the purpose of the exhibition was "to promote awareness and testing of HIV/AIDS" in line with one of this year's World AIDS Campaign slogans, "Take the Lead and Get Tested." Four tents had been set up, said Nakib, where people could get free and confidential HIV tests and be given their results the same day. "We sent thousands of SMS messages, had spots on talk shows and held a press conference two days ago to promote the day," he added. MOPH-NAP has good reason to promote awareness of HIV/AIDS as it has said the spread of the virus has accelerated. "Experts warn that if current trends continue, more than 15 countries in the Arab region could face infection rates of 4 per cent by 2015," says a MOPH-NAP information pack. The official figure of 1,172 cases in Lebanon "does not reflect the real situation because the response to HIV in Lebanon has been limited and efforts to mitigate the spread have not succeeded in curb the increasing number of people contracting HIV each year," it adds. In an effort to contain the spread of HIV, MOPH-NAP has established 20 Voluntary Counseling and Testing (VCTs) centers throughout Lebanon, offering free, confidential and anonymous HIV testing and counseling services. In addition, more than 70 people had been trained as HIV testing counselors. So far, 1,011 people have benefited from testing, and 11 people were found to be HIV positive. Addressing Jad's remark that many countries required HIV tests before issuing work permits, Nakib said the practice was "extremely discriminatory" and that work was being done to abolish the law. However, Nakib wasn't optimistic the law "would be abolished in the near future." Calling for decisive action on HIV/AIDS, MOPH-NAP said, "Experience shows that where there is strong and committed leadership, significant advances in the response to HIV can be achieved." The governmental body also called upon Lebanon's private sector to take up the fight against HIV/AIDS, saying that as it employed large numbers of young adults, it was "well positioned to adopt and implement policies, disseminate prevention and awareness, and help fight stigma and discrimination which are critical to combating HIV." Such campaigns have "to be in continuum and sustained," added Nakib, or they will fail to prevent new infections. |
Qatar’s Aids law to set new benchmark
Dr al-Khal... effective steps
A DRAFT law finalised by Qatar for combating the Aids virus and protecting the patients’ rights is expected to be the first-of-its-kind in the Arab world, a senior official said.
“We shall seek to make it a regional document in support of the Aids patients,” Qatar National Committee for Aids Prevention spokesman Dr Abdulatif al-Khal said on the eve of the World Aids Day yesterday.
The committee has been working with the legal authorities in the country to protect the rights of patients and incorporate that in the legal systems, he explained.
“Qatar and the committee are committed to the implementation of the expanded national strategy for the control of Aids, apart from formulating policies and programmes for assisting patients,” said Dr al-Khal, also chairman of Hamad Medical Corporation’s department of medicine.
“This is being done through the committee’s action plan, geared towards the building of national capabilities. Workshops for religious clerics and those in the media and training sessions for national leaders so as to enable them to support the efforts of the committee have been undertaken.
“We have formed work teams for study and research, supporting the patients’ rights, and one for introducing Aids awareness material in the school curricula in collaboration with Unesco,” the official said.
Planning is underway to train teachers with the objective of preparing them for educating students on issues related to Aids awareness. The committee inaugurated its website last year so as to disseminate adequate information about Aids.
Referring to the Aids scenario in Qatar, Dr al-Khal pointed out that the rate of incidence of the disease is still low, as there are only 235 cases.
“However, we must look ahead and think about how to deal early with the problem of Aids in future,” he suggested while recalling that countries which suffer most from Aids are those which were too late to react.
“In most communities, Aids has been an issue that is shrouded in secrecy as people try to avoid talking about it, considering it a taboo linked to social discrimination and shame,” Dr al-Khal said.
The World Aids Day this year comes at a critical time as there are only two years left from the target date of providing the necessary preventive, cure, care and support programmes all over the world by 2010.
The official observed that there are increasing signs that efforts and investments directed to this target are not enough.
“Despite the big efforts on all fronts, we are still facing substantial challenges that require more attendance at all levels, be it government or private sector, civil society, media and religious clerics among others,” Dr al-Khal said.
The Price of Silence: HIV/AIDS control in Sudan
December 5, 2008 — As the Government of Sudan (GOS) and the Sudan People’s Liberation Movement/Army (SPLM/A) signed the comprehensive peace agreement on January 9, 2005 a new era began in the history of the largest country in Africa, which has been troubled by more than two decades of civil war . Many people are hoping that the new post-conflict administration works hard to find peaceful resolution to the crisis of Darfur.
Even though Sudan’s long civil war with its devastating consequences represented the country’s national emergency crisis, yet the potential of the HIV/AIDS prevalence to increase is another monster in the absence of sufficient political will to deal with the epidemic.
The geographic location of the country, the refugee and displacement crisis, famine, economic collapse, insufficient commitment to public health education and the weak testing capabilities have all contributed to the current situation in which the reported cases represent only the visible part of the epidemic.
The weak commitment to public health education in general, and HIV/AIDS education in particular, has resulted in the great stigmatization of people living with the infection, lack of awareness with regard to the disease symptoms, signs and mode of transmission, increase of sexual practices and resistance to condom use.
Some countries in the region, such as Uganda, Kenya and Senegal, were able to demonstrate sufficient political will in dealing with the AIDS crisis, which was the key to some positive reduction in the HIV/AIDS prevalence .These countries interventions and experiences are of great benefit to the effort aimed to control the HIV/AIDS epidemic in Sudan.
