Saleh Dabbakeh, in Benghazi, Libya
Nothing distinguishes five-year-old Yousuf from the other children kicking the ball at lunchtime in the playground of Al-Ouruba kindergarten. That evening, he is still kicking the ball, this time with a much older audience, mostly Red Crescent staff and volunteers at a gathering organized by the Libya Red Crescent Society (LRCS). Yousuf is one of 417 Libyan children living with HIV/AIDS.
These children are not the only ones suffering from the disease. Ministry of health data in five North Africa countries, Algeria, Tunis, Morocco, Libya and Egypt, shows that cases are on the rise and that the disease is creeping slowly but steadily in an area that seemed immune to it some years back due to conservative sexual traditions and cultural and religious restrictions on premarital sex.
Officially, the main cause of infection is injected drug use. But other reasons such as blood transfusion and commercial sex seem to play a part in this steady increase as societies in the region continue to open up socially and economically.
So far, few countries have taken the matter seriously, limiting their ability to wage a successful battle against this most devastating disease. A combination of cultural taboos on sex education, reproductive health, use of protective measures and denial are some factors behind this trend.
But within this dark scene of HIV/AIDS in the region, one can detect some significant pools of light. Parents of the Libyan children have established an NGO to deal with the issue, gather support and, most importantly, to dispel the stigma and fight discrimination levelled against their innocent children. "My kid did not do anything wrong," says Akram, 35, secretary of the Association to Care for Infected Children. "He was being treated at a hospital and was only one and a half years old when he was infected." Stigma is such a delicate issue and a source of fear that parents did not include the words HIV/AIDS in the name of their NGO. "The kids stayed in Italy for nine months," Akram says. "They were treated like all other children, but they were able to feel the difference upon their return to Libya."
The Association to Care for Infected Children found a very solid and supportive ally in the Libyan Red Crescent, which has been in the forefront to support the children and their families. This support culminated last month in the convening of a workshop in Benghazi, Libya to train trainers on combating HIV/AIDS. Sponsored by the Libyan Red Crescent and the Federation's Amman Regional Delegation, the meeting hosted more than 30 participants from Libya, Egypt, Morocco, Tunis and Algeria.
The first of its kind for Red Crescent Societies in North Africa, the workshop revealed a positive development – National Societies in North Africa are fully aware of the disastrous consequences the disease might have in the region and are doing something about it. They feel that the time to stop the disease is now. And they are willing to assume a leading role in combating HIV/AIDS in their respective countries before the situation slides out of control.
"Infection rates in Algeria are alarming," says Dr. Jamal Abdulnour, head of the health/AIDS department of the Algerian Red Crescent. "Infection percentages are as high as Tunis and Morocco combined." WHO and UNAIDS estimate that there are 440,000 cases of HIV/AIDS in the Middle East and North Africa – a far cry from official government estimates that run only in the hundreds.
These alarming estimates and the plight of children like Yousuf are wake up calls for the region to start addressing the situation with open minds. In this context, participants in the Libya workshop decided that they would share knowledge on HIV/AIDS with their volunteers through intensive training courses. Volunteers will form an arrowhead to penetrate taboos and cultural resistance to dissemination of prevention methods to their peers. Hence, youth to youth education and raising awareness will be major contributions of Red Crescent volunteers to national prevention programmes in their respective countries.
Akram spoke to participants at the workshop, which also featured presentations by Libyan HIV-positive children. The youngsters showed an extremely positive attitude regarding their daily experiences and stigma. "I have many friends who know that I am HIV-positive and this does not stop them from being my friends, but sometimes this is a problem with people I do not know," said a 15-year-old participant. "My friends and I play football together and we talk about my infection in order to dispel a lot of misunderstandings about HIV/AIDS."
Such positive attitudes by children living with HIV/AIDS are not matched by similar public understanding. "Stigma results from ignorance about the nature of the disease," said Leena Al-Hadid, a young trainer from the Jordan Red Crescent involved in the workshop. "Much more can be done to educate people on the disease, particularly on methods of transmission, to eliminate many wrong ideas about HIV/AIDS and change people's perception of it."
This is the second workshop of its kind in the Middle East and North Africa (MENA). It comes on the heels of a similar workshop held in Damascus last December. The two meetings are stepping stones on a long way to bring the fight against HIV/AIDS to the fore in the region.
On 8 May, World Red Cross and Red Crescent Day, the Federation began a two year, worldwide campaign to fight stigma and discrimination against people living with HIV/AIDS under the slogan, The Truth About AIDS. PASS IT ON... In an indication that taboos on HIV/AIDS are crumbling, a number of Red Crescent Societies in the MENA region, such as Iran, Jordan, Tunis, Morocco and Algeria launched activities, held press conferences and celebrations to highlight the campaign.
Among all the countries in the region, Iran has been playing a leading and open-minded role in the fight against AIDS. In Kirmanshah province, where many drug users have contracted the disease, the ministry of health has been providing treatment and clean needles to stop the spread of the disease. The Iran Red Crescent organizes awareness-raising activities among school and university youth and counselling sessions at some of its clinics.
Participants at the Benghazi workshop, which was opened by Solayman Eleghmary, secretary general of the Libyan Red Crescent, and Christer Aqvist, head of the Federation's regional delegation in Amman, decided that learning through play and other interactive participatory approaches is useful in disseminating knowledge about the disease. Hence, card games and the Fleet of Hope, a Federation designed game, are being adapted to fit the cultural context of the region. The Arabic version will feature North African men, women and children in their national dress in order to bring the reality of HIV/AIDS closer to the minds of people in the region. This will be later adapted to fit each sub-region in MENA.
"HIV/AIDS is here and we have to deal with it," says Dr. Omran Fituri, head of the Libyan Blood Bank and member of the National Committee for the Prevention of AIDS. "The situation can still be brought under control. Our task is to make sure that it does not turn into a disaster like in many other parts of the world."
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