Calling attention to the non-sexual modes of HIV transmission

[Guest guest]

(Moderatros note: According to NACO Data, 6.46 % of the AIDS cases in India are

acquired through no specified routs. (3.80% perinatal, 2.05 blood and blood

products, 2.34 IDUs and 85.34 % through sexual routes). Ref: NACO, Monthly

updates on AIDS (31 August 2006). Surveillance for AIDS Cases in India (Period

of report - since inception i.e. 1986 to 31 August 2006).

ttp://www.nacoonline.org/facts_reportaug.htm)

Dear all,

Yesterday, front page in the International Herald Tribune, an

interesting article points to HIV Negative Children of HIV Positive

Mothers in Cameroon. (Where traditional customs can mean AIDS. By

beth Rosenthal. The full text follows)

It wonders why UNAIDS or others has not paid attention to non-

sexual modes of transmission, and author Rosenthal speaks of

traditional practices such as scarification..

How come there is no little in publication on these Children

affected by HIV? If science shuts up, will we be regarded as

complicit with genocide, for having prevented the populations of

India, China, Subsaharan Africa with the necessary information to

protect themselves against what is a very efficient blood borne

retroviral infection, HIV?

Are we going to have another December 1st of wild sexual talk for

well to do White male can feel like they have tuned in to their

Hotel TV " Adult movie " program, and lonely housewives dream

of " Black sex " or Asian fantasies..

What about SCIENTIFIC TRUTH? Are we trying to outdo Stalin in terms

of scientific fraud?

Nance,

e-mail: nance@...

_____________

Where traditional customs can mean AIDS

By beth Rosenthal / International Herald Tribune

Published: November 14, 2006

NKOLNDONGO, Cameroon: When Innocent Zamba Manga was born this

summer, doctors advised his mother, Marise, who is HIV positive, not

to breast-feed, since nursing can pass the AIDS virus from mother to

child. Mother and baby left the hospital with bottles and formula,

supplied by a Catholic charity.

But that very next week, the proud parents took their baby to the

father's village in the south of Cameroon, to take part in a

traditional celebration of the birth. Custom required the new mother

to nurse little Innocent, which she continued for two weeks.

" Why would you risk his health in this way? " scolded Dr. Suzie

Tetang Moyo, on seeing the parents last week at her clinic on a dirt

road here, sighing deeply in frustration.

As researchers spend more time studying Africa's overwhelming

pediatric AIDS problem, they are finding that the routes of

transmission may be different than in the industrialized countries,

and that strategies for preventing the disease's spread must be

adapted to local realities.

In developed countries, the only real risk factor for children is

that they can get HIV from their mothers at birth.

But here, researchers have come to agree, a host of traditional

ceremonies and practices are creating transmission routes unique to

Africa - dangers that have, up to now, been largely ignored.

There are birth ceremonies, like Innocent's, that may require

nursing. But there is also a host of potentially even more hazardous

practices in which body fluids of different people are mixed. For

example, in scarification ceremonies for ethnic identification and

cutting for ritual healing, blades are used in sequence again and

again. There is also the practice of communal breast-feeding a

single baby by numerous women, common in many tightly knit African

villages.

In a country like Cameroon, where more than 5 percent of the

population and 11 percent of pregnant women are infected with HIV -

the vast majority unknowingly - such practices could lead to a

wildfire spread.

" If we are only biology, biology, biology, then we are only doing

half of our mission, " said Marcel Monny Lobe, director of the new

International Reference and Research Center for HIV- AIDS in

Yaoundé, the capital. " We need also to do the sociology and

anthropology and then make biological interventions. "

Researchers here and elsewhere in Africa are just beginning to study

the role of these common traditional practices of rural Africa, to

determine if they account for a small or large portion of HIV

transmission.

But the risk is serious, and small studies in Calabar, Nigeria, have

already implicated unsanitary body cuttings and herbal injections of

traditional healers in spreading the AIDS disease.

" We don't know enough about this important topic, but there is no

doubt that traditional practices are spreading HIV - it's a growing

concern, " said Dr. Ed Mills, an epidemiologist at McMaster

University in Hamilton, Ontario, who has done extensive work in

South Africa.

