Exclusion of Disability from HIV/AIDS Program Disables the
Impact of the Interventions
Every year countries, private and public sectors, professional and business organizations, media and academia across the world express their solidarity with the World AIDS Day pledging renewed impetus on reducing stigma and discrimination and concentrating on the containment of the epidemic. The theme this year is 'Universal Access and Human Rights'. It is evident that HIV/AIDS has reached a situation where it is concerned with human rights in the context of prevention, care, support and treatment. This also reflects the global emphasis on reaching all segments of population with the needed services as essentially the basic human rights paradigm. It simply translates into action that is concerned with the right to correct information in conjunction with the socio-cultural environment, the right to the needed services in user-friendly manner and the creation of enabling environment to reduce stigma and discrimination.
The key factor is vulnerability to risk of exposure. The Bangladesh country response initiated fairly early within the region in 1985 has progressed considerably in addressing the issues that determine the spread of the virus and the detriments towards containing it. The National HIV/AIDS and STD Policy and Strategy have undergone critical review and modifications that is based on evolving needs of the program to provide the needed services. Expanding the HIV/AIDS program beyond the health parameters is a laudable initiative of the Ministry of Health and Family Welfare as it implicitly addresses issues of vulnerabilities especially of young people and the gender concerns from all perspectives. The mass media campaign has very creatively branded HIV/AIDS through the slogan 'Bachtay Holay Jantay Hobay' that has now become synonymous with the virus.
As such the program design is based on knowledge, attitude, behavior and practice that protects individuals from risk of exposure and encourages society to be compassionate and supportive.
The World AIDS Day is followed by the International Day of Persons with Disabilities on 3rd December. The theme for this year is; 'Keeping the promise: Mainstreaming disability in the Millennium Development Goals towards 2015 and beyond'. To ensure this process is embraced globally the Convention on the Rights of Persons with Disabilities and its Optional Protocol was adopted by the UN General Assembly in 2006. Bangladesh signed the convention in 2007 and also ratified the optional protocol that creates an obligation for the country to uphold and follow the objectives of the treaty.
Despite the long drawn process of formulating the convention that was launched in 1982 through World Program of Action there is no mention of HIV and AIDS in the definition of protecting the rights of people with disability. The National program conducted a survey on the situation and the need for reproductive health services for young people. The findings helped develop innovative modalities to address demand driven services. But that the young people segment also consists of persons with disability has been conspicuously overlooked and the fact that people with disability in Bangladesh are economically marginalized, compounds their vulnerability is not given due diligence.
The UNAIDS, in response to the need for directives that is missing in the convention, formulated a policy brief on Disability and HIV articulating the actions needed to increase the participation of persons with disabilities in the HIV response and ensure they have access to HIV services which are customised to their distinct requirements. It elucidates the human rights standards but also raises queries about whether people with disability are in reality at risk of exposure.
Individuals with disability have not been included in HIV/AIDS prevention efforts because it is believed that they have little or no risk of HIV infection. The World Bank and Yale University Global Survey on Disability and HIV/AIDS have proved this assumption wrong; men and women with disabilities are more likely to be victims of violence and rape and less likely to be able to obtain protection and prophylactic care. Information and HIV/AIDS messages often do not reach people with disability because of extremely low literacy rates and lack of access to media. Even if the message is conveyed, translating it into individual change is fraught with obstacles.
In Bangladesh's context gender is a cross-cutting agenda for human development but women with disabilities remain at risk of HIV infection due to lack of awareness, sexual violence and coercion and absence of social security and coverage by the traditional HIV/AIDS programs. The situation is worsened because of dislocation and mobility due to loss of livelihood caused by environment degradation and climate change impact, creating additional disability-related burdens and marginalisation of women with disability. There is tremendous paucity of research, study and data on HIV/AIDS and disability within the Bangladesh country program. The national response has progressed in leaps and bounds becoming a model of integrated approaches and public-private partnership. But the rights-based and universal access approach falls short of its fulfilment without inclusion of people with disability and the infrastructure, specific needs based service provision and access to those.
The National HIV/AIDS response and the Disability Welfare Act 2001 need now to include specialised services for people with disability as rights-based approach into action beyond rhetoric. The process may begin with a survey into their vulnerabilities, the status of primary and reproductive healthcare services available to them and designing the life skills education and drop in centres specially tailored to their needs.
The themes of 'Universal Access and Human Rights and Keeping the Promise: Mainstreaming disability in the MDG Goals towards 2015 and Beyond' are two sides of a coin that deals with capturing the under-served yet susceptible segment of population to ensure protection, prevention, care and support and treatment as the citizen's right towards paving the path for achieving the MDG.
By Habiba Tasneem Chowdhury
Institute of Hazrat Mohammad (SAW)
Pick herbs when they're at their peak just before they flower. Early in the morning is the best time to pick, when the dew has dried but before the sun has been on the leaves for too long. Remove large leaves from their stalks; small leaves can be left on and rubbed off after drying. Spread the clean leaves or leaf-bearing stalks, in a single layer, on a piece of gauze or insect screen stretched across a frame and supported so air can circulate freely underneath (between stacked bricks is ideal). The frame should be positioned in a dark, warm, dry place. Dry herbs when the weather is fine, not humid and they should be dried within a week. Store in airtight jars in a cool dry place.
Drying in the microwave
Spread washed and dried fresh leaves on three sheets of absorbent paper and cover with another sheet. Microwave on high (100%) for 2 minutes; remove any herbs that are crisp. Microwave remainder a further 30 seconds or until all herbs are dry. Be careful not to burn them.
Another traditional herb mixture mostly used in omelettes or mixed with melted butter and a squeeze of lemon to be poured over roast chicken or grilled fish. Fines herbas is a delicate blend of finely chopped parsley, chervil, chives and tarragon.
Use long stems of rosemary as skewers for lamb kebabs, and lemon grass stalks as skewers for chicken or fish pieces. They might frizzle during cooking but this is just a reaction to the herbs' liquid content.
Winter brings with it dry weather, and our skin is used to the humidity that prevails over the rest of the year. To combat the drying effects, switch to a heavier moisturising cream to add much-needed hydration. Lock in moisture by doing this while your face is still wet.
Avoid baths and showers that are too hot, and cool the water before you get out. Your skin will retain more moisture this way and you won't go through the temperature shock so much when you get out.
Rub in body lotion on your arms and legs and feet, particularly on your elbows and knees. Use eye cream at night to combat dryness. If you do this on a regular basis, you'll probably notice a reduction of fine lines and wrinkles.
Get your beauty sleep to lower stress and put your best face forward.
Instead of emptying can upon can of noxious insect spray, use it judiciously. The timing of these excursions is very important. Mosquitoes mostly enter the house at dusk, so it is important to take measures such as lighting coils near entry points like open windows, doors. When you are using the spray, do it with windows open, so that the little devils escape. Also, its worth remembering that most mosquitoes do not die from the spray; they are stunned, so after ten minutes its best to sweep the floors and clear the battleground. Now is also high time to repair any holes in the window nets, as the devious winged scoundrels are very adept when it comes to spotting chinks in our armour.