doesn't die, even though condemned to death. Shrouded in black,
she stands stuck between life and death, utterly confused, shaken
to the very root of her being. "If the government had established
a hospital for us, gave us work, we could at least live decently
the few years we're left with," she demands. "If not,
why doesn't it hand us some poison so that we could die and
find peace at last?"
it a crime that I was born poor, that I tried to earn a better
living for my family, my children?" the burkha-clad woman
breaks down sobbing. She doesn’t expect any answer. And who
is there to answer her? Being HIV positive, an AIDS survivor,
she belongs to the class of modern untouchables.
was a poor village woman, a mother of two. She spent Tk 85,000
to book a job as a cleaner at a women's madrasa in
a Middle Eastern country, at least that is what she was led
to believe. She took it as a God-sent opportunity in answer
to the years of prayers for a better future. She consulted her
husband and relatives and won their consent to accept the offer,
which came from a local acquaintance.
the passage money and the recruiting agent's commission, the
woman had to sell the only piece of land she inherited from
her mother and borrowed the rest of the sum on high interest.
Eventually, one morning she left family, home and country for
the Middle East in quest of a dream.
reaching the new land she was confronted with her worst nightmare.
Instead of a madrasa, she was confined to a hotel -- a brothel
in disguise. Initially, she screamed, rebelled, fought hard
the pimps but there's a limit how long and how far a human being
can endure brutal physical and mental torture. The brothel-keepers
know this very well and are experts in breaking the spirit of
recruits who end up as sex slaves.
next two years, she and her colleagues,also trafficked from
many other countries, had to cater to the sexual whims of men
who were predominantly Arab Muslims. Her passport and other
documents were seized and she never got paid. When she asked
for money, the pimps told her they had to buy her for Tk 300,000
and wouldn't pay her any until that 'investment' was recovered.
years, one day the brothel was raided by police and she was
arrested. In jail, she faced interrogation and torture again.
It was then that she came to know that she was infected with
HIV and was hastily sent back home without any money at all.
return to her village home, she confided in her husband about
her plight. Her husband and relatives virtually kicked her out
of the house along with her two children.
runs a small grocery shop on a footpath in Gulshan, Dhaka. Her
son is working at an auto-workshop for a daily wage of Tk 10.
She can't tell her children of her disease and needs at least
Tk 50,000 as dowry to get her daughter married.
a daily struggle for this woman, who asks between sobs whether
it was her fault that she was poor, orphaned at an early age,
and that she had only wanted to bring good days to her family
by working abroad?
IF you live
in Dhaka, you can't have possibly missed it, though you may
not have grasped its full implication. The bright-red bodies
of BRTC's Ashok Leyland double-deckers carry the message loud
and clear through the main wayfares of the city day in and day
out in large, bold letters in Bangla of the vernacular, 'AIDS
<>ekti maarattak rogue. Ei roger kono chikitsa nei. AIDS
roge mrittu abodharito<>.' This apparent awareness-raising
message means: 'AIDS [Acquired Immunity Deficiency Syndrome]
is a fatal disease. There is no treatment for it. An AIDS patient
is sure to die.'
doubt the intention behind this public notification was one
of welfare and awareness raising. However, due to information
and understanding of the communicators it has virtually turned
into a death sentence for the HIV positive people. The myths
generated by ignorant propaganda have so stigmatised the AIDS
patients as to reduce them into a new sect of untouchables,
not unlike that of the lepers in the middle ages. Only, in case
of the people living with HIV and AIDS, the stigma is more cruel,
the social boycott more complete, superstition of its association
with sin almost universal and the shroud of myths and misconceptions
harder to destroy.
on the issue in a plenary session a couple of months back, Professor
Dr M Nazrul Islam, chairman of Virology Department of Bangabandhu
Sheikh Mujib Medical University, termed the attitude towards
AIDS patients as simply insane.
a few incidents that he experienced during his day to day work
that sketch a shocking picture of the apathy towards the HIV/AIDS
patients even among the physicians and nurses.
