Your daily Selection of IRIN Africa PlusNews reports, 11/10/2006

[Guest guest]

U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network (IRIN) -

[These reports do not necessarily reflect the views of the United Nations]

CONTENT:

1 - LIBERIA: Stigma blunts AIDS action

2 - ZIMBABWE: Doctors protest condition of health system

1 - LIBERIA: Stigma blunts AIDS action

GANTA, 10 November (PLUSNEWS) - The bustling commercial town of Ganta, a

five-hour drive from the Liberian capital, Monrovia, is emblematic of the AIDS

challenge facing the country as it rebuilds after 14 years of civil war.

Ganta is the hub of trade and travel with eastern neighbours Guinea and Cote

d'Ivoire, sucking in investment and people looking to make quick money. But the

factors driving its recovery threaten to undermine its long-term stability.

" Everything passes through here; there are visitors every day and the popuation

is growing - we do expect an increase in AIDS infection, " said Dr Albert

Willicor at the United Methodist Hospital, the main health facility in town.

Newly elected President Ellen Sirleaf is committed to Liberia's recovery

and reconstruction, but the challenges are enormous in a country of three

million people and an annual budget of just US$129 million.

" The new government is very promising and well-liked here and overseas, " said

, field coordinator for Medecins Sans Frontieres (MSF)-Switzerland

in Saclepea, 40km from Ganta. " But when you think how much was destroyed during

the war ... if you scratch the surface you see you cannot even post a letter. "

The war not only stopped effective HIV/AIDS awareness campaigning, but the

trauma of the conflict and the aftermath of poverty and joblessness has had a

" deep psychological impact " , according Rev Togba, a genial and energetic

HIV/AIDS counsellor at the Methodist Hospital.

" Girls are out of school, maybe the only sponsor they had was killed, and they

often have no other option but to end up in prostitution, " said Togba.

" Sometimes it's the parents who push the child out on the streets: 'your friends

are bringing home bags of rice, why aren't you?'. "

Ganta's Nimba County is one of the main destinations for refugees, still

returning three years after Liberia's warlords made peace. " Ninety percent of

them are poor; most of them are single women, " said Berkone Nagga, protection

officer for the UN refugee agency, UNHCR, at Saclepea. " The women lost their men

during the war or were divorced. Many of them have nothing except what we give

them - it makes them very vulnerable. "

It is not that people are unaware of AIDS; everybody IRIN/PlusNews spoke to in

Ganta's main market had heard that condoms can prevent HIV infection, and

several people mentioned unsterilised medical equipment and mother-to-child

transmission as other likely routes for the virus.

The laidback owner of the motel next to Planet 44 - a popular new music bar on

the main street, insisted that he handed out condoms to all guests who asked for

them. Habbah, who turned heads as she strolled by, said: " I just want to

advise my friends on the street, 'stay at home, God will provide.' "

Despite assurances of their personal commitment to safe sex, there was much less

conviction on how widespread condom use was among others. " Liberians like

skin-to-skin, flesh-to-flesh, " was a cliché that cropped up in most

conversations on the issue. Apart from an antipathy to latex, there was the more

practical problem of availability - neither of the two pharmacies visited had

any on the shelves.

Sempti Menown, a young and opinionated motorbike taxi-driver, underlined clearly

that awareness was not synonymous with acceptance. Describing HIV/AIDS as a

" false religion " , he added: " I need to be convinced that AIDS exists; people

need to show me somebody with it. "

The problem is that he is far from alone in his denial. For community radio

journalist ine Biddle, AIDS was something that happened elsewhere, not in

Ganta. It was only when she heard an HIV treatment programme was about to start

at the Methodist Hospital under Dr Willicor's supervision that it dawned on her

that " AIDS is here " .

At the moment Liberia has no national HIV prevalence figure. Among health

workers the estimates for HIV infection vary between 5 percent and 10 percent,

but all agree that the stigma attached to AIDS will stoke the epidemic unless

addressed.

