UNGASS:Member comments:March 2 (b)

[Guest guest]

Dear eFORUM Members,

Here is an excellent comment which I would like to share with members of

the forum. Sujaya Misra

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I read through all the statements delivered at the Informal Session ahead

of GASS. What an unimpressive load of rhetoric!

I hope this is not a foretaste of GASS otherwise it will be an expensive

waste of time.

There is an excessive emphasis on pharmaceuticals, maybe because it's so

easy. But in Africa we don't even get measles and polio innoculations to

all our children; in most of South Africa - the most sophisticated country

in sub-Saharan Africa, it is impossible to get tested for HIV, there are

simply no facilities.

Yes we need antiretrovirals; we could do with container loads of Bactrim,

Diflucan and other drugs ... but in the end that doesn't really help does

it? We need to stop the epidemic, not accept it as inevitable.

Even if we get all the drugs free, we then need efficient distribution

networks, which are not in place now for other drugs; we need extensive

VCT, and we need the medical staff with the knowledge and time to

administer and care for our incredible case load of people with HIV.

I have seen nothing, anywhere, about the incredible burnout of our medical

staff in southern Africa - they simply cannot cope. They are underpaid,

overworked, have a lack of medical resources. In South Africa, we are in

the most catastrophic situation of our lives and yet the Health Department

still freezes the posts of staff that leave as a costcutting exercise -

they have been doing this now for some four or five years. Which means

that there are not enough nurses, not enough doctors and virtually no

psychologists available to deal with our severely traumatised staff; some

of whom are leaving because they are too tired, too afraid of the high

risk from needlestick injuries with such high infection rates (and PEP, by

the way, is not a right here; not all hospitals have PEP for needlestick

injuries).. A doctor at Johannesburg hospital said to me the week before

last, as we stood in the paediatric ward where 80% of admissions are HIV

infected children, " we get some weeks where all the children seem to die,

the parents are crying, the nurses are crying, the clerks and doctors are

crying, and I wonder how we can continue. Some mornings I don't want to

come to work, I can't face it. "

I have read nothing of the importance of teaching people how to MANAGE

this virus without drugs and before drugs become a necessity - I have seen

nothing about diet and lifestyle. No-one teaches this to our people once

they receive a positive result. It is critical in extending life and

delaying illness, and it can be done cheaply. I see nothing about this. I

rarely read the word " woman " in these documents. No-one talks about the

lack of sexual negotiation skills of women in Africa, that a woman who

requests condom use risks a beating ... or the incredibly high instance of

rape, especially the rape of children fuelled by the myth that if you rape

a virgin you cleanse yourself of HIV. In Zimbabwe among the highest

incidences of rape are in girls under the age of four (Unicef); in

Botswana the rape of girls under the age of 12 went up 65% in 1998 and

1999 (Botswana government report); in South Africa the Medical Research

Council reported last year that child rape had doubled in the previous

year, and that one in three men at their sex education workshops believed

it possible to cleanse themselves of HIV by raping a virgin. I believe

this myth is prevalent because of a lack of treatment in its many forms, a

lack of education about food and lifestyles, a lack of drugs to ease

symptoms, a lack of sympathetic medical staff because they are burnt out

and angry; and a lack of campaigns ñ THERE ARE NONE - to say you cannot

lose HIV by raping a virgin. Six times more girl children have HIV on

this continent than boys, according to Unicef and the World Bank. In SA

the highest infection rates are in girls aged 13 to 19.

We can't talk condoms and abstinence in the face of rape.

Why are we pirouetting around the real issues? We will make no headway

with this epidemic in Africa or Asia unless we look at issues that pertain

to the rights of women and girl children ... we need to address those

issues that make us uncomfortable. We need to look at behaviour,

behaviour, behaviour ...and then we need massive education on the things

that help that people can do for themselves and that don't cost a whole

lot of money, growing vegetables, eating healthily, caring for each other.

And then too we can, and must, talk about drugs. But I read the

preliminary reports and felt my heart sink. You are not applying

yourselves, stop looking at this in a New York or San Francisco way, we

have specific challenges in Africa and Asia, try and help us with those.

Too much of what is being said is locked into old paradigms - and look

where they have got us.

And debt relief. We need debt relief - but we need it tied to effective

AIDS projects, that linkage is critical, we don't want nations freed of

debt going off on spending sprees for arms and limousines, they must be

tied to effective AIDS work.

Charlene

Johannesburg, South Africa

Email: clsmith@...