The full implementation of the south peace agreement and the fair resolution of the Darfur crisis will indeed create a better environment for the campaign against the AIDS crisis. However there is an urgent need for a strong political will from the post-conflict administration in dealing with the epidemic. This can help in better accessing external fund, mobilizing the internal resource, building the coalition and developing comprehensive national strategic plan for the HIV/AIDS control in Sudan.
BACKGROUND
Since its independence forty seven years ago, Sudan enjoyed only eleven years of peace. The civil war divided the country between the government of Sudan (GOS) in the north and the Sudan people liberation army (SPLA) in the south. In the last twenty years the war killed two million people and displaced 4.5 million1. The war had catastrophic implications for both the north and the south. However southern Sudan remains one of the most isolated, neglected and least developed regions of Africa. The entire 4.5 million displaced population are southern Sudanese out of which 3.6 million live in the eleven states of southern Sudan, 350.000 in the transitional zone (the area of southern Darfur, southern Kordofan, northern Bahr Algazal, and southern Blue Nile) and 300.000 in displaced camps outside of Khartoum.1 The infant mortality rate is 68 per 1000 live births in the north and 82 per 1000 live births in the south. The under five mortality rate in the north is 104 per 1000 live births and 132 per 1000 live births in the south, the maternal mortality rate is 509 per 100.000 in the north and 865 per 100.000 in the south.2 The war had devastating effects on the health care system, most of the health care facilities in the south have either been completely destroyed by the war or lack the most basic medical supplies .In the north, though not destroyed, these facilities suffered a lack of medical supplies in addition to limited management capacity particularly at the local level. An example of the weak health care system is the limited access to reproductive health. In the areas under government control 86% of women deliver at home with fewer than 57% attended by skilled personnel. In the areas under the Sudan People’s Liberation Army (SPLA) in the south 79% of women do not receive tetanus toxoid during pregnancy and 94% of deliveries are done without the benefit of a trained birth attendant. Additionally the absence of contraceptive protection and the high rates of unsafe abortion are considered major threats to women’s health. Famine as a direct consequence of the war resulted in significant rise in the prevalence of malnutrition rates from 18% in 1995 to 23% in 2001 in the north and the government controlled areas in the south. The situation is more serious in the (SPLA) controlled areas, where the rate is 20% of which 15% are severely malnourished.3
Inadequate access to safe water and sanitation, as well as poor hygiene practices, are the major causes of several diseases leading to the high level of infant and child mortality rates. Epidemics of water- related diseases such as diarrhea cause 40% of the under five mortality. Sudan hosts over 73% of the world’s total guinea worms cases, 99% of them in the south.3 The above mentioned consequences of the civil war represent the root causes of the spread of HIV/AIDS. The population displacement which is commonly associated with abuses and sexual violence, the hunger which increases the likelihood of infection in the malnourished, the poverty and economic collapse which increase the commercial sex practice have all contributed to the promotion of the virus transmission.
According to Sudan National AIDS Program (SNAP) survey, which is a behavioral and epidemiological survey, conducted on Nov 2002, the overall HIV/AIDS prevalence was 1.6%. The prevalence among women attending antenatal clinics was 1.0%, among refugees was 4.0%, while prevalence in other high risk groups was 4.4% among prostitutes, 1.6% among TB patients, 2.5% among tea sellers (a group of women selling tea and food items outside public buildings, government departments and private companies), who some believe to engage in commercial sex and comprise some 25% of the suspected AIDS patients.
These statistics may not reflect the actual picture of the epidemic and there is much evidence to support this argument. First, HIV/AIDS demonstrated higher prevalence in similar conflict circumstances. In Rwanda where thousands of women were raped during the 1994 genocide leaving an estimated 15.000 girls pregnant, of 2.000 women tested for HIV afterwards 80% were HIV positive.5 Also in Democratic Republic of Congo, according to Save the Children, the cycle of armed conflict which began in the early 1990s increased the prevalence of HIV/AIDS from 5% to 6.2 % with the increasing numbers of rape cases committed.5 Second, the geographic location of the country which borders countries with higher HIV/AIDS prevalence and the rapid development of trade links between the south and the north can significantly increase the disease prevalence. The HIV/AIDS prevalence is believed to be 6.6% in Ethiopia6, 6.7 in Kenya7, 6% in Uganda8, 6.2 % in DR of Congo9, and 13.8% in Central African Republic.10 Third, the Sudan national AIDS program survey was conducted in eleven states of sixteen northern states and in only three out of eleven states in the south. The weak financial resources and the civil war in the South made it difficult to cover all the states. Fourth, even when it exists, some people never seek hospital care for AIDS and some doctors may not want to record a diagnosis of AIDS because of the stigma attached to AIDS. Fifth due to the poor primary health infrastructure and lack of services, some people with HIV infection may die of other diseases before ever being diagnosed of having AIDS. Finally the overall testing capabilities for HIV/AIDS are very weak in the country. Indeed the long course of the country’s devastating civil war which reduced such capacity fuels the epidemic and dramatically worsens the situation.
In a visit to Sudan on December 2001, I met Dr. Sayd Gotob, the Director of the Sudan National AIDS Program. I sensed a great deal of dedication and courage to tackle the HIV/AIDS epidemic from Dr. Gotob and his team. Yet to me the program looks like an island isolated from the other divisions of the Ministry of Health as well as other government bodies.
