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World AIDS day falls on 1st December 2009:

No compromise with AIDS

Dr. Nimal Edirisinghe

Sri Lanka's school curriculum is changing with the introduction of AIDS awareness needed not only to protect children from the deadly disease but to instil values on leading a better life. It is important that we talk about sensitive issues like AIDS (Acquired Immune Deficiency Syndrome) to protect our children because if we hide under the blanket of mystery, deadly consequences can happen. "There is a misconception that AIDS is spread from mosquitos which is not true. The stigma discriminating patients who have the disease is still present in Sri Lanka," said the Director of the National STD (Sexually Transmitted Diseases) and Aids Control Program (NSACP), Dr. Nimal Edirisinghe. Today, we have successful AIDS awareness programs for schools in the Sabaragamuwa Province. "We are thankful to Chief Minister Mahipala Herath who sanctioned the AIDS awareness programs in schools in the Sabaragamuwa Province. If the rest of the schools in the country follow suit, then we can prevent the spread of AIDS."

Since a substantial segment of the population are students who usually sit for the O/L, it is important to enlighten them on social perils so that they could successfully face the challenges and threats of society. In other parts of the island, there are many international and national schools which are also participating in the AIDS awareness campaigns. Even though their parents don't talk about sex, it is the education system that should make children understandard how they can protect themselves when they mature into adults.

Sex is still a taboo in Sri Lanka but by not talking about the various Sexually Transmitted Diseases (STDs) and AIDS, the future generations will contract them from the simple fact of not knowing about it.

"Even though Sri Lanka is still a low prevalence country for HIV/AIDS, the number of AIDS victims in the country is increasing," said Dr Edirisinghe.

He said, "There are some who don't divulge the disease for fear of discrimination while there are HIV infected people who spread it since they don't test their blood. Many more don't protect themselves from this disease so we have to work on more than just awareness campaigns to get the message across."

The NSACP building located near the Health Ministry doesn't have a signboard due to the stigma of STDs but has a small notice with its abbreviation. "We have a clinic to do free HIV screening tests managed by 6 specialists with a team of 30 doctors.

With me, a total of 110 staff is working for the NSACP," said the doctor. The General Hospitals and Base Hospitals around the island have free HIV tests and the National Blood Bank screens blood as a counter measure to prevent the spread of AIDS. The NSACP maintains strict confidentiality to protect the identities of their patients by giving them only a number.

"We place strong emphasis on educating the high-risk group that includes MSMs or men who have sex with men, drug users using unsterilised needles and those who contract HIV from others," stated Dr. Edirisinghe who is at the NSACP for 4 years now.

"If you have the virus, it takes a long time to develop depending on the individual's health.

However, you can infect others which is how some married women get it from their unfaithful husbands," said the doctor. Eventually, infected pregnant women transmit HIV to their children.

There are AIDs patients who live normal lives but it depends on their level of immunity. "While some patients are badly affected by a weak germ, others can live without problem provided they take medication" said Dr.Edirisinghe. Speaking about how they spread the message to the right group, the doctor said, "For example, if an AIDS patient is a commercial sex worker who takes treatment from the NSACP, we use her as an agent in protecting herself and those living in her vicinity. We advise her on educating the high-risk groups in the area."

In addition, the doctor said that they even had to educate the police force. "We have had to train police personnel about sex workers using condoms because they sometimes use it as evidence in proving prostitution. We now have successful advocacy programs to tell the police that they shouldn't discriminate prostitutes with condoms because it is one of the ways of preventing widespread AIDS epidemic. Hence, all high-level police personnel have been enlightened on not condemning prostitutes when it comes to using a condom.

Dr. Edirisinghe explained that the possible spread of AIDs is the linked activity between one high-risk person to another. "It is a linked cycle since we find cases where prostitutes have sex for money in order to buy drugs where they use unhygienic needles and both activities can make them contract HIV.

The deadly HIV

There is also a high incidence of high-risk sexual and drug abuse among males in prisons so we are in the process of educating prison inmates as well," commented the doctor. Often, it takes anything from 6 months to 1 year for HIV positive victims to develop AIDS since it depends on their immune system. "You can easily live with an HIV positive person and not contract the disease. Using the same utensils or washing in the same bathroom which an infected person used will not infect you except only if there is a wound or blood involved," he said. Dr. Edirisinghe enlightened, "The technology is so developed that an HIV positive person can be a parent to a healthy child without giving the virus to their partner or offspring," Dr.Edirisinghe explained. Also, there are ways in which a mother can prevent the transmission of HIV to her child with anti-retroviral drugs.

From the time Sri Lanka detected its first HIV positive person in 1987, about 1160 cases have so far been reported. "Out of this number, we found out that 301 developed AIDS of which 201 have died and the rest are leading normal lives" said the doctor. Commenting on the gender incidence of HIV positive cases, Dr. Edirisinghe said that 20 years ago, the percentage of women having AIDS was 20 percent but today, the percentage has increased to 42 percent in terms of reported cases.

The percentage for men is 58 percent. "The trend is now increasing in women rather than men since they often get it from unfaithful husbands," said the doctor. At the moment, 65% of AIDS victims in Sri Lanka are from the Western Province and the rest of the percentage is scattered islandwide.

