Thursday, November 01, 2007

Health: Unseen and unwelcome - living with HIV in Sao Tome

Peer educators at work - no easy task
The taxi driver snapped when he overheard two women passengers whispering, "Watch him, he is HIV-positive."

Poignant stories of prejudice were told by everyone in the group of 22 HIV-positive people who recently talked to PlusNews in C, capital of the tiny archipelago of Sao Tome and Principe, in the Gulf of Guinea.

The 28-year-old taxi driver recalled, "That day, I lost the will to work. My girlfriend left me when I told her I was positive and gossiped about me to the neighbours, who stared at me. My colleagues at the taxi rank said I was as good as dead, and now the passengers - I couldn't take it anymore."

A 50-year-old woman said only one of her nine adult children accepted her. "They don't visit me, they don't want me to visit them, they don't touch me," she said tearfully.

No one in the group wanted to be identified by name and not one has dared to disclose being HIV-positive in public. "If someone said, 'I am HIV-positive' on TV, not only this person, but his or her spouse and every former lover, partner and relative would be discriminated against," said Manuela Castro, coordinator of the Portuguese NGO, Medicos do Mundo, which provides HIV tests, counselling and treatment.

Castro is helping start a support group for people living with HIV. More turn up at each weekly meeting, seeking company, advice and, above all, discretion. "After I met other people with HIV I felt better - I am not the only one; we are many. I gained courage. Maybe one day I will return to work," said the taxi driver.

Low HIV, high stigma

Sao Tome's low seroprevalence of less than two percent is a blessing for the country but brings its own set of problems. High prejudice is one of them.

Claudina Cruz, a doctor with the World health Organisation in Sao Tome, attributes the level of prejudice to "the country's small size, the shame associated with a sexually transmitted infection, and the perception that AIDS is a killer disease".

Prejudice, whether real or perceived, is so rampant that many poor HIV-positive people do not claim the packages of corn flour, cooking oil, salt and beans offered by the United Nations World Food Programme (WFP).

"WFP delivers the food to the Red Cross [Society], but people are afraid of being seen picking it up," said Kponou Nicaise, the WFP representative in Sao Tome.

During a talk on AIDS in the village of Briguma, perched above lush cacao groves on the northern coast, Humberto Lorenzo, 38, a health worker at the hospital in the nearby village of Neves, spoke his mind: "HIV-positive people should be stamped on the forehead or arms."

São Toméans returning from richer Gabon, where many traditionally migrate to work in the fishing industry and agriculture, or as casual labourers, are blamed for bringing HIV to the islands.

Earlier this year, the latest surge of prejudice was ignited when rumours spread that a boat from Libreville, the capital of Gabon, had docked in Sao Tome with 42 HIV-positive local people on board. Gabon's seroprevalence is around eight percent.

The city and the media erupted in frenzied fear - journalists besieged AIDS officials for confirmation, waiters refused to serve people who came from Libreville, customers ignored the wares of traders. The scare eventually died down, but prejudice has persisted.

Running away

It is a catch-22 situation: "If we bring a healthy HIV-positive person, people say they are lying to earn money; if a sick person is revealed as being HIV-positive, people run away scared," said Ludmila Monteiro, a peer educator with Medicos do Mundo.

And so the cycle of ignorance and intolerance continues. "The HIV-positive person drops out of social life, gets sick, stays at home and dies out of view," said health educator Francisco Bartolomeu, who led the talk in Briguma village. This leads to denial and disbelief. "People say, 'That one died of meningitis and that one of TB [tuberculosis]'," he added. "Nobody dies of AIDS."

However, some stories leave room for hope. A woman in her fifties told how her children had lovingly cared for her through many months of painful AIDS-related illnesses. She was so sick she wanted to die, but a Medicos do Mundo doctor kept her hope alive. "You will again carry firewood and pots on your head," he promised.

Today she is on life-prolonging antiretroviral medication and healthy, and carries her firewood home and her pots to the stream to wash them. "The neighbours that treated me badly are now ashamed," she told IRIN/PlusNews.

Published with the permission of IRIN
Disclaimer: This report does not necessarily reflect the views of the United Nations or Mike Hitchen Consulting
Photo: Copyright
IRIN