The SNAP survey itself questioned the government commitment to the program structure and coordination with other health sectors and government bodies. It mentioned that the program responsibilities and authorities with regard to HIV/AIDS control are not well stated and the relationships of the SNAP with other ministries and other organizations are not identified. Also the responsibilities of the program with regard to the laboratory services and blood banks are not clear.
The SNAP survey also indicated insufficient government funding stating that the current premises where the program is housed is poorly furnished and inadequate to provide for the envisaged responsibilities and functions of the program. There are no sufficient transport facilities provided for the program, no library facilities, reference books or journals. Though the program started 16 years ago there is no documentation for the plans, strategies and activities that were carried out during the past years.
Despite the absence of sufficient and necessary political will and being forced to function within the limited financial resources, Dr. Gotob and his team were able to produce a situational analysis report. Though it did not cover the whole country, the report represented a sincere and eager effort to provide information with regard to the HIV/AIDS epidemic status in the country and serves as a good starting point for formulating a countrywide national strategic plan to control HIV/AIDS.
HIV/AIDS AND POPULATION DISPLACEMENTS (REFUGEES AND INTERNALLY DISPLACED) CRISIS
Because of the war and the limited financial resources, the SNAP survey covered eleven of the sixteen northern states and only three states in the south out of eleven states even though the Southern war zone is believed to represent the country’s most infected region. According to the survey, a total of 470 blood samples were tested from refugee and displaced persons, and out of those 20 were HIV positive, giving a prevalence of 4.3%.
The civil war forced many Sudanese to flee their homes and live as refugees in other countries. Currently there are more than 700.000 Sudanese refugees, 26.000 in Central African Republic, 325.000 in Uganda, 50.000 in Ethiopia, 118.000 in Zaire , 69.000 in Kenya , and 200.000 western Sudanese refugees from the current Darfur crisis in Chad . Refugees from other conflicts in the region also flee to Sudan, 259.057 Ethiopians, 580.173 Eritreans, 43.173 Ugandans, 4.000 Zairians and 145.835 Chadians.11 The Southern Sudanese displaced population is estimated to be 4.5 million, living both in the north and the south. The displacement population of the current Darfur crisis is estimated to be about 1.8 million living in about 130 camps and settlements.
The refugee and displacement condition is usually associated with interruption of the social fabric and human rights abuses, particularly sexual violence. Thus this population is at a higher risk of HIV infection than the overall population. The situation in the refugee/displacement camps is miserable. Most of the refugees and displaced persons face the risk of abuse, violence and sickness with little or no access to medical care, education, clean water and other essential services.
Displaced and migrant groups tend to have sexual partners often among themselves; therefore the greater risk of transmission is internal. However in other circumstances the risk of external transmission increased as in the situation of single displaced men who are employed in low status jobs and who tend to have multiple partners and commercial sex. Also displaced women have been forced to engage in commercial sex because of the poverty and economic situation. These two situations are particularly true for the displaced population in Khartoum state.
Because of the great vulnerability of the refugees/displaced population to HIV/AIDS the absence of sufficient political will to deal with the epidemic can result in particularly higher HIV/AIDS prevalence among this group.
COMMITMENT TO HIV/AIDS EDUCATION
The anti- AIDS campaigners often work in a very hostile environment and this hostility affects the efforts aimed to limit the spread of HIV/AIDS in Sudan. The stigma attached to AIDS and the pro- government religious groups are the main source of this hostility. The lack of sufficient commitment to HIV/AIDS education resulted in great stigmatization of the people living with the infection and contributed as well to the level of awareness, sexual practice and condom use. Indeed it remains a major concern in the battle against HIV/AIDS.
Stigma
There are many cultural, religious and ethnic variations between north and south Sudan. The majority of northern Sudanese are Arab Muslim while the southern Sudanese are African Christian or non-religion. In the north the Islamic values and traditional norms restrict public discussion about sex, and do not approve premarital sexual relations from a religious point of view because a sexual relation is defined to be a relation between husband and wife. The discordance between the religious rules and the publicly expressed norms on one side and the highly prevalent non-marital sexual activities on the other side create a strong barrier to the HIV/AIDS education because of the denial of the premarital sexual behavior among young people. This resulted in great stigmatization of the people infected with the virus, as they are viewed as people who bring shame and embarrassment to their families.
Additional factors contributing to stigma are ignorance, lack of awareness and traditional beliefs. According to Esther Mwanyika, HIV counselor with the International Rescue Committee at Kakuma camp for Sudanese refugees in Kenya, “the stigma is there because this is a new thing for them, they are very secretive about it, and they don’t want to declare it”. 1
In Khartoum, the country’s capital, according to The Alray Alam newspaper, O.M., a 41 year old who is living with AIDS, lost his job as a public school teacher when the Ministry of Education learned that he was infected with HIV. Also a young woman whose name was withheld told the newspaper that she was married and had been practicing commercial sex to support her family until she discovered that she is infected with HIV. "The news that I have AIDS was great shock to me, I decided to keep it secret so I would not be dismissed from my post but the psychological pressure has reached a point where I could not hide it. I was an official in the government but now I’ve lost my job because of this disease, the problem facing me is how I can feed my children."