Islam referred one of his patients, an HIV positive girl, to
a friend of his, also a specialist physician. The next day that
friend phoned him, sounding rough and angry, "Why did you
send her to me? To waste my time? These people should die anyway."
Thus, even the healer refused to deliver his Hippocratic oath.
Bangladeshi, who worked in a Middle Eastern country, built a
house for his mother with his earnings. He became infected with
HIV. Eventually his mother came to know of the nature of his
disease. After his death, the mother didn't let his wife and
children enter the very house built by his hard-earned money.
They were evicted from their home for the crime of being the
children and wife of an AIDS patient.
visit to a hospital, Professor Islam found the doctors and nurses
on duty were not giving intravenous saline to an HIV positive
patient, though there was expressed advice for that. When he
asked why, the doctors indifferently replied, what was the benefit
in giving him saline? He would die anyway.
said doctors at Dhaka Medical College Hospital morgue even refused
to carry out autopsy on dead bodies of HIV positive people.
"Due to lack of acceptance of this disease among the doctors
and nurses, AIDS patients have to be kept in hospitals showing
false ailments," he said, adding that only one NGO-run
hospital in the city was admitting and treating HIV positive
patients without any discrimination.
Professor Nazrul, T I M Zahid Hossain, an HIV/AIDS activist
working with ActionAid Bangladesh, cited two such anecdotes
further illustrating the extent of discrimination against the
people living with HIV and AIDS. In one instance, he quoted
some AIDS survivors as saying in a condolence meeting of a recently
departed fellow patient: “None of the hospitals in the city
agreed to give him a space. Doctors and nurses refused to attend.
It will happen to us. We are scared.”
In the second
case, "a hospital authority refused to provide medical
support to an HIV positive woman in delivering her child. Finally,
she was taken to a rural dispensary where no proper medical
support was available at the time of delivery."
to Professor Islam, HIV positive people in many cases victimise
themselves thinking their lives have no worth anymore, whereas
symptoms of this disease can be controlled. Due to negative-publicity
and mis-reporting, many HIV positive people think they will
die very soon. This wrong idea has to be eliminated so that
HIV infection doesn't bring in panic with it, he said.
too, described how at a South Indian hospital, recognised to
be one of the best AIDS testing and treatment centres of the
country, a number of patients committed suicide, being deprived
of counselling and suffering trauma from being suddenly informed
of their infection. He also said, "Over the last 15 years,
a number of cases have been reported in which people living
with HIV have been criminally charged, sometimes with very harsh
living with HIV and AIDS are stigmatised, isolated and deprived
of care, despite the fact that the UN Commission on Human Rights
has confirmed that "Discrimination against people living
with HIV/AIDS, or those thought to be infected, is therefore
a clear violation of their human rights." This declaration
has been signed and ratified by all member countries including
to Hossain, in countries like Bangladesh, the violation of the
rights of these modern-day untouchables has three basic features:
"Firstly, as the majority of the people living with HIV
and AIDS lack access to testing facilities, they are deprived
of information and relevant cares. Secondly, even if they are
informed, they are deprived of counselling and lifeline of drugs
and care. Thirdly, they are secluded and exposed to social scrutiny
and stigma without any legal protection."
they are not even getting any antiretroviral drugs, which are
essential for treatment of AIDS, to buy in the market, he added.
Just a decade
ago, treatment for HIV/AIDS did not exist. A positive HIV test
meant certain and imminent death. But, with the development
of anti-retroviral drugs, the treatment of AIDS and HIV has
progressed significantly over the years. It's now no more fatal
than any other severe disease, e.g. diabetes, cancer, tuberculosis,
etc. It also isn't necessarily rooted in or associated with
sin or vice, as the image portrayed by the public awareness-raisers.
in some African countries have proved that a therapy relying
on the anti-retroviral drugs which attack the virus that causes
AIDS can transform the sure death sentence into a more chronic
condition, enabling those suffering to live much longer, healthier
lives. Technically, anti-retroviral therapy is feasible throughout
the world. The cost of the medicines has also come down dramatically.
