HIV/AIDS AND THE TETRAD SOCIAL EVIL

              HIV/AIDS AND THE TETRAD SOCIAL EVIL

     Sarah has been having fever for some months, regular antibiotics and antimalarials seem not to produce any remarkable improvement. Occasional diarrhea makes her weak and feeble. She daily longs to be with her husband, Abubakar, a military man who was recently posted to Mubi (Adamawa, Nigeria) because of the activities of BokoHaram (BH). Sarah, mother of two, will not visit the hospital, let alone have a test done. Her reason she says was personal! Days glided into weeks, weeks to months but her symptoms would not abate. A local Nurse who is also a friend broke her obstinacy and brought her to the hospital. History taking revealed husband’s occupation as military officer with over 10years of service; one who visits his family once in six months and had a history of multiple sexual partners.

   

      Thereafter, the doctor counseled her and requested for a HIV test.  Immediately, the atmosphere became quiet and Sarah’s fear became palpable. She looked towards the Nurse and like a sheep to the slaughter, she was dumb! She tried to pull herself together but tears failed her. She knew she is HIV positive but the social implication of her status threatens her to the marrow. With tears she retorted, "Doctor, I cannot stand the shame and the rejection that my children and I will go through, my husband will obviously take another wife and my children will probably be forced out of school.” She cried and cried…

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     Another world HIV/AIDS day is here and I think we need to spare some thoughts for innocent women like Sarah as they battle stigmatization, discrimination, neglect and ostracism alongside a positive HIV status. I need not tell you how HIV is transmitted because you know! I need not bother you on how the virus ruins the immune system because you are aware! I need not emphasize that AIDS has no cure because you are well informed! But I must bother you on behavior change towards victims of HIV/AIDS because it is a threat to pleasant relationships, economic privileges and social order!

     Stigmatization is an act of putting negative distinguishing mark on people because of their experience. Just when you start referring to someone whose name you know as “HIV patient”, there and then you have started stigmatizing. It may be subtle at first but the societal implication is deep seated. It is a name no one wants to bear for obvious reasons. So when next you come in contact with people with HIV; give them a handshake, hug and reassure them, it will go a long way. The virus is not spread through casual contact!

     Discrimination on the other hand is a social disadvantage placed on people with HIV. This is moving a step further; it puts a restriction on patients’ social participation and interaction. However, we need to be aware that, this action is capable of preventing voluntary disclosure of status. Loss of Job, employment difficulties, limitation of participation, restriction of travel, are possible channels of discrimination. That young qualified graduate that was refused an employment because of his HIV status is being discriminated against. That middle age woman whose visa will not be processed because she is living with the virus is being discriminated against.

     Neglect by family and community members also constitute a social evil imposed on People Living with HIV and AIDS (PLHA). We've heard stories of husbands neglecting their spouse because of HIV and vice versa. Stories of extended family members denying bereaved mothers and children a living and livelihood because the breadwinner died of AIDS are common around us. Unavailability of antiretroviral drugs, lack of care and social support for AIDS orphan, PLHA, People Affected By AIDS (PABA) cannot be overemphasized.

      The last strike and definitely the most severe is ostracism. Countless number of people have been sent out of their communities and abandoned in various leprosariums all over the country. This punitive measure meted against leprosy patients is gradually creeping into the way HIV/AIDS patients are being handled. Contrary to widespread myth however, HIV/AIDS is not ‘special’ because:

1. It is a chronic, incurable disease like cancer, hypertension and diabetes
2. It is blood borne like Hepatitis B and C  virus
3. Sexually transmitted like Gonorrhea, Syphilis and Herpes
4. Preventable  like every other diseases of public health importance

Therefore, the paranoia and disgust associated with HIV/AIDS is baseless and unfounded. Truth be told, we will be doing ourselves a great deal of favor if we change our behavior towards HIV/AIDS victims. If we stigmatize them, they won’t own up to their status, this will lead to concealment of cases and ultimately to clandestine spread of the virus. If we discriminate against them, they will be furious and this can lead to vengeful spread of the virus. Whichever way, more people will become infected, the burden of the disease multiplies and more deaths ensue.

      The UN secretary general Ban KI Moon says “stigma is a chief reason why AIDS epidemic continues to devastate societies around the world”. 