" There's a lot of fear and a lack of knowledge, " said MSF's . " We're at

the very early stages of HIV intervention, we're starting from the very bottom. "

Togba said 25 of his patients had been diagnosed as HIV positive since March -

roughly four a month - most of them having lived at some stage in Cote d'Ivoire

or Guinea. They did not come for testing voluntarily, but were identified

through blood screening or clinical signs. " There is a problem of

confidentiality, that is what people are really concerned about -

confidentiality and stigma. "

For close to a year Dr Willicor has been preparing for the launch of a treatment

programme at the Methodist Hospital. In October he took delivery of the first

consignment of antiretroviral drugs from the National AIDS Control Programme,

but the initiative was delayed when the first patient selected for therapy

pulled out.

" She was so enthusiastic - I had told her it was free; it would be

confidential, " he said, shaking his head.

" What's needed is more education, done with patience, and it has to be

persistent, " said Togba, who started counselling only in 2005. " The schools have

to be involved and the churches too, and we also need visual AIDS: talking is

effective, but seeing is more effective. "

oa/he

[ENDS]

2 - ZIMBABWE: Doctors protest condition of health system

BULAWAYO, 10 November (PLUSNEWS) - Doctors in Zimbabwe's second city, Bulawayo,

have gone on strike to protest against deteriorating health services

characterised by widespread shortages of drugs, food and equipment.

The stayaway, which started on Monday, is expected to spread to other parts of

the country during the course of the week.

" It has become very difficult to work with basically nothing to use in all

departments; it is disappointing to watch patients deteriorating in a hospital,

as no help can be given to them, " medical practitioners at the city's two main

referral centres, Mpilo Central Hospital and United Bulawayo Hospitals, said in

a statement.

" Doctors took an oath to save lives, and do not want to continue lying to

patients that they can do something for them when they know very well there is

nothing they can do, as the hospitals can no longer function. "

The striking doctors said there was virtually nothing to administer to patients

at the two hospitals, and the situation was the same in government-owned health

institutions across the country.

Zimbabwe Association of Doctors for Human Rights, an NGO, indicated in a recent

statement that the country's health facilities had " in fact become death traps,

as patients continue to die unnecessarily due to drug shortages. " In some

instances hospitals had no running water.

Officials have acknowledged shortages of key drugs in the recent past.

The health delivery system has virtually collapsed in the last seven years due

to lack of foreign exchange to purchase medical requirements and a shortage of

qualified personnel, who have fled low pay and poor working conditions for

greener pastures in other countries.

Zimbabwe is going through a severe economic crisis, with serious fuel and food

shortages brought on by recurring droughts and the government's fast-track land

redistribution programme, which have disrupted agricultural production and

slashed export earnings.

Doctors in the Bulawayo hospitals were also concerned about the quality and

quantity of food being given to patients, and claimed that malnutrition was

rampant in government health institutions. At least five patients at the

Ingutsheni Hospital for the mentally challenged in Bulawayo died last month

after allegedly being diagnosed with malnutrition.

The Zimbabwean deputy health minister, Edwin Muguti, confirmed the five deaths

at the hospital, but said the authorities had yet to establish the cause.

" There is basically no food to feed the sick, yet it is only natural that

patients need to eat for their conditions to improve. This is worrying us so

much, and we demand that government sets its priorities right and starts working

towards rebuilding the health sector, " the doctors said.

There was no comment from the Zimbabwe Doctors Association, which officially

represents the country's medical practitioners.

nn/jk/he/oa

[ENDS]

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the United States of America. For more information, go to:

http://www.IRINnews.org/donors

[This item comes to you via IRIN, a UN humanitarian news and information

service, but may not necessarily reflect the views of the United Nations or its

agencies. All IRIN material may be reposted or reprinted free-of-charge; refer

to the copyright page (Http://www.irinnews.org/copyright ) for conditions of

use. IRIN is a project of the UN Office for the Coordination of Humanitarian

Affairs.]