Bangladeshis -- including the leaders, governors, judges, gurus,
priests, teachers and even the healers -- are persistently deluding
themselves by believing that the disease will not be of much
significance in a predominantly Muslim country and it is not
only fuelling ignorance but also impeding new detection of case
in the country. Meanwhile the possibility of an epidemic is
flourishing on the myths, living unchecked in the shadows of
oblivion. There is every sign and probability of its pounding
all of a sudden on the nation unprepared and ill-equipped to
combat it. By harbouring negligence and apathy we are creating
our own future hell.
to the UNAIDS 2003 Fact Sheet, world-wide over 60 million people
have been infected with HIV since it was first diagnosed 20
years ago. While these numbers are shocking, what is more frightening
is the experts' estimate that between 2000 and 2020, over 68
million people will die of AIDS prematurely in the 45 countries
most affected by the disease.
the prevalence in Bangladesh is still low -- 13,000 as of April
2001, estimates the UNAIDS and the World Health Organisation.
But experts believe the actual figure to be much more than that.
In one region
of Bangladesh, HIV prevalence among injection drug users (IDUs)
jumped from 1.7 percent in 2001 to 4 percent in 2002. While
HIV prevalence in the overall population is reportedly still
low, the country's poverty, gender inequality, and proximity
to raging epidemics in India and Southeast Asia point to the
possibility of an AIDS explosion. Globally, reaching 5 percent
in any high-risk group is seen as an epidemic. Experiences from
Indonesia, Thailand and India show that HIV among the IDUs can
increase sharply from 4 per cent to 50 per cent within as few
as four years.
percent of the IDUs in Bangladesh visit female sex workers.
Seventy percent of rickshaw-pullers visit female sex workers
and have wives at home. The spread of HIV/AIDS from IDUs to
sex workers and rickshawallas would be very fast unless it is
effectively prevented. Men having sex with men also have sex
with female sex workers. This is how it could make inroads into
the general population.
Choudhury, HIV/AIDS coordinator of Bangladesh Red Crescent Society,
reported in October 2002, "Experts are predicting that
the AIDS pandemic could be set to explode in Bangladesh. According
to official figures, there were 182 HIV-positive men and 35
HIV-positive women in the country at the end of last year. However,
no one knows the actual figure.
people living with HIV/AIDS are unwilling to be tested and even
though there are private and public laboratories carrying out
HIV testing, the results are not sent to the national AIDS/sexually
transmitted diseases (STD) programme."
observed, “The plain truth is that we cannot afford to be complacent,
especially as, according to a recent Unicef report, 96 percent
of girls and 88 percent of boys don't know how to protect themselves.”
confirmed HIV-positive cases were reported during the last six
months and experts believe that new cases of HIV infection might
be double this year compared to last year's total of 31. Of
the 22, 18 are migrant workers and four are housewives. Officially
detected cases are only the tip of the iceberg, but this sudden
rise in the detection rate indicates a rapid increase in transmission
rates which should set alarm bells ringing."
a researcher of the Human Rights Watch, reported on August 20
last year, "Bangladesh is brutalising exactly the people
it most needs as allies if it is to avoid a severe AIDS epidemic.
Violence against at-risk people traumatises them and drives
them out of reach of HIV prevention services, which can increase
their risk of infection."
In his 51-page
report "Ravaging the Vulnerable: Abuses Against Persons
at High Risk of HIV Infection in Bangladesh," Maru records
rapes, gang-rapes, beatings and abductions by both police officers
and mastans. Their targets -- sex workers, men who have sex
with men and injection drug users -- are both at high risk of
HIV infection and the people most capable of bringing AIDS information
and services to their peers. In a direct blow to the fight against
AIDS, some of the abuses are committed against AIDS outreach
to the sheer rise of HIV prevalence among the IDUs from 1.7
percent to 4 percent in 2002, Maru said, "This is a critical
situation. Strong intervention now could save countless lives,
but time may be running out.”
writer is Senior Sub-editor of the Daily Star)