Tuesday, April 27, 2010

A new lens on HIV/STDs

Published in The Fiji Times, Wednesday 21st April, 2010

I was happy to read of the HIV Prevention and Treatment Decree (FT 20/4/2010) which is expected out in the next few months.

That this decree will make it illegal to stigmatise a person on the ground that the person is living with HIV is an important step to address not only the discrimination that people living with HIV face but also the stigma associated with HIV as well as other Sexually Transmitted Infections.

It has taken some very brave women and men to step forward to tell their stories and put a human face to this epidemic.

Their struggle for acceptance within their families and communities, and to face an uncertain future while retaining hope and embracing the present is a lesson for all of us on our own prejudices and misconceptions about who can contract HIV and under what circumstances.

But there are many more who find themselves unable to disclose their status for fear of rejection and reprisal, or denial about their condition.

With the amount of literature available and agencies, community groups and individuals providing HIV/AIDS awareness and education, it is only our own attitude towards HIV that prevents us from understanding the true nature of this pandemic instead of believing the myths.

The article was of particular interest to me because this week I am in Nadi for a UNICEF-organised Pacific Sub-regional consultation on the Prevention of Parent to Child Transmission (PPTCT) of HIV.

I find myself among doctors, nurses, midwives, lab technicians and counsellors from around the Pacific, along with representatives of UNICEF, UNAIDS and UNFPA, ambassadors from the Fiji Network for People living with HIV, as well as the Pacific Conference of Churches. The consultation is focused on scaling up the prevention of parent-to-child transmission of HIV. This includes discussing the possibilities of integration of PPTCT services as well as setting standards, guidelines and policies for the region in maternal and child care services, counselling and testing of HIV and reproductive healthcare, including family planning.

Until recently this issue was termed as "Prevention of Mother to Child Transmission" and the change in terminology to "Prevention of Parent to Child Transmission" broadens the issue to address the involvement of men, especially expectant fathers in this important issue.

Our responsibilities to our wives and partners and to our children should include partnership in ante natal care (before birth), including agreeing to be tested if the expectant mother is diagnosed as HIV positive, continuing into post natal (following birth). It is not just an issue about HIV but more importantly about shared responsibility in parenthood.

While some of us have difficulty engaging in the issue of HIV from the point of view of sexuality, this issue is about families, about our children and ensuring that they have the best possible chance of having a healthy life.

As the ambassadors of people living with HIV shared the fear of a HIV-positive mother for her baby each time she took the child for testing after birth, I recalled my fear as I watched my wife give birth to each of my two children.

Would they be alive?

Would they be normal?

What was that fear compared to a mother who asked herself, "Will my baby be diagnosed with HIV?"

Before rushing into condemnation of women who are HIV-positive having children, it is important we understand that a number of women are only diagnosed as being HIV-positive when they are tested during their ante natal clinic visits.

Our climbing onto "the moral high ground" must be tempered with the appreciation that many of these women have been faithful to their husbands or partners and it is from either the unfaithfulness of these husbands/partners who become infected with HIV and the lack of men voluntarily undergoing HIV testing.

Recently Health Ministry permanent secretary Dr Sala Saketa was quoted as saying that the burden of responsibility should not be placed on one part of the community and it was important to have a law which would give a shared responsibility on HIV testing and reporting.

An issue raised during the discussion on HIV testing and pre and post-testing counselling was the role of ministers, pastors or religious and community leaders in the Pacific context when communities are small and in rural and remote islands where professional counsellors are not available and given the cultural context, more approachable than counsellors who are already stigmatised as "AIDS counsellors".

For this to take place, ministers or other religious leaders need to include in their pastoral counselling training, components on HIV/AIDS.

More than that, they need to look at HIV/AIDS not as an issue of morality but as an issue of life and death.

For Christians we look to Christ who came that we may all have life and life in abundance.

On April 8 this year, leaders from the Roman Catholic, mainline Protestant and Pentecostal churches signed a statement of commitment which includes the following words:

"We, Christian Church leaders in Papua New Guinea recognise the HIV epidemic as a very special Cross to be carried in our time. The HIV epidemic affects all aspects of our living our cultural norms and practices socio-economic conditions, economic development, human responsibility, issues of gender, sexuality and morality, marriage and family life. Papua New Guinea is seen as a Christian country. If we are to live according to Christianity and to be seen as genuine, then our response to the HIV epidemic must be similar to that of the "Good Samaritan", a response in the spirit of Christian love and sacrifice that we become true neighbours to one another!"

The statement, which is to be launched on May 5, goes on to say that, "the AIDS crisis is bringing us together because we are living with HIV and AIDS.

We need to share knowledge, understanding and experience from our various religious communities so that our united efforts become more effective and inclusive.

Through this, we will seek to establish a new culture of ecumenical and interfaith co-operation; respecting the uniqueness within our traditions while focusing on our shared values of human dignity and human rights."

In the absence of a functioning national council of churches in Fiji, it would take both the leaders and those on the ground to commit to a meaningful Christian response to the HIV crisis that is in line with declarations statements made and endorsed by the church leaders of the Pacific in the "Nadi Declaration" of 2004 and at the Pacific Conference of Churches General Assembly in Pago Pago in 2007, both of which had representatives of Fiji churches.

Sitting amidst healthcare workers who are passionate about preventing the spread of this epidemic holistically and are examining how to improve their work remembering the human face of the lives involved, I am inspired to recommit to engaging in this issue in a more meaningful way. Not just as a talatala or a lecturer but as a husband, a father, as a human being.

How about you?

May the rest of your week be blessed with simplicity, serenity and spontaneity and the courage to act with compassion.

* Reverend JS Bhagwan is a member of the faculty at Davuilevu Theological College and the associate minister of Dudley Methodist Circuit in Suva. This article is the sole opinion of Mr Bhagwan and not of this newspaper or any organisation that he is affiliated with. padrejamesgmail.com

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