" Unaids has been ignoring it, " he said, referring to the UN agency

that deals with the disease. " I think it's because people think it's

culturally insensitive to talk about. Even if it turns out to be

only a minor amount, it's a preventable amount so we really need to

address it. "

The practices also may explain a mystery that has long perplexed

both local and foreign doctors: They kept seeing children with AIDS,

who had no obvious explanation for their infections, whose mothers

were HIV negative. The children had never had transfusions, where

unscreened blood might be blamed.

In Batie, a village three hours from Yaoundé, most people go to both

traditional healers and medical doctors, and traditional treatments

often involve blades to cut the skin.

On a recent afternoon, Berlin Simeu, a villager, visited the

darkened hut of Sop Kamtchewo, a healer, in a ceremony intended to

ward off both illness and witchcraft.

With a razor blade that had been wrapped in a sheet of paper, the

healer made three short cuts on his patient's body - one each on his

wrist, back and shoulder. A fruit was placed on the wounds to draw

out any bad influences.

It was unclear how - or if - the blade would be cleaned before its

next use.

Yves Moumbe, a doctor in Batie, said that almost all of his patients

with HIV went to traditional healers before they saw him.

" It is not clear if they are using any sterile technique at all, "

Moumbe said. " They don't have much knowledge of HIV and how it is

spread. So it could be a serious problem. "

An estimated 70 percent of Africans use traditional healers as their

primary source of health care, a function of tradition and

availability.

In Africa, there is one medical doctor for every 40,000 people, but

one healer for every 500.

Healers' practices vary widely from place to place, Mills said, and

often involve cutting, the administration or injection of herbal

medicines, and the practice of siphoning blood.

" We're used to saying this is all about sexual intercourse, but now

we have to remind people it can be elsewhere in the body, and there

are other dangers as well, " said Bertrice Mabule, who started the

Children's Education and Health Foundation to promote HIV awareness

in Batie.

A 2004 study in the journal Tropical Doctor by Dr. Etete s at

the University of Calabar in southeastern Nigeria concluded that

there was " a serious risk inherent in the practices of Nigerian

traditional healers " because of " the continuous usage of

unsterilized instruments and cross contamination of patients' blood

and body fluid in their practices. "

Though s has continued to work with the healers, he said there

was little funding to carry out HIV sensitization campaigns directed

at this group, so " such awful practices persist in Nigeria and

Africa in general. "

In much of rural Cameroon, tiny scars are made to identify members

of different ethnic groups, with large numbers of children scarred

simultaneously.

" You see them everywhere, three lines on a cheek, on the forehead -

the pygmies make slashes between the eyebrows. It's a real worry, "

said Serge Florent Moudt, an HIV educator who works at the Center in

Yaoundé as well as in the West Province, his home.

If just one child in a village had HIV, a common blade could spread

the virus to dozens who come after him. The same is true for group

circumcisions.

" There are traditionally African aspects of this fight, " said Jean

Stéphane Biatcha, executive secretary of African Synergy, an AIDS

prevention group that focuses on women and children.

" We're taking the message to rural areas where traditions are very

strong, and you have to work carefully and slowly. "

Another traditional practice that government officials acknowledge

could be spreading HIV is communal breast- feeding, the norm in many

rural villages.

Polygamy is legal in Cameroon and a chieftain might have 30 or 40

wives, Biatcha said, since wealthy men routinely marry the wives of

male relatives who have died.

And it usual for the wives - or even friends - to help out by

nursing each others' infants. In fact, it is an essential service if

a mother has to go to work or take a trip into the city.

But again, in a country where studies have found that 11 percent of

women of child-bearing age are infected with the AIDS virus, the

practice presents an open conduit for childhood infections.

Biatcha said people were generally unaware of such risks, so the

first step was information.

In the last few years, an increasing number of medical doctors have

warmed to collaborating with the traditional healers, both to

encourage safe practice and to use them as AIDS educators.

" We have to open a dialogue with the traditional healers, " Mills,

the epidemiologist, said. " They may well be spreading HIV, but

instead they could be part of the solution. "

http://www.iht.com/articles/2006/11/14/news/cameroon.php?page=2