According to the SNAP survey, "more than half of the respondents (53.2%) said they do not buy food from sellers who have AIDS. Forty four percent said they do not eat with an AIDS patient, about (30%) said they prohibit a teacher with AIDS from teaching and prohibit their student to go to school to prevent contamination."
Awareness
Many people do not know enough about the disease, its methods of transmission or devastating consequences. Many also have not heard about the disease. Some even confuse the word AIDS with aid and relief food. Dr. Osman Mohamed Alkhidier, head of the health ministry’s National AIDS Committee, said, "Our problem is we can not talk about condoms now because people have not yet heard of AIDS, secondary school students do not know what AIDS is, AIDS was included in 1996 secondary examinations but the students failed to explain it. They confuse AIDS with aid and relief food; do you think such people will dream of condoms?"
According to the SNAP survey 21% of the respondents knew about the symptoms of AIDS and less than 16.5% knew about the signs of the disease. Only 20% recognize the virus as the cause of AIDS. When asked about the mode of transmission, 53.2% mentioned sexual intercourse, 29% mentioned blood transfusion, 17.9% mentioned skin penetration and 7.6% said AIDS is transmitted from mother to child. About 62% mentioned one mode of transmission, 12.1% mentioned two modes.4 Indeed, the absence of sufficient commitment to public health education in general and to the education with regard to HIV/AIDS in particular have hampered the drive to raise the awareness.
The lack of awareness with regard to HIV/AIDS is mainly due to the insufficient government commitment towards public health education, the weak role of the media and also the latest government’s educational policies, which favor unplanned expansion in admissions over quality, and content of curriculums particularly at the secondary and the higher educational level.
Sexual practices
The government’s economic policies, the overspending on war, and the international sanctions since the early 1990s, have all contributed to create a very difficult economic situation in which incomes are very low and the unemployment rate is high. The economic situation forced some groups such as young college students and tea sellers to engage in commercial sex to meet their financial obligations or to support their limited family incomes. The SNAP survey identified tea sellers, soldiers, truck drivers and street kids as at high risk for HIV/AIDS.
In south Sudan traditions such as polygamy or widow inheritance have promoted the HIV/AIDS transmission. In an interview with Plus News Mary Biba, who is the SPLA country secretary in Yambio, said, “Behavior change is a problem. I think people here most of them are after sex. You wonder why I say that. If a man dies from AIDS another man will marry the widow immediately, so that means they are not caring for their lives."
The use of condom
As a medical general practitioner I observed the resistance to using condoms. This resistance reflects deeply rooted rejection of family planning policies particularly by religious and traditional leaders and compounded the efforts to control HIV/AIDS epidemic. Due to the lack of sufficient public health education, the use of condom has been viewed as a method of contraception more than a method to prevent sexually transmitted diseases and HIV/AIDS. The idea of preventing pregnancy to plan families and limit population growth has been strongly opposed by the religious groups because they view it as refusing and rejecting God’s will and gift.
There are some in the Sudanese society who believe that condom use is not a solution for the spread of AIDS because people continue to die in the west and some African countries, even though condoms are being used .In their view, AIDS has to be fought from a religious and moral perspective.
According to the SNAP survey channels for getting condoms are very limited as they are only available in some pharmacies (very costly), NGOs, family planning clinics, and some local shops.6 In fact even in the limited pharmacies that sell them they are kept under the counter and only dispensed to those who ask for them. In south Sudan many people do not hear of condoms and even among those who are aware of them, condoms considered a luxury many cannot afford. According to Bill Colford, an HIV/AIDS counseling trainer in Yambio, in a meeting with health NGOs working in the areas, "people can spend that money on condoms or food. They are not going to spend their food money on a piece of rubber."
Another issue of great concern is the powerlessness of women with regard to negotiating the use of condom with their partners. This powerlessness considered one factor that minimizes the use of condoms as a means of protection against HIV/AIDS and sexually transmitted diseases.
THE ROLE OF MEDIA, NGOS AND CIVIL SOCIETY ORGANIZATIONS
The campaign against HIV/AIDS receives minimal and insufficient coverage. The media is under the government control and although recently there has been some good movement towards more press freedom, still many newspapers have been subjected to confiscation and their publishers or journalists to interrogation if they approach sensitive subjects in a way that the government does not feel comfortable with. Dr. Ibrahim Mohamed Abdullah, a committee member of the Sudan National AIDS Program, admitted that the media has not yet played its expected role in the HIV/AIDS control campaign.
Another concern is the capabilities and the experiences of the health personnel, educators and people working in the media to deliver influential messages to control HIV/AIDS transmission.
The NGOs played a good role in the campaign against HIV/AIDS. Their ability to respond is to some degree better because of the absence of bureaucratic impediments; even the coordination is better among NGOs compared to other stakeholders. An example of the active role of NGOs is the HIV/AIDS pilot prevention project of the International Rescue Committee (IRC), which focuses on increasing the awareness of HIV/AIDS, improving reproductive health practices and capacity of health facilities in south Sudan.
HIV/AIDS EPIDEMIOLOGICAL SURVEY AND TESTING CAPABILITIES
According to the SNAP survey, limited epidemiological surveys have been conducted by Khartoum state and by international NGOs among the military and a few vulnerable groups such as street children and antenatal care attendants. But not a single state has surveillance activities or a blood safety program.
