No friends, few drugs and little expertise for AIDS patients

Palestinian woman waits inside Ramallah Emergency Department in Ramallah Governmental Hospital, as Palestinian health sector employees agree to a partial return to work following a deal to give them part of their salaries, after more than 85 days of the nation-wide general strike November 19, 2006. (MaanImages/ Fadi Arouri)

The manner in which 14-year-old Mahmoud (not his real name) caught the HIV/AIDS virus was unusual - but the subsequent reaction of Palestinian society was all too predictable.

“I got it from a blood transfusion when I was 12. Now, no one talks me. My friends all left me when they knew that I’m AIDS patient. I feel I’m alone in this world. They are afraid to get infected from me, as I was infected, but it is not my fault that I have AIDS now,” said the youngster from the West Bank.

“I’ll never finish college. I’ll never have a family like the others. I will never have babies. I also believe that it will not be long before I leave this world,” he added.

Mahmoud is one of 36 people known to be living with HIV/AIDS in the Occupied Palestinian Territories (OPT), according to the Palestinian National Authority (PNA). Altogether, there have been 61 recorded cases of HIV/AIDS in the West Bank, Gaza and East Jerusalem since 1987, with five times as many men infected as women, according to Ezzat Gouda, a doctor and director of the sexually transmitted diseases (STD) unit at the Palestinian Ministry of Health.

Twenty-five of those sufferers have already died, Gouda said. More than half the existing patients are described as being heterosexual, two as bisexual and one, homosexual. A further 11, including Mahmoud, were infected during blood transfusions. Three were infected from injecting drugs.

Gouda added that efforts by Palestinian health care providers and institutions to help sufferers, were not coordinated, and provided patchy cover. “It is necessary and urgent to have a national plan for STD and HIV services in Palestine,” he said.

Social stigma

Gouda heads the Palestinian National AIDS Programme (NAP), established in 1998. He told IRIN that officials may not know the true scale of the problem in OPT because the social stigma attached to AIDS in the Arab world means some sufferers will possibly not report it to medical or other authorities, because they do not want to be ostracised.

In a situation unique in the Middle East, the stigma attached to AIDS in the OPT means Palestinian sufferers are both automatically denied entry into Israel for security reasons, and identified by Israeli intelligence services as potential informers, according to an Israeli non-governmental group, Physicians for Human Rights Israel (PHRI).

The Shin Bet, Israel’s security agency, believes that the stigma of having AIDS in Palestinian society means people living with it are more likely to be coerced into carrying out an attack to reestablish their family’s reputation, PHRI said.

“There have been instances where the weakness and desperation of sick Palestinians were exploited in recruiting them to carry out attacks within Israel,” PHRI wrote in a report in October. “The Shin Bet also exploits exactly these things to recruit them as collaborators and to wring information out of them.”

Israeli security sources denied to IRIN that they employed such broad profiling criteria when dealing with sick Palestinians wanting to enter Israel.

Islam a shield to AIDS

Many Palestinians believe they will not be infected by AIDS because Islam takes a hard line on some of the practices by which the virus can be spread, like homosexuality, prostitution and intravenous drug abuse. “The Islamic religion stands as a shield to AIDS. If we follow Islam’s instructions, AIDS will never be a problem at all,” Sheikh Taysir Tamimi, the Palestinian Chief Justice, told IRIN.

According to Palestinian health director, Gouda, Palestinians who travel to Israel and abroad are more exposed to the virus - there are an estimated 4,000 people living with HIV/AIDS in Israel, according to a UNAIDS survey in May, which did not include an estimate for OPT.

Some efforts to spread AIDS awareness have been made by the Palestinian authorities and the United Nations Works Relief Association (UNRWA), which looks after Palestinian refugees. But both organisations spend most of their time grappling with the more immediate crises affecting Palestinians, Gouda said.

Though Palestinians who are known to have HIV and AIDS are treated for free, anti-retroviral drugs are not always available, he said. “We depend on the donation of drugs, national and international. So we have many problems in view of Israel’s siege and repeated closures of the Palestinian territory. In some cases, patients were suffering unnecessary illness because they had no drugs or were denied access to Israel.”

Mahmoud and Palestine’s 36 other HIV/AIDS patients continue to suffer from a lack of expertise among medical staff, Gouda said. “The lack of trained medical staff and social workers for counselling and psychological support in the field of HIV/AIDS also stands as a grave constraint,” he added.

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