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Ono Hiromi (Japa Vietnam's staff) |
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The first public report concerning AIDS patients was issued in the USA
in 1981. The history of AIDS is only 22 year old.
Two years later, in 1983, the virus producing AIDS was discovered in France
and in the USA. In 1985, the antibody medical examination, i.e. an examination
to find out an infection of the HIV virus, was developed. Medically speaking,
the AIDS disease was fast made clear and the medicine to control it has
been already developed.
The cause of the HIV/AIDS infection and the ways it spreads (by blood transfusion,
sperm, vagina's secreting fluid and breast milk) are also medically clear.
It is a disease very easy to prevent. Anybody with a right knowledge and
a life style that follows preventive behavior should be, easily, able to
defend oneself from HIV infection. On top of that, the infection of HIV
virus is not strong at all.
HIV has spread very rapidly everywhere and the international community
has also taken fast action against it. The first International AIDS Congress
took place in 1985. The UN started in 1996 a combined AIDS Program as a
sign of a global commitment.
It is estimated that at the end of 2001 there were 40 million people infected
with HIV/AIDS and over 20 million persons have died of AIDS. Why is it
that HIV infection, that could be so easily prevented and brought to control
with new developed medicines, has spread so widely during the past 22 years,
without being able to stop it?
Africa is the continent where HIV/AIDS has shown explosive developments
followed by Asian countries. The reasons for it vary from country to country,
but lack of preventive practical education in many developing countries,
as well as the superficial knowledge regarding the dangers of AIDS are
serious problems. On the other hand, the low rate of compulsory education
and the lack of human rights' awareness exert great influence.
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A different problem is that HIV infection is mainly caused by sex practices
and it is very difficult to change them, due to the traditional sexual
customs, moral standards and life practices. For instance, in some African
countries there is a social custom of well considering those women that
bear many children, and this is a hindrance to the wide use of condoms.
Young Japanese today have become open to sexual activities and, since their
awareness has not changed much, the cases of HIV infection among the young
have increased.
It is believed that, in order to solve the AIDS problem, there is a need
to reform the social system and customs. This requires a step by step long
way.
From the medical point of view, the situation surrounding HIV patients
differs enormously according to the economic levels of each country. In
Japan and other industrial countries the so-called cocktail method was
developed in 1996 and the possibilities to control the outbreak of AIDS
through pills developed quite drastically. In these countries AIDS has
changed from incurable, leading to death, to a chronic disease. There,
HIV patients are getting accustomed to just survive with the disease. It
is different for the patients of developing countries who are not blessed
with good medical systems, for whom the outbreak of AIDS leaves them without
hope of living long.
From the points of view of preventive awareness and medical systems there
is a clear gap, concerning AIDS, between the industrial and developing
countries, as numbers show. When one considers a human ideal that medical
innovation technology is a property of humankind and, thus, should also
be used to cure all patients suffering from HIV/AIDS infection, the realities
surrounding us lead us to reflect on the injustices and absurdity of our
world.
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According to the official figures given by the government in December 2001,
there were 41,622 HIV infected and 6,251 AIDS patients. About 3,421 persons
died of AIDS. Compared to Japan, the number of infections in Vietnam is
10 times higher. According to some opinions, the reality is ten times more
than the numbers given, but it is very difficult to know the objective
situation.
The use and overuse of needles for drug injections count for about 60 per
cent of all the infections in Vietnam. The cases of HIV infection among
sex workers have gradually increased, especially in the southern provinces.
Many of them, as well as drug addicts in Vietnam, live in poor areas and
HIV/AIDS hits them badly. Nowadays, people of other social ranks, like
new soldiers and police officers, teachers, housewives and university students
are also starting to be affected by the HIV infection.
In the city of Ho Chi Minh 7 hospitals perform charged HIV medical examinations.
Pregnant women consulting a doctor are free to have HIV examination, but
it is compulsory for new military personnel and prisoners that are drug
addicts. Some public hospitals in Ho Chi Minh have a section for HIV/AIDS,
but that is out of reach for the poor and the daily experience shows that
many hospitals refuse to treat AIDS patients.
Last June a new HIV preventive medicine, made in Vietnam, was developed,
but people have to pay 350 yen a day for it. Since patients have to drink
it daily and the average monthly incomes of slum dwellers are about 5,000
yen, they can not afford the cost of the medicine.