In the north, testing facilities are limited to big hospital and central laboratories in Khartoum, while in south Sudan there is a complete absence of HIV/AIDS testing capabilities. In her interview with Plus News, Mary Biba, the SPLA country secretary in Yambio, said, "There are a lot of people who are HIV positive, we just know by the symptoms and reactions that this is AIDS. There are signs of diarrhea, getting sick, vomiting, opportunistic diseases, so when all these appear people know that it is HIV/AIDS."
The weak testing capabilities are part of the weak health care system, which continues to suffer the consequences of the war, national disasters, insufficient funds and limited management capacity particularly at the local level. Voluntary testing of HIV is a major concern even when testing capabilities exists.
FINANCIAL RESOURCES
According to the World Bank group the GNI was 9.1 billion in 1998 and 11.5 billion in 2002. The GDP was 10.7 billion in 1998 and 13.5 billion in 200220. The overall health spending according to the World Health Organization post-conflict strategic framework in Sudan (September 2002) is at $30 per capita per year.2 The actual federal government disbursement to the Sudan National AIDS Control Program cannot be identified. However the SNAP survey mentioned that the main source of finance is the federal government. The survey also mentioned that the program office is poorly furnished, there are insufficient library facilities, no reference books or journals, no documentation and the transport facilities are insufficient. These facts indicate that the government federal fund does not completely cover the program’s responsibilities and functions.
There are many reasons for the insufficient financial resources. First the civil war which used to consume most of the country’s income. According to the WHO post-conflict strategic framework, (September 2002), 27% of the total government spending is for defense.2 The oil revenue used to fund the war by building the government’s arms industry, paying for more arm imports and spending to secure the oil exploration zone. According to Amnesty International, a direct link between the nature of the war and guarantees for security for oil exploration by companies become most obvious in intensified warfare in the beginning of 1999. Taban Deng Gai an officer in Sudan People Democratic Front (SPDF) one of the government’s southern alliances, resigned from his constitutional post of State Minister in the federal ministry of roads and communication. In his resignation letter dated December 9, 2000 Gai said, "The government of Albashir has chosen a military option, exploiting the revenue from the oil to fund its military machine rather than a peaceful resolution of the conflict." Second, Sudan is a heavily indebted country. According to the World Bank, the country struggled with a high and rising external debt burden since the late 1970s. By the end of 2003 the total debt is projected at about US$21.1 billion, most of it in arrears. Third, the government foreign policy since the early 1990s has resulted in cutting most western funding and discourages international donors from funding the country’s projects. For example, in January 1991 Britain suspended its development aid to Sudan, which had amounted to US$58 million in 1989, while continuing humanitarian aid. This policy change was caused by a number of factors including alleged terrorist activities by Sudanese agents against Sudanese expatriates in Britain.Also, the World Bank in mid -1991 announced the closing of its office in Khartoum by December 31, 1991 as a result of the deterioration in the relation between the Sudanese government and the international monetary bodies following cessation of debt repayment by Sudan to the World Bank and the IMF.
Recently the price of oil continues to climb and Sudan oil revenue has shown dramatic increase. According to Sudan Tribune, Sudan Oil revenue reaches $449m in November 2007. However, the spending priorities continue to be defense and security and the funding for the HIV/AIDS program remains insufficient.
POLITICAL COMMITMENTS AND THE ABILITY TO MAKE CHANGES
HIV/AIDS pandemic has a devastating impact in Africa, particularly in Sub-Saharan Africa, which accounts for about two thirds of the estimated number of global HIV/AIDS cases.24 In some African countries the demonstration of strong political will was the key to some reduction in the HIV/AIDS prevalence rates.
Uganda
In Uganda, a country with a population of about 23 million people according to Census Bureau’s world population profile, the HIV infection levels among pregnant women in major urban areas reached 30% in 1992. By 1998 there was about 50% decline in this level, even more for women age 15-19 years. UNAIDS reported that in two large clinics for pregnant women in Kampala, the capital, the number of HIV infected women in the age group 15-19 years dropped from 28% in 1992 to just 8% in 1997.25 According to the Ugandan government the HIV/AIDS prevalence is now 6%. Uganda is considered to be an outstanding example of strong and eager political will and commitment to combat the epidemic. President Youri Museveni’s government was the first in Africa to acknowledge that it had an epidemic, declare it, and appeal for the international community to help.
An example of the successful efforts to access external help is the $50 million contribution from the World Bank to Uganda’s sexually transmitted diseases project in 1994. The project objectives were to limit the virus and to prevent the sexual transmission of the disease through increasing awareness and prompting safe sexual behavior.
Under this kind of leadership silence was broken, all sectors of society were involved and the message was able to spread. The evidence showed that there is reduction in number of partners and increase in the use of condom, and almost every Ugandan knows about AIDS and knows about what is needed to stop its spread.
Kenya
Former Kenyan president Daniel Arap Moi talked openly several times about the HIV/AIDS epidemic. He advocated for the use of condoms for those who could not abstain or remain faithful to their partners. He showed neither weakness nor hesitation when faced by the strong criticism from church groups. Due to the government’s active interventions and the increase in the use of condoms, the HIV/AIDS prevalence has been reduced to 6.7 % from 13.6%. According to the former Director of the Medical Services, Dr. Richard Muga, the active interventions that have gone on the last 10 years have led to the HIV/AIDS prevalence reduction. Dr. Muga estimated the use of condoms to be 100 million per year up from 70 million in 1998. According to Dr. Muga also, the government was intensifying voluntary counseling and testing and increased access to condoms and teaching people on their proper use.
