Your daily Selection of IRIN Africa PlusNews reports, 2/11/2005

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CONTENT:

1 - COTE D IVOIRE: HIV/AIDS time-bomb ticking away in rebel north

1 - COTE D IVOIRE: HIV/AIDS time-bomb ticking away in rebel north

BOUAKE, 11 February (PLUSNEWS) - As the only girl in a family of five

orphaned by HIV/AIDS, Awa Keita spends the day cooking and cleaning for

her brothers and her own baby boy.

Four months ago, life took a dour twist for the family marooned in the

war-hit north of Cote d’Ivoire. Awa and her son both tested HIV-positive.

But like millions of others, they cannot get medical help in territory

under rebel control.

As the war grinds on, causing more of the poverty that fuels the pandemic

and wearing down the few surviving health facilities, an HIV/AIDS crisis

looms ahead.

" Every day I think about the sickness, " 23-year-old Awa says in Senoufo,

the language used across much of the dry northern scrublands. " I've cried

so much. Often my head hurts and I feel hot. "

" It is God’s will, " she adds, referring to the illness that people here

never mention by name. " But I wish I could get treatment. "

Health services for the more than six million people living in the north

all but collapsed after civil war split the country in two in September

2002.

Once brisk and busy clinics are a shamble of smashed windows, tall grass,

rust and decay. Equipment is creaky, medical supplies are low, government

funds have dried up and worst of all, the doctors and nurses have

vanished.

Like other civil servants, most medical workers stationed in the north

fled to the safety of the loyalist south that pays their wages when the

conflict broke out.

Among the casualties of war were just-opened HIV/AIDS testing and

information centres designed to curb the expansion of the pandemic in West

Africa's hardest hit nation.

Bouake, Cote d’Ivoire’s proudly second biggest city at the time, boasted a

freshly-painted AIDS treatment centre at the general hospital, manned by a

staff of six offering testing, counselling and prevention.

" Nowadays we don’t advise people to take a test, " one doctor at the

hospital told PlusNews. " What’s the point? We can’t offer them treatment.

It’d only bring them despair. "

NO HIV/AIDS CARE AVAILABLE IN REBEL NORTH

Awa’s HIV-positive two-year-old is often feverish and has diarrhoea, she

says.

A social worker helping the orphans says the boy’s face is puffy, that he

looks increasingly unwell. “I get so upset dealing with all this,” said

Veronique Dje. " When a child dies, it makes me cry. "

Awa's own mother died of AIDS two years ago.

To survive, she and her son would have to travel 380 km south, across the

frontline, to the capital Abidjan. There they would be able to obtain

antiretroviral (ARV) drugs that might improve their health and extend

their life.

A local NGO, the SAS centre, helped steered the family of orphans into

school and jobs after the death of their HIV-positive mother.

Now it is ready to cough up the 35,000 CFA francs (US $70) needed for

their trip to Abidjan. The sum is equivalent to about half the average

monthly earnings of Cote d'Ivoire's 16 million people.

But in this nation torn by strife between the peoples of the north and

south, Awa can’t physically get to the capital to save her life.

She has never applied for an identity card, so doesn’t have the ID needed

to pass the dozens of roadblocks manned by soldiers and militia groups

along the tarred highway that provides the main link between the

rebel-held north and the government-held south.

Awa thinks her older brother, who has joined the rebels, might just have

put away somewhere a receipt for her birth certificate. And Dje, the

social worker, says that if they find this document, it might be enough to

enable the mother and child to travel safely south.

SAS helps to send dozens of people living with HIV/AIDS in the rebel-held

north to Abidjan every three months to see a doctor and pick up three

months’ worth of ARVs. Every six months they also undergo a check-up.

" We’re trying to see if we can send one person down to pick up the drugs

for several people at once to cut the costs, " Penda Toure, who heads SAS,

told PlusNews. The NGO currently assists 800 families, or around 5,000

people affected by HIV/AIDS.

It receives help from the UN World Food Programme (WFP), the UN Children’s

Fund (UNICEF), CARE, the International Committee of the Red Cross (ICRC)

and others.

SAS is held up as an example of good practice by many experts because of

its global approach to the fight against HIV/AIDS. The NGO ensures

schooling for children, work for families and provides counselling as well

as treatment and medical support.