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The UNAIDS, a UN-sponsored Program, runs through WHO various projects for
which Japan, USA, Germany, Canada and Australia provide funding to run
workshops, blood examinations, and to buy medical machines and automobiles
in different countries. Such foreign assistance is channeled through the
Vietnamese government and it does not reach the people.
On the other hand, ordinary people do not participate in activities regarding
AIDS. Catholic Sisters, mainly, and some volunteer medical personnel are
taking care of AIDS patients, but it is by no means enough.
The Vietnamese government produced a 10-year Communication Program that
tries to create social awareness regarding AIDS, among the youth and decided
to tackle the problems of high-risk sectors, like sex workers and drug
addicts. The government has made a network of several official organs,
like the Social Welfare and Labor Departments, the Social and Invalids'
Committees, the Police Department etc., to deal with the problems of AIDS.
Nevertheless, the fast increase in the numbers of HIV infections has provoked
a frightened campaign to arrest, as soon as possible, all HIV suspects,
in order to bring to an end the whole issue.
During my visit to Vietnam last August I heard the news that, from a year
ago, the government had declared a national campaign, under the slogan
of wiping out drug addicts, sex workers, homeless and street children,
all kinds of criminals. As a result, only in the city of Ho Chi Minh 17,000
persons were put in 12 jails, but for lack of space they were planning
to open more jails.
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When our team of Japa Vietnam visited Ho Chi Minh City on 11 August of
this year, Mr. Van told us that he would like us to meet a young person.
One of the activities of the group working with Mr. Van is with street
children. Some of those children collaborate also with the group as volunteers.
Truong (his nickname), now 18 years old, was one of them. At the beginning
of the year and due to the new control policy, he had problems with the
police and was arrested. Mr. Van's group looked around for him but they
could not find him. Later on, the group realized that Truong was put in
a jail of Binh Thuan, the next Province. They visited his mother, who is
psychologically weak, but she did not inform them about the whereabouts
of her son. In fact, they found out later that she did not go to visit
him for already half a year. In the mean time, Truong got dystrophy and
was unable to walk and the police transferred him to a hospital in Binh
Thuan province to die.
Truong was a drug addict infected with HIV. When Truong was brought to
the hospital he could still remember the telephone number of Mr. Van and
asked the doctor to call Mr. Van and inform him where he was. Mr. Van's
group could finally detect him and went to visit him. They made immediate
arrangements to bring him to a hospital in Ho Chi Minh and just 10 days
before our arrival they moved him by car to the city. The first hospital
where they interned him refused him after a few days. Just two days ago
he was moved to a new hospital.
After telling us the story of Truong, Mr. Van asked us whether we would
like to pay a visit to him in the hospital. Three of us, Miss Kato, Fr.
Ando and myself followed Mr. Van to the hospital. We bought some foodstuff
in the shops of the hospital and while we were there Mr. Van told us: "The
first time I met Truong again, after several months, he had changed so
much that I was totally caught by surprise." Mr. Van is always caring
for incurable AIDS patients in the slums and he, seldom, shows in his face
any emotion, but this time his lips were trembling.
We entered the patients' room where Truong was lying in bed. The only thing
he had was a mat beneath his body. The bed was surrounded with some bars,
like a fence. We saw handcuffs hanging down from there. They told us that
he was not yet released. One of the collaborators of Mr. Van's group was
taking care of Truong in the hospital. There were old newspapers on the
floor and also on the mat where he was lying. Mr. Van spoke first with
him and afterwards we also exchanged words of encouragement with him, under
the curious surprise of several people who gathered in the corridor, near
the window of the room. When Truong entered the hospital the other patients
looked at him with discrimination, but Mr. Van's group talked often to
them and they gradually showed a friendly attitude towards him. We waited
for Truong to calm down and then we offered him some food. He drank the
soup and ate bananas with much joy.
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On August 19, a day before coming back to Japan, we asked Mr. Van to meet
with Truong again. We were told, then, that the hospital had refused to
keep him and he was back home. Mr. Van's group brought him to their office
and we met him there. They said that it was also good for Truong to go
out from time to time.
Truong, drawing in his arms and legs, bones covered by skin, was lying
on the floor with vacant eyes. When I watched him I worried very much,
because he seemed to have lost all energy and was unable to move, but then,
when Mr. Van's staff woke him up and we could see him reacting with his
head to their questions, I felt relieved. Truong could not recognize any
more his former friends. They showed us an album of photos with Truong
when he was still healthy, but there was almost no similarity with the
young one we had in front of us. Yun, one of the staff members encouraged
him, "Truong, you have to eat much more and get healthy again".
