HIV/AIDS a threat to Ladakh

[Guest guest]

HIV/AIDS a threat to Ladakh

By Terri Chapman • May 18, 2008

HIV/AIDS exists in all corners of the world. On every continent,

every country and every region. However, here in Ladakh, a remote

part of the Himalayas, it seems that everyone including doctors

denies its existence. This is alarming since India has the second

highest prevalence in the world and 60 percent of South Asia's AIDS

cases. " AIDS is knocking on the door of Ladakh and wants to come in, "

says a 17-year-old student. In reality, AIDS is very much present

here. What I found was a culture that undermines the dangers of the

virus and won't let the epidemic taint a pristine picture.

An understanding of the culture's taboo approach to such matters is

crucial in understanding why HIV/AIDS is not acknowledged in a public

way. Dr. Ghulam Mohd of the Leh Government Hospital said that " AIDS

does exist here, and we have seen cases. " Dr. Ghulam Mohd explained

that the most common cause of death among young people included TB,

diarrhea and pneumonia, which are all secondary infections of AIDS.

I interviewed several students of Students' Educational and Cultural

Movement of Ladakh (SECMOL) as well as several students in villages.

Almost every student said that HIV/AIDS does not exist in Ladakh. The

way in which people in Ladakh have separated themselves from the

virus can in part be due to the fact that they don't like to talk

about it. If they don't talk about it, it doesn't exist, and that

concept is what reaches the people.

Ladakh is made up of small villages scattered among high mountain

passes. Their inaccessibility due to few roads can be part of the

idea that they are completely separate from the world. The villages

are secluded in beautiful valleys and along rivers.

The remote sense of Ladakh is interrupted every summer when 50,000

domestic and foreign tourists come here. This makes it seems

inevitable that the people of Ladakh would be exposed to the virus.

Over half of a group of students reported that they had heard or

believed that tourists sleep with tour guides. Several students

mentioned that they thought that outsiders including Nepalis,

Tibetans and Americans had AIDS. However, there was no connection

drawn between the tourism and presence of Tibetans here, and their

own vulnerability to the virus.

Rural Development and You is a large non-governmental organization

stationed in Leh. Its intern said that, " Yes, AIDS does exist here

but mostly among non-Ladakhis. " From here my surety of its existence

increased. The military's presence in Ladakh is visible everywhere,

from the second that you get off of the plane. The idea that soldiers

from southern India were in Ladakh for three months triggered the

idea of prostitution and its relevance in Ladakh. When a group of

teenage boys were asked if they thought that there was prostitution

in Ladakh, every one said yes. However when girls were asked, most

said no. Several of the boys said that the presence of prostitutes

could be attributed to the presence of the army. One student

explained, " Prostitution is good for men who were away from their

wives for a long time, but is not good because they sometimes spend

all of their money and have nothing left. " However there was no

mention of the effects on the women or potential health risks.

Commercial sex workers play a key role in the spreading of the virus,

especially in the early stages. When society doesn't want to

acknowledge that prostitution exists in Ladakh, these vulnerable

women will continue to be at a high risk of both contracting and

spreading the virus further. Without the knowledge of its relevance,

women will not be able to be reached by prevention groups.

Most students reported having some form of education about AIDS in

school, whether it was through their science textbooks or guest

speakers. But the message isn't getting across if none of them know

of its relevance here and how it can potentially affect them. The

students had received education about AIDS in school, but their

parents and grandparents still don't know what the disease is.

Students who are unable to discuss this issue with their parents

feeds into the idea that AIDS is irrelevant. Because education hasn't

reached adults, the potential of it spreading among them without

knowing it is a serious concern.

Even though Ladakh has a very conservative society, students have no

education about AIDS before age 15, leaving children uneducated about

potential health risks when doing something as simple as getting an

injection at the hospital where clean needles may not be used.

Most students said that they would get tested if they thought that

they had AIDS. However, none of the students knew where testing was

available and they were afraid of social stigma. " We provide testing

here, and do have people come in commonly for voluntary testing, "

explained Dr. Ghulam Mohd. However the confidentiality and readily

available testing is questionable.

It is clear that HIV/AIDS is present in Ladakh, and will continue to

be an issue until people acknowledge its existence openly. Without

acknowledgement, the virus will continue to spread throughout Ladakh.

The realization of its global impact, and that its relevance will not

ruin their culture but strengthen it through a communal effort, can

stop the virus.

Thorough education should be required for all students including how

the disease is transmitted, who are at the highest risk, where

testing and treatment are available, as well as the proper use of

condoms and other protective measures. Also, testing should be free,

readily available and confidential. And finally the message of health

officials needs to improve. There should be billboards, ads,

propaganda and information in order to get rid of stigma. Addressing

HIV/AIDS in Ladakh is crucial in keeping it from spreading further.

Terri Chapman is a junior at Thetford Academy in Thetford. She enjoys

ice skating and has recently discovered the challenge of skating in

the thin air of the high Himalayas of Ladakh.

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