Titania K

Traditions, stigma kill the fight against HIV/AIDS, experts say

In Essays & Published Ponderings on September 17, 2009 at 5:25 pm

I snagged an early copy of my article to be released  Sat, Sept. 19 in The Spectator. The editor said he’ll mail me two copies of the real thing once it hits newsstands. Here’s a sneak preview:

Traditions, stigma kill the fight against HIV/AIDS, experts say - The Spectator. Ghana, Africa. Sept, 5 2009.
After she was diagnosed with HIV six years ago, Gifty Torkurnu went to a church to get anointed with a cure. “I was given two bottles of anointed oil and I drank and I vomited and the pastor told me I vomited the virus,” Torkurnu, 45, says.  She returned to the church five times for the treatments before she learned of her HIV- positive status from a doctor, joined a support group and began taking conventional medicine.

“Because of my denial,” she says, her son died four months ago after becoming infected through her breast milk. She is not alone.

Despite having a high knowledge of how to prevent and treat HIV/AIDS infections, many Ghanaians continue to rely on traditional cultural beliefs to avoid the disease, according to UN officials. This misinformation and denial is killing people.

Esi Awotwi, National HIV/AIDS Programme Officer at the United Nations Fund for Population Activities (UNFPA), says reducing the stigma associated with the illness, encouraging people to get tested and improving access to antiretroviral medications and other HIV services are the primary ways of fighting the spread of HIV/AIDS in Ghana. She acknowledges that some cultural ideas and behaviors are impeding these remedies. “We still have some people still visiting herbalists, people still visiting prayer camps for a cure,” she says.

“The problem we have in this country is that we are God-fearing people,” Torkurnu says. “Any problem we have we take it to God, so whatever the pastor says, we do. Some people are convinced that if I pray or if I do this without the antiretroviral drugs, you will be cured. But if God will cure me, it will surely come from above not from the pastor.”

She explains that traditionally in Ghana, people with HIV are thought to be bewitched. “They wouldn’t take you to the hospital. But if you don’t know your status, and think ‘I don’t know, so I must be okay,’ you’re defeating yourself.”

Fraudulent Herbalists

Many herbalists, like some pastors, claim to offer a cure for a price, but their concoctions only suppress the symptoms.

On the main road of Tema, Ashaiman, Lashibi and Kumasi, hand-painted signboards with a Dr. Nicholas Antwi’s name and phone number advertise a “fast and reliable cure for HIV/AIDS and other chronic illnesses.” In the waiting room of his large Lashibi clinic, three men sit silently on couches watching a soccer match on the television.  A receptionist leads guests one-by-one into the doctor’s office, a large room flanked by ornate twin sofas. Antwi leaves the T.V. on while he talks to this reporter.

“I have a cure,” he says. “I take the virus from the bloodstream and I take them out, I take them out. I don’t use antiretroviral drugs. I leave that for the hospitals. It’s not about the price. It takes five months and it’s gone.” Antwi refuses to reveal any of the ingredients in his concoction to test whether they are effective. Once someone has invested in his potion, he still will not disclose its contents. A refund in case it fails is also not an option.

“We have lost a lot of people who use such facilities. They have died,,” Dr. Robert Mensah, Reproductive Health Programme Officer at the UNFPA, says. “What these alternative herbal medical practitioners do is they confine the person. If the person is slim-slim they make them fat. If they have diarrhea, they give them something to make it stop. And the person thinks they are healed. But [the herbalists] only deal with the symptoms, they don’t cure the disease.”

Awotwi agrees that some of the herbal medications tested can help in the treatment of infections that come as a result of HIV, but they do not cure it.
She explains that before antiretroviral medications were introduced to Ghana in 2003, many people living with HIV were taking herbal treatments to boast their immunity. “Because they helped, sometimes people continue to visit herbalists. The herbalists think they have a cure, but they do not have a cure. Now people living with HIV have been encouraged to take anti-retroviral medications.”

There is no cure for HIV/AIDS, but antiretroviral drugs are allowing people to live long healthy lives and raise a family if they choose, Awotwi adds.

Torkurnu, who has a fiancé who tested negative, is a living testament to the effectiveness of antiretroviral drugs, “When I tell people that I am HIV positive they don’t believe me because they see that I am a very healthy woman. The perception is that since I’m not thin-thin and sick and bed-ridden I must not have it,” she says

Dangerous  Stigmas

In March 2009, 913,611 people were tested in Ghana for HIV/AIDS, according to the National AIDS Control Program’s HIV Sentinel Report. 236,157 people are known to be living with HIV in the country, the same report shows. But this number is probably higher, according to Clement Azigwe, National President of the Association of Persons Living with HIV (PLWHA). “Plenty people are walking around with HIV and they don’t even know it because of the stigma,” he says. “Eighty percent of Ghanaians say that if you are positive and you’re selling food, they won’t buy it from you.”

Despite a provision that makes it illegal to fire someone because of their HIV status, Torkurnu says she was dismissed from her work site when her employers discovered she was positive.

Patience Dogh, 20, says she cannot return to her community because it discovered she has HIV, and forced her leave.

“When people see people who have HIV they tend to shut them out,” Mensah says. “People are forcibly evicted from their accommodations, some employers fire you. When there is stigmatization, there is potential for spreading the condition.”

To encourage people to get tested, the UN is launching a National HIV Stigma Campaign and a Know Your Status Campaign, says Awotwi. “We are knocking on the doors of Ghanaian people, and that includes a provision of outreach counseling and testing services. What we really want to come out has to do with reducing stigma, emphasizing the fact that there’s hope with people living with HIV. You don’t have to be stigmatized.”

Dangerous Attitudes about Condoms

Mensah says many people in Ghana believe that using condoms is one of the major ways of protecting themselves against the virus. “Condoms are readily available to locals especially in the urban area,” he says, pointing out that in 2007, the UNFPA purchased and distributed 32 million of them. “Condom availability is not a problem, it’s attitudes over its usage that is. Its use is very low because of people’s attitudes.”

“Some people in rural areas believe that when a sexually active woman is beautiful it is because she is getting nourishment from the semen of the man. That is the mentality of some people,” Mensah says. “Others use the analogy: how do you enjoy eating toffee when it is wrapped in rubber? You need to remove the rubber before you can enjoy the candy.”

Awotwi agrees that some Africans feel that sex is less enjoyable with the use of condoms. She adds “Some people have religious beliefs which are against the use of condoms. Due to economic problems, some women can’t negotiate condom use. Some of them depend on men for economic gains. Empowerment – that is the problem.”

The inability of many people living with HIV to afford antiretroviral treatment is also causing the virus to spread. Ninety-five percent of people living with HIV in Ghana are unemployed, according to the PLWHA. The treatment cost 5 Ghana Cedis a month, causing many people not to take it. This is dangerous since the treatment makes the disease less infectious, according to UNAIDS. “Unfortunately for us the number of people who are supposed to do antiretroviral therapy, we are unable to support because of lack of funding and the need for facilities that do that,” Mensah says.

Due to the high unemployment rate and lack of accommodations faced by people living with the virus, Aziwe urges the government to provide more social services to people who are positive as a means of defeating the disease.

“We want the government to empower people living with HIV, to do more income generating activity to help support our funding,” Azigwe says. “We have to look at those infected to give them care, empowering them economically.”

Torkurnu warns Ghanaians against treating HIV/AIDS as an isolated condition that does not affect them. “Some people ask what does someone who is living with HIV look like. I say, ‘Look in the mirror and that is how someone living with HIV looks like.”


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