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14 January 2002 by Sébastien Carliez in Damascus Dr Jari Vainio was working in Africa when the HIV/AIDS epidemic began to really take hold. In his seven years as a physician in rural Zambia, about 1,000 of his patients died of the disease - many of them neighbours, colleagues or personal friends. He is now the International Federation's regional health delegate for the Middle East and North Africa. If no effort is made towards education and prevention in this region, the Finnish doctor warns, it could be rapidly overwhelmed by the disease. "It is our duty to make sure that a catastrophe like the one unfolding in Africa never occurs in this part of the world," he declared in an opening address to the 21 participants in last month's Damascus 'train the trainers' workshop on HIV/AIDS. The first initiative of its kind in the region, the course brought together representatives of eight Red Crescent and Red Cross societies, from Iran, Iraq, Jordan, Lebanon, Libya, Palestine, Syria and Yemen. The number of people living with HIV in the Middle East and North Africa now stands at some 200,000, according to the UN. In relative terms the region remains among the least affected in the world, with less than one per cent of the global total. But if HIV prevalence continues to be generally low, increasing numbers of infections are being detected in several countries, among them Iran and Libya. "Until very recently governments were merely denying the facts," says Dr Muftah Etwilb of the Libyan Red Crescent, "but now they realize they have to help prevent the spread of the epidemic." The Damascus workshop was intended to help participants become community leaders in the battle against HIV/AIDS. Firstly, they have to understand the global thinking behind the Movement's approach, Dr Jari Vainio explained. Secondly, trainers in the region need to be able to get key messages across to young people. The Federation's Action with Youth, HIV/AIDS and STD [sexually transmitted disease] training manual, for example, has been adapted for the Middle East and is now available in Arabic. Darine El-Sabeh, a 22-year-old student of business and computing and the coordinator of AIDS programmes for youth at the Lebanese Red Cross, talks about AIDS and other sexually-transmitted diseases to schoolchildren, students and workers. Interactivity is the motto. Nowadays in Lebanon nearly all youngsters know what AIDS is about, Darine explains. "But what really counts is that boys and girls can change their behaviour, above all sexually, making the right decisions at the right time, and for this, discussion is crucial." The Damascus meeting gave representatives of National Societies a rare opportunity to debate openly an issue that is still regarded as taboo in the region. More than anywhere else in the world the sexual connotation of HIV/AIDS is sensitive here. "People feel shy about it," admits Rabie Al-Faqih, a 23-year-old volunteer from the Syrian Red Crescent for more than 10 years and a trainer since 1998. "They want to talk freely about the disease, but wait for their friends and colleagues to speak first." A possible entry point into AIDS education is first aid community training - a "rather innocent" thing, as Dr Jari Vainio puts it. In his branch of Swaida, in southern Syria, Rabie has started to include the issue of AIDS as well as other sexually transmitted diseases in his curriculum for training young volunteers, and is now working on unifying first aid training techniques in a manual that will contain specific sections on HIV/AIDS. The region's health professionals have been afraid to be seen to spread "western ideas" in trying to raise awareness about the disease. For Jari Vainio this is exactly why National Societies should help break the silence. And slowly but surely they are starting to. When asked whether values like abstinence and fidelity could prevent the epidemic spreading, all participants agreed that "ideally" they should but unfortunately, in practice, do not. AIDS is here and real so let's face it, they all said in Damascus. In Iran, for instance, the Red Crescent launched a major prevention campaign in the western province of Kermanshah, where a quarter of the country's HIV-positive population live. The large majority are drug-users who probably caught the infection by sharing needles. The National Society last year started support activities for those living with the disease, mainly migrants and former prisoners, as well as educational programmes in schools and universities. These have already reached 8,000 young people, explains the Iranian Red Crescent's Leili Khaleghi. "Special attention is paid to women," she says. Forty per cent of HIV-positive adults in the Middle East and North Africa are women, according to the UN. As a direct result of this pioneer workshop, the National Societies agreed to form a knowledge-sharing network, and over the course of this year Dr Jari Vainio will visit them all to help with education and prevention programmes. Meanwhile a second 'train the trainers' workshop for North African Red Crescent societies is now planned to be held in Libya. |
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