PLUSNEWS

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Fax: +27 11 784-6759

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To make changes to or cancel your subscription visit:

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Subscriber: AIDS treatments

[Guest guest]

U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network (IRIN) -

[These reports do not necessarily reflect the views of the United Nations]

CONTENT:

1 - LIBERIA: Stigma blunts AIDS action

2 - ZIMBABWE: Doctors protest condition of health system

1 - LIBERIA: Stigma blunts AIDS action

GANTA, 10 November (PLUSNEWS) - The bustling commercial town of Ganta, a

five-hour drive from the Liberian capital, Monrovia, is emblematic of the AIDS

challenge facing the country as it rebuilds after 14 years of civil war.

Ganta is the hub of trade and travel with eastern neighbours Guinea and Cote

d'Ivoire, sucking in investment and people looking to make quick money. But the

factors driving its recovery threaten to undermine its long-term stability.

" Everything passes through here; there are visitors every day and the popuation

is growing - we do expect an increase in AIDS infection, " said Dr Albert

Willicor at the United Methodist Hospital, the main health facility in town.

Newly elected President Ellen Sirleaf is committed to Liberia's recovery

and reconstruction, but the challenges are enormous in a country of three

million people and an annual budget of just US$129 million.

" The new government is very promising and well-liked here and overseas, " said

, field coordinator for Medecins Sans Frontieres (MSF)-Switzerland

in Saclepea, 40km from Ganta. " But when you think how much was destroyed during

the war ... if you scratch the surface you see you cannot even post a letter. "

The war not only stopped effective HIV/AIDS awareness campaigning, but the

trauma of the conflict and the aftermath of poverty and joblessness has had a

" deep psychological impact " , according Rev Togba, a genial and energetic

HIV/AIDS counsellor at the Methodist Hospital.

" Girls are out of school, maybe the only sponsor they had was killed, and they

often have no other option but to end up in prostitution, " said Togba.

" Sometimes it's the parents who push the child out on the streets: 'your friends

are bringing home bags of rice, why aren't you?'. "

Ganta's Nimba County is one of the main destinations for refugees, still

returning three years after Liberia's warlords made peace. " Ninety percent of

them are poor; most of them are single women, " said Berkone Nagga, protection

officer for the UN refugee agency, UNHCR, at Saclepea. " The women lost their men

during the war or were divorced. Many of them have nothing except what we give

them - it makes them very vulnerable. "

It is not that people are unaware of AIDS; everybody IRIN/PlusNews spoke to in

Ganta's main market had heard that condoms can prevent HIV infection, and

several people mentioned unsterilised medical equipment and mother-to-child

transmission as other likely routes for the virus.

The laidback owner of the motel next to Planet 44 - a popular new music bar on

the main street, insisted that he handed out condoms to all guests who asked for

them. Habbah, who turned heads as she strolled by, said: " I just want to

advise my friends on the street, 'stay at home, God will provide.' "

Despite assurances of their personal commitment to safe sex, there was much less

conviction on how widespread condom use was among others. " Liberians like

skin-to-skin, flesh-to-flesh, " was a cliché that cropped up in most

conversations on the issue. Apart from an antipathy to latex, there was the more

practical problem of availability - neither of the two pharmacies visited had

any on the shelves.

Sempti Menown, a young and opinionated motorbike taxi-driver, underlined clearly

that awareness was not synonymous with acceptance. Describing HIV/AIDS as a

" false religion " , he added: " I need to be convinced that AIDS exists; people

need to show me somebody with it. "

The problem is that he is far from alone in his denial. For community radio

journalist ine Biddle, AIDS was something that happened elsewhere, not in

Ganta. It was only when she heard an HIV treatment programme was about to start

at the Methodist Hospital under Dr Willicor's supervision that it dawned on her

that " AIDS is here " .

At the moment Liberia has no national HIV prevalence figure. Among health

workers the estimates for HIV infection vary between 5 percent and 10 percent,

but all agree that the stigma attached to AIDS will stoke the epidemic unless

addressed.

