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Thread: AIDS, Asian Values And States Of Denial

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    AIDS, Asian Values And States Of Denial

    By Barbara Crossette, U.N. Wire

    UNITED NATIONS Tackling AIDS in countries with extensive poverty, inadequate public health systems and a dearth of good communications networks is hard enough. But imagine adding threats from criminal traffickers, attacks on people trying to help the sick and the unwillingness of government leaders to recognize the needs or sometimes even the existence of the most vulnerable citizens, among them gay men, male and female prostitutes and intravenous drug users.

    As Secretary General Kofi Annan's envoy for HIV/AIDS in Asia and the Pacific since last year, Nafis Sadik has been traversing Southeast Asia and the expanses of South Asia the Indian subcontinent from the Himalayas to the Indian Ocean and been shocked at what she sees and hears.

    Almost everywhere she goes, Sadik said in a couple of conversations between trips to the region, government ministers play down her message that parts of Asia are becoming new epicenters of HIV/AIDS. Leaders tell her that Asians are different.

    "I've heard this sentence 'Our Asian values protect us' so often that I think they really start to believe it themselves," said Sadik, a physician born in India and raised in Pakistan.

    When she begs to differ, they tell her she has been away too long and has lost touch with Asian culture. We aren't Africa, they say. It can't happen here.

    "I'm telling the Asians," she said, "the Africans said the same things to me. It's like a nightmare being repeated."

    The Asia-Pacific region, with more than 7.2 million cases of HIV/AIDS at the end of 2002, ranks second to Africa, which has over 28 million infections. More than half of Asian cases are in India.

    Sadik, who holds the rank of an undersecretary general at the United Nations, is known worldwide for her revolutionary work as executive director of the U.N. Population Fund from 1987 to 2000, when she turned the agency into an advocate for women's reproductive rights. She has always been a straight talker who can look a prime minister in the eye and say "condom" without flinching. It annoys her to no end to find candor in such short supply in too many Asian countries, where homosexuality as well as prostitution is often illegal.

    When the Economic and Social Commission for Asia and the Pacific, known in the United Nations as ESCAP, met last month to discuss HIV/AIDS, it heard a powerful speech from Festus Mogae, president of Botswana, where the disease has savaged society and lowered life expectancy dramatically. He warned Asians of the lethal consequences of denial. Sadik also spoke to the audience in stark terms.

    "But when the final recommendations were being drafted," Sadik said, "they would not even allow the term 'vulnerable groups' to be used because, they said, if they recognized them as vulnerable they would have to do something about it."

    Asian leaders often acknowledge only that infections happen in what they call "deviant populations," she said. Yet it is well known that sex industries across the region attract men from every level of society, and that gay people cannot be wished away.

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    Stories of abuses crowd Sadik's impressions. "In some of the Southeast Asian countries, there's this huge demand for virgins, and now that demand is being fueled also by this myth, quite prevalent in Africa, that if you have sexual relations with a virgin you'll be cured of sexually transmitted diseases and HIV and AIDS," she said.

    With U.N. help, Cambodia had significant early success in cutting
    Asia's highest HIV infection rate to about 2.8 percent from about 4
    percent of the population (still small compared with prevalence rates of 20 percent or higher in some African countries). But now a thriving sex industry threatens to reverse gains. Trafficking in women, sometimes with powerful political protectors, is more lucrative than drug smuggling, Sadik was told in Phnom Penh, the Cambodian capital. Nongovernmental organizations find it hard to work in safety.

    "I met an NGO woman trying to rescue girls lured to the city within Cambodia, and also those who had been abducted and brought from neighboring countries, like Vietnam and even from Thailand," Dr. Sadik said. "She was telling me how she is in danger of her life. Her house had been burned down. She always travels with security guards because she's been threatened. This is big business. There are many senior officials, even in the police, quite involved in this."

    When a Cambodian journalist who interviewed her asked a government Health Ministry official for comment, he replied that he saw no connection between AIDS and trafficking. "I think what he tried to imply was that I was an envoy for HIV/AIDS so why was I talking about women and girls and their rights," she said.

    "The situation of girls and women in South Asia and Southeast Asia is really still so bad in this day and age, and the HIV/AIDS problem just exposes it and brings into sharp relief how vulnerable girls and women are to infection not because of their behavior but because they have no control over their own lives," Sadik said. "They cannot negotiate anything. I know in some cases that even when they know that the spouse is infected, they cannot insist that he use a condom. They have no
    rights." Brothels intimidate or throw out women who insist on condom use, she said.

    There are exceptions. In Thailand and Sri Lanka, for example, HIV
    infections have been reduced or prevented in part because women have more rights, are better educated and are more active in campaigns against the disease, and against trafficking. But in Pakistan, India, Nepal and Bangladesh, women have less education and a lower social status and are often married young to a man chosen by relatives. Many of these men will have had their first sex experiences with prostitutes. Others who are gay have likely had sex with men before being forced to conform and marry. In either case, innocent women pay with their lives.

    "In the subcontinent in particular women are very protected," Sadiksaid. "The girls have their first sexual encounter with their spouses. Now they're finding that some of these spouses have already got HIV.There are many cases that are documented [where] women find out either when they're tested during pregnancy or when the husband dies or become ill. The irony is that in some of the cases I was told by the family, 'Well, she's the one who has brought it in.' Poor woman. She's stigmatized even when she's not done anything."

    "There are so many, many things that seem to happen to girls and women in South and Southeast Asia, and it is making them so vulnerable to sexually transmitted diseases and HIV/AIDS," Sadik said. "There are horrible cases in India, for example. Just recently there was a woman who was found to have AIDS from her husband. The husband's family sent her back to her parents. When she arrived in her home village, the villagers asked the parents to get rid of her. But the parents said, No,
    she's dying."

    When the woman fell into a coma, the crowd declared her dead and burned her alive. The Indian press covered the story extensively.

    Sadik sees some positive signs. Though leaders don't want to talkpublicly about AIDS and deny that it is a problem, they are beginning torecognize that the disease could be a future threat, she said. She urgesofficials to support many programs run by NGOs and to think more about protecting whole populations from a potential epidemic, starting with prostitutes. AIDS has already made the leap into the general population in Asia, and government leaders are aware of this.

    "They realize in their heart of hearts or they know in their minds,
    even that what I'm saying is correct," Sadik said.

    Reuse Guidelines View Complete Issue: October 20, 2003 All U.N. Affairsarticles: October 20, 2003

    2003 by National Journal Group Inc., 1501 M St., N.W., Washington, DC 20005. Any reproduction or retransmission, in whole or in part, is a violation of federal law and is strictly prohibited without the consent of National Journal. All rights reserved.

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