AIDS cuts a lethal swathe through PNG Fri, 4 Feb 2000 09:23:23 -0500 Via NY Transfer News * All the News That Doesn't Fit source - Grassroots Media Network The Sunday Age newspaper. melbourne, Australia. 30 January, 2000. AIDS cuts a lethal swathe through PNG. By SANDY GUY and DAVID CROFTS. A Papua New Guinean mother in her late teens boards a bus in the country's capital, Port Moresby, heading home to her remote village. Cradled on her lap is her 12 month-old son. The woman wipes away tears as the bus winds its way though the mountains towards her village; she knows these few hours will be the last she will ever spend with her baby. The young woman has AIDS and realises she hasn't long to live. The senior social worker at Port Moresby Hospital, Tessie Soi, had given the young woman money for the return bus fare after her baby tested negative for HIV. The woman chose to leave the baby with relatives and return to the hospital to die. These same relatives, who traditionally care for their sick, refused to look after her. This is not an unusual story in Papua New Guinea, a country that has seen an explosion in HIV-AIDS infections over the past decade. "Most people are terrified of the disease," says Ms Soi in her hot, cramped office. "There have been many cases where people with AIDS, upon returning to their villages, have been completely ostracised by the community. Often they are placed in a hut at the end of the village, are not given food, and simply left to die alone." The young mother had acquired the disease from her husband. In PNG, HIV is transmitted through heterosexual sex in 94 per cent of cases. AIDS is now the biggest killer of adults at Port Moresby General Hospital medical ward, having overtaken tuberculosis and malaria, according to Dr Clement Malau, director of PNG's National AIDS Council. "PNG is certain to experience a massive AIDS epidemic within the next decade if it does not respond quickly and effectively to the current crisis," he says. Although statistics have been difficult to gather in this rugged,mountainous country, where many provinces are still inaccessible by road, the number of new HIV cases continues to rise exponentially. By July 1999, 1952 cases were reported to the Department of Health  an increase of 50 per cent on the previous year. But Dr Malau predicts there could be as many as 20,000 people infected with HIV across the country. ``The majority of cases are not detected until the late stages, and this can lead to a huge underestimation of the prevalence of the virus. In most Third World countries, there are an estimated 10 cases in the general community for every diagnosed case of AIDS. ``Since colonisation, sexually transmitted diseases have been rampant in PNG. In 1987, we had one of the highest rates of sexually transmitted diseases in the world at 106 per 10,000 population. And given that we have not been able to control STDs, we could be on the brink of a major health catastrophe.'' According to the World Health Organisation, more than 95 per cent of the 33.4 million people in the world with HIV-AIDS live in developing countries. In addition, 95 per cent of all deaths from AIDS have been in the Third World. The first HIV-positive person in PNG was detected in April 1987 but, like many countries throughout the world, PNG was slow to respond to the problem. Although PNG's Department of Health set up a national AIDS surveillance committee in late 1986 and, in June 1988, developed a national policy document on AIDS control, it was not until 1997 that the Government formally established the National AIDS Council. ``There was an initial phase of denial about HIV-AIDS among the country's political leaders, health workers and researchers,'' says Dr Malau. ``But the AIDS epidemic is now firmly established in PNG and is spreading rapidly.'' The issue of public education about AIDS in PNG is extremely complex. More than 60 per cent of the country's four million people have no access to media such as television, radio or newspapers, and more than half the population have limited literacy skills. PNG's population is made up of more than 700 different cultures who speak one-third of the world's languages. Each tribe or clan has its own complex tribal heritage dating back between 25,000 and 50,000 years. Says Dr Malau: ``Worldwide, there are very few countries that have the same challenges we face in terms of getting safe-sex messages out into the community and changing long-held sexual beliefs, roles and practices.'' One of the biggest challenges the country faces in combatting HIV-AIDS is confronting the traditional patriarchal structure of PNG society. ``A traditional `big-man' attitude, stemming from centuries of male-dominated tribal society, is still prevalent in many parts of the country. In tribal society a `big man' would marry four or five wives who, for the most part, he was faithful to. But these days `big men' include wealthy businessmen, bureaucrats or politicians who may be having sex with their wives, mistresses and sex workers, leaving everyone open to HIV infection.'' Research conducted by the PNG Institute of Medical Research indicates that 17 per cent of sex workers in Port Moresby are HIV positive. It also shows that a broad cross-section of society  from street vendors to the wealthy  have regular sex with prostitutes. More than 60 per cent of these men are married. Not surprisingly, increasing numbers of women are becoming infected with HIV. ``Many women attending ante-natal clinics are testing positive when carrying their fourth or fifth child,'' says Ms Soi, who has worked at the overcrowded, under-resourced Port Moresby Hospital for 16 years. ``They always ask, `Why me? I've been faithful to my husband'. ``It's extremely difficult to educate PNG men about safe sex. We find they are generally uninterested in learning about HIV, and baulk at the idea of using condoms.'' In a society where polygamy is widespread and social problems such as domestic violence and incest are still largely unreported, there is little precedent for women to insist on safe sex, according to Ms Soi. According to WHO estimates, most children with HIV infection are thought to have acquired the virus from their mother before or at birth, or through breastfeeding. Says Dr Malau, ``While mother-to-child transmission can be reduced by providing HIV-positive women with anti-retroviral drugs and alternatives to breast milk, PNG has a national policy that bottle feeding should not be prescribed. A lack of hygiene education, sterilisation and money for formula means that babies are more likely to die from diarrhoeal diseases, such as dysentery, rather than AIDS.'' The problem is compounded by the fact that the majority of women in PNG do not seek ante-natal care, says Dr Malau. Although people in PNG traditionally support each other in times of crisis, Ms Soi says in the case of HIV-AIDS, fear is rampant. ``Education is our biggest challenge,'' says Ms Soi, who deals with people's prejudice and ignorance every day. The only qualified HIV-AIDS counsellor in PNG, she admits to sometimes being on the point of exhaustion. ``If we're going to talk about AIDS in this country, we've got to start talking about sex, and sex is not something we talk much about.'' Dr Malau agrees that education is the key to curtailing HIV infection in PNG. ``We're focusing on hosting national and regional workshops with the aim of establishing provincial AIDS committees.'' The Australian Government, through AusAID, is in the process of establishing a A$56 million national AIDS support program over five years, which will assist the PNG Government in tackling the crisis. Meanwhile, Tessie Soi fights an uphill battle to improve conditions for AIDS patients rejected by family and friends. PNG has no established welfare system. In desperation, Ms Soi recently formed a Friends Foundation for people with HIV-AIDS in the hope of raising funds to set up basic services such as home care, access to medication and a voice for people living with the virus. The foundation's wish list is staggeringly modest. It includes a car to visit dying patients, a computer for the office and funding to employ extra staff. ================================================================= NY Transfer News Collective * A Service of Blythe Systems Since 1985 - Information for the Rest of Us 339 Lafayette St., New York, NY 10012 http://www.blythe.org e-mail: nyt@blythe.org ================================================================= nytpac-02.04.00-09:23:21-4328