" There's a lot of fear and a lack of knowledge, " said MSF's . " We're at

the very early stages of HIV intervention, we're starting from the very bottom. "

Togba said 25 of his patients had been diagnosed as HIV positive since March -

roughly four a month - most of them having lived at some stage in Cote d'Ivoire

or Guinea. They did not come for testing voluntarily, but were identified

through blood screening or clinical signs. " There is a problem of

confidentiality, that is what people are really concerned about -

confidentiality and stigma. "

For close to a year Dr Willicor has been preparing for the launch of a treatment

programme at the Methodist Hospital. In October he took delivery of the first

consignment of antiretroviral drugs from the National AIDS Control Programme,

but the initiative was delayed when the first patient selected for therapy

pulled out.

" She was so enthusiastic - I had told her it was free; it would be

confidential, " he said, shaking his head.

" What's needed is more education, done with patience, and it has to be

persistent, " said Togba, who started counselling only in 2005. " The schools have

to be involved and the churches too, and we also need visual AIDS: talking is

effective, but seeing is more effective. "

oa/he

[ENDS]

2 - ZIMBABWE: Doctors protest condition of health system

BULAWAYO, 10 November (PLUSNEWS) - Doctors in Zimbabwe's second city, Bulawayo,

have gone on strike to protest against deteriorating health services

characterised by widespread shortages of drugs, food and equipment.

The stayaway, which started on Monday, is expected to spread to other parts of

the country during the course of the week.

" It has become very difficult to work with basically nothing to use in all

departments; it is disappointing to watch patients deteriorating in a hospital,

as no help can be given to them, " medical practitioners at the city's two main

referral centres, Mpilo Central Hospital and United Bulawayo Hospitals, said in

a statement.

" Doctors took an oath to save lives, and do not want to continue lying to

patients that they can do something for them when they know very well there is

nothing they can do, as the hospitals can no longer function. "

The striking doctors said there was virtually nothing to administer to patients

at the two hospitals, and the situation was the same in government-owned health

institutions across the country.

Zimbabwe Association of Doctors for Human Rights, an NGO, indicated in a recent

statement that the country's health facilities had " in fact become death traps,

as patients continue to die unnecessarily due to drug shortages. " In some

instances hospitals had no running water.

Officials have acknowledged shortages of key drugs in the recent past.

The health delivery system has virtually collapsed in the last seven years due

to lack of foreign exchange to purchase medical requirements and a shortage of

qualified personnel, who have fled low pay and poor working conditions for

greener pastures in other countries.

Zimbabwe is going through a severe economic crisis, with serious fuel and food

shortages brought on by recurring droughts and the government's fast-track land

redistribution programme, which have disrupted agricultural production and

slashed export earnings.

Doctors in the Bulawayo hospitals were also concerned about the quality and

quantity of food being given to patients, and claimed that malnutrition was

rampant in government health institutions. At least five patients at the

Ingutsheni Hospital for the mentally challenged in Bulawayo died last month

after allegedly being diagnosed with malnutrition.

The Zimbabwean deputy health minister, Edwin Muguti, confirmed the five deaths

at the hospital, but said the authorities had yet to establish the cause.

" There is basically no food to feed the sick, yet it is only natural that

patients need to eat for their conditions to improve. This is worrying us so

much, and we demand that government sets its priorities right and starts working

towards rebuilding the health sector, " the doctors said.

There was no comment from the Zimbabwe Doctors Association, which officially

represents the country's medical practitioners.

nn/jk/he/oa

[ENDS]

This is non-reply e-mail. Please do not hesitate to contact us at

Mail@....

Principal donors: IRIN is generously supported by Australia, Canada, Denmark,

ECHO, Japan, Netherlands, Norway, Sweden, Switzerland, the United Kingdom and

the United States of America. For more information, go to:

http://www.IRINnews.org/donors

[This item comes to you via IRIN, a UN humanitarian news and information

service, but may not necessarily reflect the views of the United Nations or its

agencies. All IRIN material may be reposted or reprinted free-of-charge; refer

to the copyright page (Http://www.irinnews.org/copyright ) for conditions of

use. IRIN is a project of the UN Office for the Coordination of Humanitarian

Affairs.]

PLUSNEWS

Tel: +27 11 895-1900

Fax: +27 11 784-6759

Email: Mail@...

To make changes to or cancel your subscription visit:

http://www.irinnews.org/subscriptions

Subscriber: AIDS treatments