AIDS
was a mere speck on the horizon when the World AIDS Day was first observed in
Sri Lanka in 1990. At the time there was a sense of complacency about AIDS in
Sri Lanka. Though other South Asian countries were feeling the urgency of the
scourge, Sri Lanka seemed to be happily immune.
However,
by the middle of the nineties complacency began to give way to concern as a
gradual increase in numbers of HIV infected persons began to emerge. A range of
factors contributed to this increase. Chief among these was the burgeoning
tourist trade and increasing incidence of homosexuality, growing number of sex
workers in the areas where armed forces were stationed and in major transport
routes. There was also the low use of condoms; high and growing number of
sexually transmitted diseases (STDs); and high levels of mobility, displacement
of population and sexual violence due to the ethnic conflict1
and particular vulnerability of young women in the Free Trade Zones (FTZ).
Stigma
As
official numbers increased, the possibility that infected persons were not
coming forward for treatment due to the stigma and possible discrimination by
family, community and at workplaces became a serious concern.
The
government’s concern precipitated the formation of a special unit, the
National STD/HIV/AIDS control program in the Ministry of Health.
According
to this unit, the estimated figures stand today at 3 500 cases of HIV with 38 of
these being new cases detected in the third quarter of 2005, a mirror to the
rapid increase of numbers.
However,
the actual figures of sufferers could be much higher as discrimination and
stigmatization still keep patients away from hospitals and clinics. A landmark
study by the Centre of Policy Alternatives (CPA) in July this year has shown
that discrimination not only keeps patients away from seeking medical help, some
have lost their jobs as a result of their status being made public. There have
been a number of cases of discrimination in the health sector itself.
One
of the tragic cases of discrimination concerns a respected pediatrician of the
largest children’s hospital in Colombo, the Lady Ridgeway Children’s
Hospital, who contracted HIV after a blood transfusion given to her when she was
involved in a serious motor car accident2. She had to
leave her post as other medical personnel discriminated against her so much that
no children were sent to her for treatment. Adding to this tragic tale is that
her husband, a senior pediatric surgeon in the same hospital also had to resign
his post as he could not carry on due to discrimination by colleagues.
This
case received much publicity as the lady doctor, despite her illness, launched a
program to create awareness among the general public about AIDS, to urge them to
seek medical help and not be deterred by discrimination. During her lifetime her
services to AIDS sufferers was so noteworthy that she received a Presidential
Award for her courage.
Of
course stigmatization is not only in high places. There are many instances where
confidentiality has not been respected. The need to create awareness regarding
HIV and AIDS and dispelling the myths surrounding these are urgent. Several
studies have shown that many people living with AIDS who have faced stigma and
discrimination due to their status, were unwilling to share information through
fear of further repercussions. They have to deal with more than the trauma of
being infected by an immune system destroying virus, they also have to face
humiliation and ostracism.
“For
example, many Sri Lankans regardless of their educational attainments, believe
that merely touching a person infected with HIV can lead to it being
contracted,” says the CPA study.
Being
Proactive
Many
Sri Lankans regardless of their educational attainments, believe that
merely touching a person infected with HIV can lead to it being
contracted—Centre of Policy Alternatives |
|
Several
Non-Governmental Organizations (NGOs) have awareness programs for people living
with HIV/AIDS. Some have behavioral change interventions in addition to
educational interventions. The Community Strength Development Foundation (CSDF)
implements its program through 200 peer leaders who have to work against the
serious situation of stigmatization by society.
They
have found their work especially difficult when working with sex workers, drug
users and homosexuals. There have been serious objections to their work, from
neighbors and house owners as well as family members of those afflicted. However
the CSDF project has had some luck specially in finding alternative employment
to sex workers.
Discrimination
and stigma have always acted tragically on women. Loss of employment, and forced
separation from children have bedeviled the lives of many women. The Women’s
Development Centre (WDC) operating in central Sri Lanka has played a significant
role in changing women’s perception that AIDS is limited to drug users and
others practicing “risk” behavior.
“We
are working with sex workers, one of the most vulnerable groups as well as with
poor girls and women forced into prostitution and untrained traditional birth
attendants working in exposed environments and rehabilitate them so that they
and their children will be spared the stigma of AIDS,” says Pearl Stephen,
Director of WDC.
This
NGO works with the staff of the University of Peradeniya, the police and
religious leaders in the area to identify the nature of rehabilitation required
and creating opportunities for HIV affected sex workers to live a normal
everyday existence within the confines of the WDC hostels and try to bring up
children of pregnant HIV positive women to save at least the next generation
from the stigma of AIDS.
Among
the several recommendations of a National Policy on HIV/AIDS which has been
recently formulated and which is expected to be in place soon, is to seek the
cooperation of religious leaders to “take an active role in promoting
awareness about and working to reduce the stigma and discrimination related to
HIV/AIDS.”
This
is already happening in all religions3. In the karmic
context of both Buddhism and Hinduism, the suffering caused by disease or other
misfortune including AIDS is the result of sins committed in previous births.
The religious leaders assist the patient to alleviate his suffering and explain
the karmic sequences to live a better life on the principle that, as in science,
every action has a reaction. Many AIDS sufferers seek spiritual help from their
religious leaders. In all religions the clergy plays an effective role in
advocacy and awareness raising among the public to educate them in clean living;
to avoid AIDS and other STDs; to refrain from “risk” behavior and practical
know-how about how AIDS spreads. This helps dispel serious misconceptions people
have about how AIDS is contracted. They do not take a strong public stand
against homosexuality, lesbianism or other deviant sexual activity. However, in
their advocacy role they all condemn stigmatization and discrimination against
the AIDS afflicted in our society.