The Kenyan government recognized the importance of the multi-sectoral approach in tackling the HIV/AIDS epidemic. The government formed up a multi-sectoral national AIDS control council (NACC). The council is responsible for coordinating all government and non-government HIV/AIDS interventions. The representatives include key line ministers as well as persons from NGOs and private sector.
Senegal
In this West African Muslim country of 10.6 million persons, the campaign to control HIV/AIDS is considered one of the world’s HIV/AIDS success stories.
HIV/AIDS prevalence has been kept below 2% through different strategies. These include an aggressive awareness campaign, enhanced testing capabilities and the encouragement of voluntary testing, promotion of condom use, a good surveillance system and active involvement of the country’s political and religious leaders.
In fact the involvement of Senegal religious leaders in the fight against AIDS was remarkable. According to UNAIDS the government in Senegal conducted a survey of Muslim and Christian leaders to better define a role for them in AIDS mitigation. The survey found that religious leaders needed and wanted more information about HIV/AIDS, so in response educational materials were designed to meet the need of religious leaders. Training sessions about HIV were organized for Imams and teachers of Arabic and brochures were produced to help them disseminate the information. AIDS became a regular topic in Friday sermons in mosques throughout Senegal and senior religious figures addressed the issue on television and radio. In 1996 a meeting on AIDS prevention was held for Christian leaders, every bishop in Senegal attended and consensus was reached that AIDS prevention was an important national priority. The following year in late 1997 Senegal hosted the first international colloquium on AIDS and religion in Dakar. It was attended by some 250 persons from 33 countries, including Muslim, Christian and Buddhist religious leaders and the Ministers of Health of five African countries.
Senegal’s former first lady Vivane Wade encouraged voluntary testing of HIV. She thought one of the effective approaches to control the spread of AIDS in Senegal is to develop willingness among compatriots to have themselves tested voluntarily.
Indeed because of the strong political will and active involvement of all society sectors, particularly the country’s religious leaders, Senegal’s AIDS control campaign was successful in maintaining the HIV/AIDS prevalence rates between 1-2%.
WINNING THE BATTLE
The emotional and economic impacts of HIV/AIDS exceed family, friends and community to affect countries production, health care practice and the capacity of the societies to provide essential services and plan for the future. The following recommendations are aimed to help the current planning initiatives succeed in building solid and comprehensive national strategic plan for HIV/AIDS control in Sudan.
The inspiring leadership role
The lessons learned from the experiences of countries like Uganda, Kenya and Senegal can help the efforts aimed to combat HIV/AIDS in Sudan.
The active involvement of these countries leadership in the battle against HIV/AIDS and their strong commitment to fight the epidemic can serve as a model for the other countries in the region. In recognition of their commitment in the fight against AIDS in their countries President Youeri Museveri of Uganda and former President of Senegal Abdou Diouf received excellence awards at the seventh conference of the Society for Women and AIDS in Africa (SWAA) held in Dakar December 2001.28 In Sudan the overwhelming civil war consequences represent the country’s national crisis for more than 20 years. Yet HIV/AIDS is another monster and courageous movement by the country’s leadership is desperately needed. It is the right time for many reasons. First, the full implementation of the peace agreement can modify the environment and shed a considerable amount of light on Sudan, which had been subjected to isolation and sanctions for more than a decade. Second, the implementation of the peace agreement will also promote donor interest to fund the country’s projects including the HIV/AIDS control program. In an article for the LA Times former US Secretary of State Colin Powell wrote, "Once a peace accord is signed we will begin normalizing our bilateral relations with the Sudanese government, together with our international partners, we will promote reconstruction and development. Indeed we are already planning for coordinated donor assistance to get peace off to a good start."31p2 And third, the recent positive changes towards peace and democracy shall encourage leadership openness and transparency in dealing with the AIDS epidemic.
The active religious leader’s role in mitigating HIV/AIDS stigma
In Senegal the active involvement of the country’s religious leaders in the campaign against HIV/AIDS had played an important role in breaking the silence, dealing with the stigma attached to the disease and getting the message crossed. Now could the Senegal experience be considered an inspiring model for Sudan. It can be argued that although predominantly Muslim, Senegal is a secular state and an influential moderating voice among its African neighbors, Senegal had more room for transparency and openness with regard to the religious leaders approach and involvement in the campaign against HIV/AIDS. Such a role does not exist in Sudan. The truth is that such involvement can be difficult to witness quickly because of the strong pressure of the Islamic hardliner institutional lobby backing Al Basher’s government. However, the proper implementation of the peace agreement and the active involvement of the new post-conflict administration might effectively soften this pressure. It is also important to mention that the popular support for the Islamist injunctions had declined particularly in the recent years. In his article "Sudan’s Perfect War" Randolph Martin wrote, "Arab northern Sudan is not an Islamic fundamentalist culture. Traveling through the region, a westerner does not sense the kind of deep antipathy and xenophobia found in states such as Iran, the Taliban’s Afghanistan or Pakistan."32p6. Thus there is a strong base for a moderate Islamic voice in Sudan that can allow transparency and openness in discussing HIV/AIDS and the stigma attached to it within the scope of respecting human rights, promoting justice, dignity and tolerance between different groups.