If we don't speak on topics about sex, drugs and homosexuality, we will not be able to control the spread of AIDs and HIV in Sri Lanka. "I would advise anyone, not just those who suspect themselves of HIV to get the free HIV test done preferably annually, just to be on the safe side," said Dr. Edirisinghe.

Prevention of AIDS and HIV Infection

The only way to protect from contracting AIDS sexually is to abstain from having sex outside the mutually faithful relationship. Otherwise, risks can be minimized if you:

* Don't have sexual contact with anyone who has symptoms of AIDS or who is a member of a high risk group for AIDS.

* Avoid sexual contact with anyone who has had sex with people at risk of getting AIDS.

* Don't have sex with prostitutes.

* Avoid having sex with anyone who has multiple and/or anonymous sexual partners.

* Avoid oral, genital and anal contact with partner's blood, semen or vaginal secretions. Unless you know with absolute certainty that your partner is not infected, a latex condom should be used during each sexual act, from start to finish. The use of a spermicidal agent may provide additional protection.

* Don't share sharp objects that could become contaminated with the blood of anyone who is or might be infected with the AIDS virus.

* Exercise caution regarding procedures such as acupuncture, tattooing, ear piercing, in which needles or other non-sterile instruments may be used repeatedly to pierce the skin and/or mucous membranes.

Such procedures are safe if proper sterilization methods are employed or disposable needles are used. Ask what precautions should be taken before undergoing such procedures.

NOTE: You cannot get AIDS/HIV from touching someone or sharing items, such as cups or pencils, or through coughing and sneezing. Additionally, HIV is not spread through routine contact in restaurants, the workplace or school.

(Reference: www.healthscout.com)


Your simple cold matters to us !

I stepped into the Bandaranaike International airport hoping to see more than few travellers with masks. But for my surprise I saw only one for the three hours I spent there. I was a bit relieved and boarded the flight hoping to see a lot of travellers wearing masks when I arrive at Arlanda airport. But I was thrilled to see an almost empty airport neither masks no passengers ! What a relief ! I almost forgot all risks and started to move freely. This is not about wearing masks. It is all about Novel Influenza (A)H1N1.

"Oh ! You are having a very simple cold. You don't need to take medicine for that. Anyway who takes medicine for a very minor thing like a cold ? You take medicine for a simple thing like this. Are you crazy to take leave and stay at home because of a simple cold ? Are you crazy to waste your leave on such a matter ? " Those are the exact words I heard many times in my life. May be you also heard the same words at least once in your life. It shows what type of attitude some people have towards sicknesses. This attitude is good for you sometimes but it is not good at all for the common society, especially at a time like this, the Novel Influenza (A)H1N1 is spreading rapidly all over the world including Sri Lanka.

It is heartaching to see the very irresponsible and dangerous attitude of some people in society. Facing a disease without taking medicines or reporting to work is something heroic for them! But they do not think that it is deadly for some others such as the people who suffer from chronic illnesses such as asthma, diabetics mellitus etc. There is a possibility that they can lose their life because of your simple cold and ignorance! What if one of your own family members dies of a respiratory system related sickness because of the selfishness and carelessness of another ?

The Novel Influenza (A)H1N1 is on the rise in Sri Lanka. According to the latest statistics 260 cases had been reported from Sri Lanka from many parts of the country and eight persons had died of the disease. The State, the Healthcare and Nutrition Ministry or the provincial health authorities cannot prevent any type of disease without the support of the general public. It's another impossible mission !

"Oh, I can't breathe and I am shivering with fever. I have loose motion too. I came to office because I have a lot of work to finish. The other reason is I don't have much leave left and want to take leave for my cousin's wedding. So I have to work these days no matter what happens to me. I'll take a rest in the rest room/ladies room and go home after my shift. Then I can save the leave". This is not something new for us. All of us hear this story almost every day in our life and may be you are one of the persons who says this to others. But the time has come to think twice before reporting to work when you have a simple cold. May be you are spreading (A)H1N1 among your colleagues free of charge unknowingly !

"Oh! My son had a cold today but I sent him to the school. Today there is an important science lesson. He can't miss it". This is another story you hear often. How about the other innocent children with chronic illnesses who sit next to your son and study for six hours? May be one of them can lose his life because of your attitude! Step into any road of Sri Lanka and just walk hundred meters. You can find more than one hundred spots where people have spat on the road. Spitting on roads or anywhere possible is something `normal' in Sri Lanka. Some people never cover their mouths when coughing. We can forgive the illiterate people who do not have any idea about hygiene. But how about well educated people who work in reputed companies? It is all about their selfishness and irresponsible behaviour.

It is the State which suffers because of the selfishness, ignorance and carelessness of a few persons. It cost between Rs. 12,000 and Rs. 20,000 to carry out a test to detect (A)H1N1 in one blood sample. And it takes 24 hours. A mask cost over Rs. 18.00. If the infected persons follow the guidelines issued to the public by the Epidemiology Unit of the Healthcare and Nutrition Ministry we can stop spreading Novel Influenza (A)H1N1 immediately. Anyone can gain access to those guidelines and to those issued by the WHO through media and the Internet. It is up to you to save your fellow citizens.

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