WAR AND SEX FUELS FEAR OF HIV/AIDS BOMBSHELL

Cote d’Ivoire’s HIV prevalence rate is estimated at 7 percent, according

to UNAIDS statistics for 2004. The government's own statistics point to a

higher prevalence rate of 9.5 percent.

But north of the UN-monitored buffer zone that cuts a swathe across the

land, the pandemic is believed to have reached alarming proportions.

" We risk seeing figures three times the national average here, " Toure

said, lamenting the international community's failure to deem the looming

crisis " an emergency " .

" There have been no prevention or awareness campaigns since the war broke

out, but there is a lot of sexual freedom. People have forgotten HIV/AIDS.

The only talk is war, the only concern is to survive. Bringing a soldier

home is like winning a trophy. "

Towns such as Bouake have lost huge sectors of their populations, civil

servants, southerners, craftsmen.

Instead, troops from the 4,000-strong French peacekeeping force and

Bangladeshi or Moroccan soldiers serving with the 6,000-strong UN force

haunt the streets and bars. They are joined there by groups of gun-toting

rebels.

Located on a key transport route linking the Ivorian coast to landlocked

Burkina Faso to the north, Bouake boasted a higher-than-average percentage

of HIV/AIDS even before the war.

Adama Coulibaly, the only nurse left at the now dilapidated HIV/AIDS

centre at the city hospital says " the situation's bad. There are more and

more infections. "

Coulibaly was part of the large pre-war staff at the AIDS treatment

centre, which serviced a population of 500,000 people.

His left side was left paralysed by a stroke, so he hands out test strips

and carries out other tasks with his one working hand and the helping hand

of a cleaner.

Pulling out a sheet of statistics from a desk decorated by a large penis

wearing a condom and faded AIDS prevention posters, the nurse says 14

percent of the 195 people who asked for tests in the last half of 2004

turned out to be HIV positive - which is twice the national average.

" All I can do is tell people how to avoid transmitting the virus, and

refer them to a local NGO. There’s no treatment available here, " he said.

SEVEN OUT OF 10 VILLAGE CHILDREN POSITIVE

The government of Cote d’Ivoire, which has set up a special Ministry to

Fight AIDS, is currently undertaking the country’s first nationwide HIV

prevalence survey for 15 years.

Results of the survey of 5,060 households in both the north and south of

the country - covering around 12,000 people - will be available in June,

Mamoudou Diallo, the UNAIDS coordinator in Cote d'Ivoire told PlusNews.

UN troops will help investigators carry out the survey in the rebel-run

north.

" I’m alarmed, " Diallo said. " The war has disrupted efforts to open new

centres, decentralise treatment and train personnel. Prevention campaigns

have fallen off. "

With a million people internally displaced, health services disrupted,

people too short of cash to pay for tests, treatment or condoms, and sex

work on the rise, it was impossible to get a proper picture without a

survey, he said.

But in villages 250 kilometres north of Bouake, there was more evidence of

an HIV bombshell on the horizon.

On a dusty dirt road beyond the town of Korhogo, a handful of

Spanish-speaking Catholic nuns running a clinic near the village of Koni

reckon the situation is desperate.

Alarmed by the dire condition of babies brought into the clinic for help,

the sisters from Colombia and Spain decided last July to test 10 toddlers

for the virus.

" Seven of the 10 tested positive " , said Sister Brigida of the Hermanitas

de la Anunciacion. All seven of their mothers also proved to be positive,

she added.

Conditions are tough in the rural north nowadays. Farmers have not been

paid for their cotton, their main cash crop, for three years, the rains

have been bad, and there is little available cash.

Rebels manning roadblocks at every village entrance and exit need food and

drink and pester passers-by for cash.

Skinny children with distended bellies play in the dust while older ones

take turns to draw water at a single pump for a couple of thousand people.

There is malnutrition and a lot of young mothers.

" On the basis of the symptoms we're seeing, we think there's a huge

increase in HIV/AIDS, " said Sister Marleny.

" But up here in the north there's nothing you can do about it. There are

no drugs, there’s no cash. Even if you take the test there’s nothing you

can do, except perhaps avoid infecting others. "

[ENDS]

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