Fighting Ignorance And Stigma On a Shoestring

Health workers in Malakal, capital of Upper Nile State in southern Sudan, face great odds in trying to counter the ignorance and stigma that prevents people benefiting from available HIV/AIDS services.

Despite the presence of a voluntary counselling and testing (VCT) site in the city, little is known about HIV. Regina John, 18, who works in her mother's food shop, did not know the government-run VCT centre existed, even though it was just 100 metres away from her doorway.

"I don't know where people are being tested for HIV/AIDS," she said. "I have heard about AIDS on the radio, and from people talking about it, but I do not know how it is contracted or where it originated."

A survey by the Sudanese National AIDS Control Programme and United Nations agencies in 2005 found that less than 10 percent of Sudan's young people knew how to prevent HIV or what a condom was.

Dr Onuar Obathur, director of preventive medicines in Malakal, told IRIN-PlusNews that few of the town's people volunteered for HIV testing. "The stigma is very high about this disease. People are refusing to come for testing. They think that if they are found HIV-positive, the information will be circulated all over and it will be difficult for them to live in the community."

Sudan has a relatively low HIV prevalence of 1.6 percent, according to a 2003 UNAIDS survey. However, it is thought to be higher in the southern region, and there are fears that increased population mobility could see it spread more rapidly since decades of civil war ended in 2005.

"So far, we have found 22 HIV-positive cases. Out of these, 11 are eligible for drugs, but only one person is benefiting from these ARVs [antiretrovirals]; the rest have disappeared and we have no means to trace them," said Obathur.

Malakal's VCT centre can provide ARVs, but lack of awareness means few use the available services. State health minister James Thubo said educating the local community was a priority.

"HIV/AIDS is not [worse] than the war that the SPLA [Sudan People's Liberation Army, a former rebel movement] fought before," he said. "It is our duty now, as a government, to fight this disease; otherwise it is really a threat to our communities."

Although the government as well as donors have acknowledged that HIV needs to be tackled early and decisively to limit its spread, efforts in Malakal have been hampered by a lack of funds.

"I thought of conducting a workshop for the community and the health workers on HIV/AIDS awareness," Obathur said. "But we don't have a budget to do that from anybody."

[ This report does not necessarily reflect the views of the United Nations ]