22 May 2006

Wednesday May 17, 2006

HIV on the rise


ROHANI is a 17-year-old girl whom anyone would mistake for being only 14. At age 12, her stepfather started to rape her. When she was 14, he died. Soon after, her mother also died, like her husband, of AIDS. Rohani got tested and was found to be HIV-positive.

Sent to live with her grandmother, she found her way to the hospital where she was put on anti-retroviral drugs. Now she feels better and wants to go back to school. But she remains an introverted girl, perhaps because of the horrific life she has experienced so far. Rohani was one of about 40 women I met in Kota Baru not too long ago, all of them HIV-positive. An NGO there, Persatuan Prihatin was set up two years ago by an extraordinary staff nurse Zaimah Hussin, along with two dedicated doctors, Dr Maheran Mustafe and Dr Norliza Ariffin. As a counsellor at the Tengku Ampuan Zainab Hospital, Zaimah became concerned about the number of HIV-infected women she was seeing, about eight or nine new cases a month. Today Prihatin has a membership of over 100 women, all of them infected with the virus that causes AIDS.

There have been many articles written about Prihatin in the past few months. They are doing extraordinary work but rarely do these articles explain what the phenomenon of Prihatin really means.

Firstly, it is very clear that women are becoming infected with HIV in our country in ever-increasing numbers. The 100-over members of Prihatin are all from one state; who knows what is happening in other states? Secondly, despite this, nobody seems to be alarmed at all. The Health chapter in the 9th Malaysia Plan mentions HIV/AIDS but said nothing about the increasing number of women becoming infected, a sure sign that the epidemic is making inroads into the general population.

The chapter on Women also makes no mention of any concern about this except to say that there should be more awareness about HIV/AIDS among women. The recently announced National Strategic Plan on HIV/AIDS in turn relegates women to marginalized groups, making it seem as if they are marginal to the problem rather than increasingly central. This will affect how we prioritise prevention.

Experience from all around the world shows that AIDS is rapidly becoming feminised. As more women become infected, the consequences for society are disastrous.

We lose not just wives and mothers but caregivers and nurturers, farm workers, teachers, nurses and factory hands. Children become orphans, the elderly are left to care for their grandchildren. If anyone thinks this is only happening in Africa and elsewhere, they are wrong.

The rising number of cases among women in Malaysia is invisible and silent, which makes it deadlier than anything else. As much as people seem to sympathise with women who get infected by their husbands (which is mostly the case), few HIV-positive women dare to declare themselves for fear of being shunned. Most of them are poor, barely able to feed themselves and their children on less than RM200 a month. This drives them to find ways to survive that includes finding new husbands without necessarily informing them of their status. Prihatin tries to counsel them and their potential spouses to ensure everyone understands what is involved.

If we look at the phenomenon of women becoming infected, then it is obvious that when there is inequality between men and women, women become very vulnerable. Our society tolerates the idea of men being “weak” when it comes to affairs of the loins, yet refuses to make the obvious link with disease. We recognize that women are vulnerable yet refuse to empower them in any way so that they may say no to unsafe sex.

We think mandatory testing is the answer, yet this only tells us about a person’s status at a certain point in time. It does not give women any power to ensure that their status remains HIV-negative in the future when we also condone a man’s right to do as he pleases, because we tolerate, and sometimes even promote, men’s so-called “predatory” nature. We condemn men after they have done something wrong, but subtly encourage their machismo beforehand while at the same time ensuring that women have no power to protect themselves.

This Sunday (May 21) is International AIDS Memorial Day when we remember the thousands of Malaysians who have died of AIDS, and the many thousands of families and children left bereaved by their deaths. We would do well to ponder how many more deaths there will be in the future, all due to our neglect and unwillingness to take real steps to protect people. Is empowering women to protect them so unpalatable because it will up-end the status quo between the sexes?