Disease marks AIDS day- How?

[cargal]

I read this article this moring and I saw that they are burying their teachers, doctors and other professionals. My question is "how are doctors getting AIDS?" Are they reusing needles on syringes or not protecting themselves? Are they engaging in unprotected sex? If the doctors can't protect themselves, who will take care of this nation?

http://apnews1.iwon.com/article/20021201/D7NL47980.html

Disease-Ravaged Africa Marks AIDS Day

Dec 1, 12:15 PM (ET)

By MIKE COHEN

(AP) A woman walks past a banner placed around the perimeter of the Rand Afrikaans University in...

Full Image

CAPE TOWN, South Africa (AP) - Southern African countries marked World AIDS Day on Sunday with hopes that the region, which has the highest rate of HIV positive people, can slow the spread of the disease.

South Africa has more HIV positive people than any other country in the world. Figures released by the government more than two years ago showed that 4.7 million people - one in nine - were infected, and the figure today is believed to be substantially higher.

There are 42 million HIV positive people worldwide, with sub-Saharan Africa the worst affected region, according to UNAIDS, the U.N.'s AIDS agency.

Outside of sub-Saharan Africa, the AIDS epidemic in Asia threatens to become the largest in the world, and activists there on Sunday also tried to raise awareness of the disease and how to prevent it.

While South Africa's government had come under fire for not doing enough to combat the AIDS epidemic, it has recently shown signs of addressing the issue.

This year the government almost tripled its anti-AIDS budget to $108 million, and plans to up this to $194 million in the next financial year.

Tony Leon, leader of the main opposition Democratic Alliance, said more needed to be done in light of the fact that South African women's average life expectancy would fall from 54 to 38 over the next 10 years and over 2 million children would be orphaned by AIDS.

"South Africa's fight against AIDS has been massively hampered and harmed by government's dithering, denial and dissent from the orthodoxies associated with the disease," he said.

President Thabo Mbeki previously questioned the link between HIV and AIDS, but over the past few months has refrained from commenting on the issue.

World AIDS day events were low key in most southern African countries.

In Malawi, where about 9 percent of the population is HIV positive, the government warned that AIDS was decimating the civil service and the economy.

"Every day we are burying our workers, our teachers, our doctors and other professionals," Vice President Justin Malewezi said in a statement issued together with the findings of a new study on the impact of AIDS in Malawi.

The study found that secondary schools had to replace 77 percent of their staff every year as a result of teachers dying or being too ill to work.

In the tiny mountain kingdom of Swaziland, King Mswati III placed advertisements in local newspapers urging his subjects to protect themselves against AIDS and look after those who had contracted it.

The government also urged priests to speak about the AIDS crisis in their Sunday sermons.

In Mozambique, AIDS awareness marches were staged countrywide, debates on AIDS were held on national radio and television and the government urged people to ascertain their HIV status.

In politically troubled Zimbabwe, President Robert Mugabe acknowledged that 2.2 million of the country's 13 million people were HIV positive, and that 700,000 children had been orphaned by AIDS.

"The impact of this tragedy has been such that each and every one of us knows of a relative, a loved one or a friend who has either died of the epidemic or is living with it," he said.

Countries across Asia commemorated World AIDS Day with events to raise awareness of the disease amid warnings that the number of people with HIV/AIDS in China and India - the world's two most populous nations - will reach epidemic levels.

Bearing banners and signs, thousands took to the streets in Hanoi and Bangkok on Sunday to promote AIDS awareness. India staged a marathon to raise public knowledge of HIV/AIDS, while Beijing's imposing legislative hall hosted an awareness event.

"Silence is death when it comes to fighting HIV/AIDS," said Jordan Ryan, the U.N. resident coordinator in Vietnam, at a rally in Hanoi that drew 3,000 people. "It's time to tear down the walls of stigma and silence."

[maureeno]

heterosexual contact and childbirth spreads the virus in Africa. Stigma and shame, sexual practices and customs, gender inequality, government denial, war and poverty all mix together to set the conditions for the greatest public health crisis since the Bubonic Plague.