The promotion of condom use
The use of condoms can be promoted through a comprehensive social marketing plan that carefully targets high risk groups. The plan can use sound strategies such as effective presentation of product, proper distribution through strong outreach community campaign and effective use of primary and secondary channels. Such a plan can seek community leader’s support and improve the quality of information to allay fears, rumors and wrong believes. One of the good approaches is the encouragement of peer group discussion with regard to the use of condom through information sharing network.
Strength commitment to public health education
Education can reduce vulnerability to HIV/AIDS by increasing literacy and general awareness level so people acquire the knowledge, attitude and skills necessary to resist negative pressure, avoid harmful behavior and make healthy choices. It is very important for the Post-conflict administration (The National Unity Government) to demonstrate great commitment to public health education in general and to the HIV/AIDS control education in particular. In order to accomplish such a goal there should be a systematic and well-planned information dissemination advocacy campaign targeting all segments of the community. The campaign should make use of all available means that would ensure maximum coverage of the information regarding HIV/AIDS transmission, prevention and control. For example, sex education programs can be included at the high school curriculum level, conferences and seminars can be organized to address the role of the community and religious leaders in the campaign against AIDS, TV and radio can repeatedly air constant warning messages. There is an urgent need for the people to understand the nature of the infection, how it is transmitted, what behavior to avoid, how to reduce the risk and what attitude needs to be adopted to limit the spread of the infection.
Building management capacity and promote coordination
The experience of countries like Uganda and Senegal showed the effectiveness of having the national AIDS program supervised and overseen by the country’s leadership. This can be an inspiring example for Sudan. It will promote the campaign against the HIV/AIDS epidemic and encourage the international donors to fund its control activities. There is an urgent need to clearly define the Sudan national AIDS program’s (SNAP) responsibilities and authorities and its relation with other ministries, laboratory services and blood banks. HIV/AIDS related interventions should be decentralized to encourage building of local capacities at the state level. Also coordination between different stakeholders such as MOH, international agencies, NGOs, and civil society organizations can be stimulated through joint meeting, workshops and seminars.
Promotion of financial resources
Internal resources can be mobilized by building financial analysis skills to improve effective use of resources and by developing alternative financing mechanisms, such as community-based health financing schemes. The external fund is better accessed by establishing well-defined and clearly articulated strategies to control HIV/AIDS. The full implementation of the peace agreement can create a good opportunity to attract donor interest and to mobilize internal resources, particularly oil revenues.
CONCLUSION
The HIV/AIDS epidemic is the next national emergency crisis in Sudan. All the optimism and the dreams of peace and development can be easily destroyed by an epidemic that is capable of wasting the country’s manpower and productivity. This epidemic is terrible, yet we are not powerless against it. The same faith and spirit that end a devastating civil war can with no doubt help to confront the HIV/AIDS epidemic and win the battle against it. There is an absolutely urgent need for strong will and commitment from the post-conflict administration in dealing with the AIDS crisis. Resources must be mobilized, external help must be sought, coalitions should be built and the current strategic planning initiatives should be developed to build a solid and comprehensive national strategic plan for HIV/AIDS control in Sudan.
The author is a Public Health Program analyst at Philadelphia Department of public Health - AIDS Activities Coordinating Office
Friday, December 5, 2008
Le sida abordé dans sa stricte réalité à Constantine «La concupiscence, l’homosexualité, la toxicomanie sont des réalités dans notre pays»
A. Lemili
La maison des jeunes Ahmed Saadi a abrité au cours de l’après-midi de lundi dernier une rencontre organisée et animée par les membres de l’association «Santé pour tous» autour du sida. L’aspect particulier par lequel se démarquera sans doute ladite association dans le traitement du fléau du XXe siècle est d’avoir abordé sans retenue la question. Il est certainement difficile pour une personne n’appartenant pas à la ville de Constantine d’imaginer un seul instant qu’une telle rencontre n’ait été tenue qu’en la présence d’une majorité de femmes, les hommes se comptant sur les doigts des deux mains non pas par exclusion délibérée mais parce qu’il se trouve que, dans la ville des Ponts, il n’y aurait que la gent féminine qui détienne le courage de parler d’un mal considéré à tort comme une tare et frappé par voie de conséquence des plus incompréhensibles tabous.
Il est d’ailleurs facile d’évaluer le mutisme qui entoure la question du sida à Constantine par un argument frappant : il n’existe aucune association de type loi 90-31 à même d’être le porte-parole d’une population dont ne sauraient être tus la réalité et certainement le désespoir profond dans lequel elle serait plongée. D’où l’initiative de «Santé pour tous» de ne pas laisser passer un rendez-vous aussi important. Bien au contraire, à partir de la tribune, les intervenantes ont tout fait pour en parler et non seulement en parler mais en faisant tomber tous les interdits mnémoniques des uns et des autres des membres de la société locale, quitte pour cela à rappeler qu’être musulmans n’exclut pas les membres de cette société d’être les victimes volontaires ou involontaires du sida. Mieux, les docteurs Badaoui et Boutamine dont les interventions ont monopolisé l’intérêt de l’assistance ont insisté sur la nécessité d’en faire une préoccupation de tous les jours, les semaines et les mois qui font l’année, rappelant qu’il ne suffit plus d’évoquer le sida uniquement le 1er décembre au moment où l’épidémie décime des millions de personnes dans le monde et met en situation de danger permanent des Algériens même si, selon les recensements officiels, il n’existerait que 3 357 séropositifs dans notre pays, dont 873 sidéens (définitifs et en phase terminale)… et que le premier cas de sida enregistré en Algérie date de 1986.