     

     Lets us not forget the increasing spate of insurgency around the world and its effects on HIV/AIDS ; Al-Qaeda, Al-Shabaab, Islamic State of Iraq and Syria (ISIS), BokoHaram etc, all tend to increase the number of internally displaced persons and refugees with disruption of family lives and homes, consequent upon this can be spread of diseases like HIV/AIDS. 

      The abduction of over 200 school girls in Nigeria over 7months ago with theories of them being married off to unknown men or the possibility of them being used as sex slaves is not only heart breaking but pathetic especially if HIV transmission is found in the mix.

      Time will fail me to talk about rape and forced marriages, whose victims are now suffering from HIV/AIDS. The sad episode may get worse, the frustration may escalates and the hopelessness may become irretrievable if we continue to stigmatize, discriminate, neglect or worse still ostracize these innocent souls. Our behavior must change and the time to start is now! Stop the Stigma, Don’t Discriminate, No to Neglect, Oppose Ostracism and End this social Evil. 

 




N.B- The names in this article are fictitious-any coincidence is not intended.

REJECTING HEALTH, PROCLAIMING IGNORANCE

               REJECTING HEALTH, PROCLAIMING IGNORANCE
   

    Health status remains one of the determinants of wellbeing that is often underestimated, taken for granted and least appreciated; nevertheless it remains core to our continued existence on this side of the world. It should be clear to us that, not even our occupation, belief, social status, educational attainment on their own can bail us out when our health fails. A patient with serious debilitating disease will probably not go to work, neither will he attend functions, nor remember his beliefs but his only desire will be to get healed. Furthermore, quality of life of the citizens of a country is no longer dependent solely on the Gross Domestic Product (GDP) of such nation, but also on life expectancy at birth (which is a health status indicator) and literacy level of the populace. If not, how do you relate a country with the largest GDP in a continent yet majority of its citizen struggle daily to meet their basic physiological needs of food, shelter and clothing? A nation where achieving security needs is practically impossible. A land where meeting one's social need is considered out of place and aspiring to attain one's esteemed need would mean asking for too much. In this part of the world, the vicious cycle of poverty, ignorance and disease is inseparable!

   

     Learning from the foregoing, health status is not only a determinant of an individual’s wellbeing but it is also an economic parameter that measures the wellbeing of a country. If our health status is so sacrosanct to our general wellbeing, why are some folks handling it with so much levity and triviality? Truth be told, if health is not lost there is no point trying to restore it. Staying healthy like I always say is cheaper than getting treated, it however requires some commitment like searching for correct health information, sustaining healthy lifestyle through discipline and psychological training and re-training. The recent “Ebola and salt water hoax” however shows how far we are lagging behind. Why do we discard sound health information and keep proclaiming ignorance despite the resources at our diaposal? Here are some reasons:

     Firstly, people are most times lazy and tend to respond only to easy solutions. Getting things done fast, easy and at practically no cost has blinded us to the most obvious facts of life. Sadly, this mindset has invaded not only the way we handle our health or information related to health but other facets of our lives has also suffered.If salt and water could cure Ebola why would United States be spending so much to manufacture a vaccine? Why would grants be given solely to develop a drug, if common table salt and water at any random concentration was equally effective? Health Information is everywhere, yes; on Google world, Twitter street, Facebook domain etc, but always check with a medical professional, you might just save yourself from a catastrophic health event! Information is power but negative information is paralysis in itself.

     Moreover, terms like health risk, risky behavior and relative risk seems intangible and distant to most people. The notion that, if it is not happening to me now, it can never happen to me should be very well considered. Hypertension for example is primarily a hereditary disease; also men with hypertensive parents have over four-fold increase in risk (chances) of developing Hypertension after the age of 30-35years. This risk can be increased further by indulging in risky behaviors like smoking, drinking alcohol, increased stress and increased salt intake. In other to reduce the risk of hypertension in such people, we do advise them to quit smoking, stop drinking, reduce salt in diet, avoid too much stress, exercise more and take more fruits. These are scientific facts which holds true in most cases. My sincere appeal is that if you are at risk of hypertension, do not wait till stroke sets in and you can't move your limbs. Consult your physician for check up and begin those lifestyle modification stated above in earnest.