Truong, pointing at his insensible feet, answered back, "I eat but
I can not get strong".
When we saw him off, Ando told him, "Next time we come back we want
to see you recovered". I shook his hand and I still feel clearly how,
unexpectedly, Truong held my hand strongly. His deep desire to live together
with his lack of all hope touched painfully my heart.
Back in Japan I couldn't forget him and after discussing the matter with
Ando we decided to provide the needed funds for his medical treatment and
medicines. I didn't want him to die and I was, just, praying that he could
recover again.
On October 3, Mr. Van sent us an e-mail message; "The sad news is
that Truong died yesterday. We lived with him and took care of him for
about two months". Mr. Van's group had tried all means to save him.
The police had caught him and they could not find his whereabouts for more
than half a year, but finally, after they could contact him, they were
able to accompany him for, at least, 2 months.
My first reaction was, "what a pity, it was too late". Normally,
it seems that when a person is infected with the HIV virus it takes from
5 to 10 years to get AIDS, provided that no treatment is given. Truong
had been in jail, under very poor conditions, during 7 months and, due
to his HIV infection, his body lost all immunity and became very weak.
If the police would not have arrested him, he could have lived with health
for many more years. The vacant face expression of Truong I saw when I
met him at Mr. Van's office remained vividly printed in my mind, since
then.
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In August of this year, we met with a group of about 30 persons at the
"Condom Cafe". The participants, some over 60 years old, were
mainly young collaborators of the group of Mr. Van and belonged to 4 slum
communities. Since they live in far away places, they seldom come together.
We gathered together with them and shared our opinions and the activities
we ordinarily perform.
They introduced themselves one after the other: "I'm teaching 12 street
children". "I participate in the study group of Mr. Van and teach
AIDS awareness and basic education of how to read and write". "I
distribute condoms in District 7 and bring sick women to the Health Center".
All of them were ordinary residents of poor slum communities who usually
participate and cooperate with Mr. Van's group. Many have used drugs before
or have among the members of their families drug addicts or AIDS patients;
some of them have relatives that died of AIDS. Slum dwellers that have
AIDS suffer from discrimination less than other citizens, according to
Mr. Van. People of poor communities confront AIDS and other problems supporting
mutually each other and living together in communities. Mr. Van's group
promotes the use of condoms to the sex workers and invites drug addicts
not to use in common injection needles.
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They showed us a Video program with their activities. All of us enjoyed
the show in which the volunteers visited a school in a nearby province
to perform a program about AIDS, recreation activities for street children
and a relaxation picnic for families that had lost relatives because of
AIDS. Some persons appearing in the Video had already died of AIDS. I feel
the interest of Mr. Van's group to record the human drama of each one of
those persons who, after being drug addicts for a long time, become HIV
positive and end their lives as victims of AIDS. Here it is still impossible
to prolong life by using medicine, but the AIDS patients are friendly accepted
and the volunteers try to build communities with them.
The day before departure we paid a visit to the "House of Hope".
Eleven young persons that are HIV positive live there and attend vocational
schools outside. Almost half of them already graduated from school are
looking for jobs. Some can not continue their studies and drop from school
and since it is difficult to find a job, some children try new skills,
like learning how to use a computer.
The volunteer staff makes all efforts to confront the hardships of the
children who, accustomed to live in the streets, have strong personalities
and get easily into a fight, but at the same time have lost all confidence
in themselves. In August, the government organized in Hanoi a national
conference with children suffering from HIV/AIDS and some participated
exposing their opinions there. That helped them to gain confidence. In
the center they made them write their impressions of the conference and,
among many other trials, they also teach them musical instruments. We received
a very good impression of our visit to the children of the House of Hope.
The children looked happy and they were respectful.
One can say that the people in the slums and the children of the House
of Hope that are supported by the group of Mr. Van are certainly lucky.
It is impossible to know how many HIV/AIDS victims are left abandoned without
any treatment and care, because volunteer people, like Mr. Van's group,
are physically unable to assist them. That's why sad incidents that surpass
all imagination tend to occur, almost daily.
People do not expect anything from official policies, but put their expectations
in the activities of groups like Mr. Van's and the House of Hope.
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