In Africa fewer than one in a thousand infected people receive any medical treatment. Men, who often had to leave their families to find work, refuse to use condoms. Marriage is a risk factor for women, many of whom marry older men already infected. "Dry sex' is a practice, women often use herbal astringents, this increases tears and abrasions. The sex trade for many women is for economic survival.

Last year 2.3 million people died in sub-saharan Africa. 3.4 million were newly infected.

[cargal]

Maureeno,

Thanks so much for your informative post. But how do MD's in Africa contract HIV? They obviously don't use universal precautions. I guess it is naive of me to think they have gloves and equipment, incl disposable syringes.

[James Huffman]

An interesting analysis of the African AIDS problem is found in Robert Root-Bernstein's book 'Rethinking AIDS' (New York: Free Press, 1993). See especially ch. 9: "Sources of Acquired Immunopression in Heterosexuals: A Comparison of North Americans and Equatorial Africans."

Although the book sounds dull, it is anything but that. It's a fascinating, well-written survey (from almost 10 years ago, but I find that nothing substantive has changed pertaining to Root-Bernstein's analysis) of the whole AIDS problem.

Jim Huffman, RN

http://www.NetworkforNurses.com

[sjoe]

"heterosexual contact and childbirth spreads the virus in Africa."

also:

1) "Universal precautions" means little when there is often not even clean water, much less running and hot, or soap.

2) A lot of UN-supplied vaccinations have been given, and are still being given, using the same (disposable) needles and syringes over and over again, since these items are scarce and expensive. So "you are now protected from polio but, oops, now you have AIDS."

3) Many of these countries have health care budgets of well under $5 (that is FIVE dollars) per year per person. they simply do not have the money to use disposable items only once, maintain sterile fields, wear gloves much of the time, use condoms (even if they wanted to--which they often don't), use alcohol swabs, etc. In these and other ways, the healthcare system spreads HIV, including to healthcare workers, rather than preventing it.

4) And of course there are numerous folk tales like this one, for only one example, that if a man becomes infected and shows symptoms of AIDS, he can get cured by having sex with a virgin (usually a child under 6 or 8). If it "didn't work" the first time, then obviously the girl was not a virgin and you need to find a younger one ASAP. This is widely believed and acted on, as are dozens of others.

There is next to nothing going on which would slow or stop the spread of ANY diseases in much of sub-Saharan Africa. Something like 90% of the population of Timbuktu, for only one example, has had syphillis for the past 100 years. These are NOT new problems.

[maureeno]

cargal,

I have no special information about AIDS; just saw your post the other day, and think the topic of AIDS of vital importance to our world.

I would think the doctors have contracted AIDS the way everyone else does. I do know in Malawi 10-20% of women between the ages of 15 and 24 are infected with the virus, the figure is higher in South Africa, Zambia, Botswanna, Zimbabwe and Nambia. I remember the government of South Africa denied the problem until just several years ago. As sjoe lists above basic health care is not available so the danger of AIDS with its long course was not a priority, $5/year does not go far. Also, sex is a touchy topic, many countries officially called the virus a western homosexual problem; and behavioral change, especially about taboo topics, is slow. The epidemic is primarily in urban areas and so has raged among professionals. Doctors are human beings, products of their cultures; they most likely acquired the virus through sexual contact. The tragedy is immense.

If it seems impossible doctors would have placed themselves at risk, think about the nurses you know who still smoke. Public education is long, slowed by history and tradition, and much distrupted by war, famine, mass migration and hunger.

[donmurray]

I've noticed the sort of subliminal message in those reports here too. "They are losing the very professionals they need" kind of thing, like only the well-educated get infected, when you would suppose that of all groups, they would have most awareness of the risks. Or do the others just not count?

[sjoe]

"They are losing the very professionals they need"

That reminds me of a point I left out above.

60 Minutes did a piece a couple of months ago from South Africa, talking about the major healthcare problems the US is creating there by encouraging so many of their nurses to leave and to "come to America" where they can make a LOT more money and where equipment, facilities, medications, etc. actually exist and are in use. (Not that they have very many such people to begin with, since they don't have much money to train them.) Just increases their overall healthcare problems.