Bien évidemment, toutes les associations disposent des mêmes statistiques. Ce qui dénote quand même que, malgré tout, elles restent tributaires des seules informations officielles communiquées par les structures publiques et que, pour qui estimerait réaliser ses propres investigations sur le terrain, le black-out règne en maître. Et rien que pour cette raison, les statistiques données ne peuvent que prêter à doute sur leur authenticité quoique le gros avantage reste, bien entendu, l’énorme concession qui prend de plus en plus de forme avec, enfin, l’idée pour la société d’admettre l’existence du sida.
Les animatrices de «Santé pour tous» qu’on ne pourrait très certainement pas étiqueter d’agnostiques ont tenu à souligner à l’endroit de l’assistance que «la société, si bigote soit-elle, ne saurait dorénavant faire face à une réalité, voire des réalités sans doute réductrices aux yeux d’un peuple musulman ; l’homosexualité, l’adultère, la toxicomanie sont là et bien là. Il ne suffit plus dès lors de pratiquer la politique de l’autruche et de laisser croire que les valeurs religieuses ont toujours fait que ces déviances ne concernent pas notre société».
En conclusion, ce qui est à retenir d’une rencontre où l’épidémie -ses origines, sa cause, ses conséquences- a été disséquée techniquement, sociologiquement et scientifiquement, c’est aussi et surtout la levée de tous les non-dits qui ont prévalu jusque-là.
La lutte contre le sida, une «priorité» au Maroc, selon Mme Baddou
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''سجينان مغربيان مصابان بالسيدا يوجهان نداء استغاثة للمنظمات الدولية''
| اتصلا بمكتب ''الخبر'' بوهران ''سجينان مغربيان مصابان بالسيدا يوجهان نداء استغاثة للمنظمات الدولية'' | ||||||
وجه السجينان المغربيان ''ك.أ'' و''م.ب'' نداء إلى المنظمات الحقوقية والإنسانية العالمية لنجدة ''المساجين المغاربة المصابين بداء فقدان المناعة المكتسبة (سيدا)، الذين يتكاثر عددهم يوميا بسبب توفر أسباب العدوى وانعدام وسائل الوقاية منه، وحرمان المصابين من العلاج في السجون''. | ||||||
سوريا تعلن أنها الأقل بإصابات الإيدز في العالم
ترحيل حاضنة أطفال فلبينية مصابة بالإيدز بمستشفى الجمهورية ببنغازي
أفادت وثائق رسمية صادرة عن عدة جهات صحية وأمنية تحصلت عليها صحيفة (ليبيا اليوم) أمس الاثنين بترحيل حاضنة أطفال فلبينية تعمل بمستشفى الجماهيرية منذ العام 2002 مصابة بالإيدز.
وقال مصدر أمني رفض تعريفه إن عملية الترحيل جاءت في ظروف غامضة دون إجراء أي تحقيق في القضية، في حين أن السلطات الصحية كانت على علم بإصابتها، وتعمل في قسم وصفه المصدر بالحساس.
وأضاف أن ضابط التحقيق في مباحث الجوازات رائد ( ع.ب) طالب مدير المباحث العقيد يوسف قويدر إخطار الإدارة العامة في طرابلس قبل الترحيل والتوسع في التحقيق مع المصابة لكنه رفض، وقال"ليست لدينا إدارة عامة في طرابلس".
وذكر كتاب رسمي صادر عن مستشفى الجماهيرية في 23/11/2008 أن الفلبينية (نورا في هوويلار) رقم جواز سفرها 878171 تعمل طرف مستشفى الجمهورية مصابة بمرض فقدان المناعة المكتسبة الإيدز وسبق أن تم مخاطبتكم (في إشارة إلى مدير مباحث جوازات بنغازي) من قبل جوازات بنغازي بأنه قد انتهت إجراءاتها المالية وحصلت على تذكرة سفر وحدد موعد السفر وهو بتاريخ 30/11/2008 والمعنية تسكن بعمارة داخل المستشفى وتتنقل من مكان لأخر.
ويفيد تقرير رسمي صادر عن المختبر الطبي المركزي المرجعي ببنغازي أن المعنية مصابة بالإيدز، في حين تشير تقارير صادرة عن مختبرات غير رسمية بأنها غير مصابة، الأمر الذي عزاه المصدر إلى التزوير الحاصل في التقارير الصادرة عن المختبرات الخاصة .
وطالب كتاب رسمي صادر عن مستشفى الجماهيرية موجه إلى مدير الرعاية الصحية الأولية وصحة المجتمع بإيقاف المعنية عن العمل بشكل عاجل لإصابتها بالإيدز.
وقال المصدر الذي كشف أوراق القضية إن زوج المعنية نيجيري مصاب بالإيدز من مواليد 1978 ولم تتمكن السلطات المعنية من القبض عليه وترحيله إلى هذا الوقت .
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