     Lastly, people’s priority and problems also cloud their sense of judgment and affect their disposition towards sourcing or using health information at their disposal. Truly if one can’t figure where the next meal is coming from, one might probably not be bothered if the food one gets after waiting for two days or more was prepared in the toilet. This cycle of poverty, ignorance and disease has to broken at some point. The preponderance of poverty in this country is only a pointer that our government really needs to do more. Be that as it may, ignorance which is the next culprit is a choice we have to make. If we choose information we get good health in return but if we choose ignorance we get disease and as such perpetuate the vicious cycle. For so many people, health information is still regarded as intangible and should not compete with more tangible realities in their lives, but is that position safe? Remember if one's health falters, life may crumble. Maintaining healthy status is an end, getting sound health information and implementing it through a positive behavior change is a means to this end. Health they say is wealth, but shall we continue in ignorance and expect our health to blossom?

 
                                                                     

BRIDGING BEHAVIORAL CHANGE AND DISEASE PREVENTION

BRIDGING BEHAVIORAL CHANGE AND DISEASE PREVENTION

        It is often said that the world is changing and as such the inhabitants. However, the point I think should be stressed is that man’s expectations in life, disposition to issues, response to setbacks and yearning for discovery has changed over the years and this had affected his world. Therefore, man is the variable factor and the effect of his variability is now reflected on his world.  The fluidity of this generation and the desire to get all things done at the snap of the finger has lured us into breaking health frontiers without knowing.  Man’s ignorance of the limit of his ability and over-exploitation of his constitutional make-up has opened up a floodgate of diseases for which he lacks economic, scientific, emotional and spiritual reserves to deal with. The upsurge of new diseases coupled with old ones changing form and character which was  conceptualized as Emerging and Re-emerging disease is now a menace to man’s survival.

         In elementary science “a matter will continue in its state of REST or UNIFORM MOTION unless acted upon by a force”. Sadly, the “motion” of Emerging and Re-emerging of diseases has started and unless a suitable and sustainable “force” is put in place by people and community at least to slow down the progression and if possible halt it, we may continue to have Ebola outbreaks, Middle East Respiratory Syndrome (MERS), Double burden of disease and Environmental and Climatic Emergencies. The good news however, is that Disease Prevention offers a safe haven! The ideals of disease prevention are simple and practicable in most settings provided the principles are well understood. What then is Disease Prevention? What are the ideals?

         Disease Prevention can be defined as actions aimed at eradicating, eliminating or minimizing of disease and disability and if none of these are feasible, retard the progress of disease and disability. The concept of disease prevention is gaining more prominence now than ever before because man is becoming increasingly aware that he cannot keep pace with the rate at which new diseases are springing up and old diseases becoming more lethal. Dr Chan (DG World Health Organization) said recently that, public health must shift its focus from cure to prevention, from short term to long term. Why spend fortune to cure a disease (which in itself cannot guarantee cure) when it is possible to prevent it? How then do we prevent disease?

        Disease prevention don’t exist in isolation, like most concept it requires a medium through which its values can be communicated, learnt and implemented, this is what Health Information and Behavioral change represents. Health Information simply deals with acquisition facts concerning a disease condition while Behavioral change involves application of these facts in the prevention of disease. Behavior change may involve lifestyle modification such as smoking, drunk driving, unprotected sexual intercourse, exercising, feeding etc. Health Information is of little account and significance without a corresponding Behavior change. Therefore, Health Information couple with Behavioral change is the necessary bridge to Disease prevention! 

Consider this for example:

“Smoking cigarette causes lung cancer”- Health fact/Information

“Staying in company of smokers even if you don’t smoke also put at risk of lung cancer”- More fact

The behavior change to avoid lung cancer is to quit smoking and stop hanging around smokers if you don’t smoke.  Lagos State (South-West, Nigeria) has even gone a step further by banning smoking in public places. All these are geared towards preventing lung cancer and other respiratory disease in the population by enforcing a behavior change.

Again:

“Cervical cancer is caused by Human papilloma virus HPV”- Health fact/Information

“People with multiple sexual partners are at risk of contracting and transmitting the virus”- More fact

The behavioral change dimension to this involves; restricting yourself sexually to a single uninfected partner, going for screening test (pap smears) against cervical cancer once you are sexually active and getting children especially girls between 10-12years immunized against HPV. Behavioral change is applicable to other non-communicable disease like hypertension, diabetes and other health-related events like climate change.

            We need not remind ourselves of notable people that have departed from diseases which are amenable to behavioral adjustment. The time to begin is now, delay might be dangerous. Unhealthy lifestyle has a way of provoking a ripple effect. Let us live but live right, eat but eat healthy, change but positively!