Tuesday, September 23, 2008

PNG needs relevant HIV/AIDS strategies

I REFER to Dr Scarlett Epstein’s column in The National regarding the battle against the HIV/AIDS epidemic.
She rightfully stated that “prevention has a full range of meanings” in PNG’s context and prevention strategies would vary depending on each target group.
The approach must be specific to get the maximum effect.
In PNG, this will be a mammoth task given more than 800 languages (and their respective cultures and subcultures) with the majority living in remote areas and the geographical terrain posing a challenge.
Then, consider the literacy, education and language barriers that one had to consider when developing appropriate “messages” to educate the people and contain this epidemic.
As such, would it not be relevant to carry out a comprehensive, indepth, objective and multi-disciplinary study into the cultural, social and economic situations to identify gaps based on which preventive measures would be drawn to minimise the impact of the AIDS tide in PNG?
This does not mean a quick “yes” or “no” survey in nightclubs, bars and at bus stops around urban areas which are believed to be the main “pick-up” points.
The study must include rural, urban and peri-urban areas covering the various cultural groupings taking into consideration but not limited to their social, economic and political situations and affiliations.
From the study, relevant strategies and measures must then be developed to address these problems.
Costs, resources, mechanisms, institutions and convenience would determine the type, extent and intensity of activities to prevent the epidemic.
But the truth of the matter remained that AIDS had been in PNG for over 20 years. The number of people infected is increasing despite huge sums of money and resources being spent by various organisations to address this issue.
If nothing of significance was done now to stop the AIDS tide, PNG could be in a worse position in 10 years as stated by the Centre for Independent Studies report, which suggested that the disease could strike one million people in PNG by 2020 and the National AIDS Secretariat’s estimation that 200,000 people would be infected by 2012.
Not surprisingly, in a couple of independent researches conducted previously in rural areas in PNG, most people, when asked if they were at risk of AIDS, said that “HIV is only for people living in towns and prostitutes; we are living in the villages are OK”.
Being that ignorant and having a strong leaning towards cultural beliefs of sorcery and witchcraft, Dr Epstein might be correct in saying that HIV/AIDS could have a positive relationship with sorcery-related killings.
But due to the increasing rural urban migration, sorcery-related killings were also evident in towns like Lae as reported in the media recently.
Therefore, we need more comprehensive studies as Dr Epstein indicated to establish the correlation between these two social phenomena. And, there might be other determining factors as well.
Are these people more vulnerable because of their ignorance and strong cultural belief of witchcraft while, in some of these areas, promiscuity is a traditional norm?
How should they be addressed?
That is where social action research comes in.
While HIV/AIDS is a medical disease and will need a medical cure, its preventive strategies would be social (cultural) as the right information was needed to educate, empower and give ownership of the problem to the respective target groups using participatory approaches.
Is it not true that when AIDS is mentioned, the first (or second next) thing that comes to one’s mind is sex? It is something imprinted in one’s mind, whether intentionally or unintentionally.
The people must be made to see AIDS as a disease that kills, just like TB.
And rather than wasting valuable time talking about the means of transmission, the root cause – the lack of prevention – must be well understood.
Lastly, AIDS is not only a medical problem but a social, cultural, political and economical problem.
It can affect anyone regardless of academic or professional background, economic status, etc.
Like global warming, we must all work together to help minimise this global problem, as the saying goes “think locally, act globally”.

Paul Hukahu Jr
Port Moresby

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