In Morocco, the struggle against HIV has been so successful in recent years that campaigners worry about losing funding for combating the virus, but for people living with the disease it remains a heavy stigma.
In Casablanca, a group therapy workshop offers HIV patients an opportunity to speak openly about their disease. “Here I feel normal, I’m treated like a human being,” said Zineb, a 29-year-old mother.
Organised by the Association for the Fight Against AIDS (ALCS), on a recent Thursday the workshop brought 12 HIV patients together with a psychologist and a therapist. The ALCS also organises follow-up therapeutic care in hospital, and prevention and screening campaigns, with funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
These programmes were developed shortly after the first HIV case was detected in Morocco in 1986. This early start is partly why UNAIDS, the Joint United Nations Programme on HIV/AIDS, calls Morocco a “model country” for its HIV response.
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Thanks to improved screening, access to treatment and monitoring, new HIV infections in Morocco declined by 42 percent between 2010 and 2016, compared to an average reduction of four percent across the rest of the Middle East and North Africa.
Morocco had 350 deaths from AIDS in 2018, from a population of about 35 million. But some groups remain vulnerable, with intravenous drug users, men who have sex with other men, and sex workers accounting for two thirds of Morocco’s 21,000 identified cases.
And the stigma attached to those infected remains high, even within the family. “My mother treated me like a murderer. For a long time I felt alone in the world,” said Youssef, a 28-year-old who has twice attempted suicide.
Like other HIV patients interviewed, he asked to be identified by a pseudonym. And all of them – save for a 40-year-old considered very lucky by the group – have either hidden their illness or been rejected by loved ones.
Don’t tell them anything
In this conservative Muslim society, where sex outside marriage and homosexuality are illegal, HIV patients seldom talk publicly about the virus. “The subject is taboo, because the infection is linked to sex, itself a taboo subject in Morocco,” said Yakoub, a 25-year-old ALCS worker.
“The social rejection is such that some (HIV patients) lose everything: family, friends, work, home,” he said.
Zineb, like many HIV patients, hides her medication to conceal her illness. For 10 years, the former teen mother has told her family that she is being treated for diabetes. “My 17-year-old son knows nothing, I can’t bring myself to tell him, I’m too afraid,” she said with a sad smile.
“Once you’re sick, you’re no longer a person,” said Sakina, a mother who says she never speaks of her illness except with doctors, the ALCS staff and other HIV patients. Like 70 percent of HIV positive women in Morocco, Sakina was infected by her husband. She cannot bring herself to tell her 15-year-old son that he is also infected.
She has always lied to him but she can no longer sleep at night, she told the group through tears. “My advice: above all, don’t tell him anything,” said a young man. “For your sake, let him find out from someone else,” another group participant suggested.
Then the psychologist interjected to say that private sessions are available to “reflect on these difficult questions”. The shame of HIV is so entrenched, it even permeates the medical establishment.
“For 30 years we’ve been talking about it, the virus is well known but the discrimination is still there,” said Dr Kamal Marhoum El Filali, head of the infectious diseases department at Ibn Rochd Hospital in Casablanca, which hosts an ALCS branch.
“The stigmatisation isn’t just from society but also from medical staff within the hospital environment.” Amina, another group therapy participant, experienced this first hand.
“When I went to the hospital to give birth, no one wanted to take care of me, no one wanted to touch me, I ended up in intensive care,” she recalled indignantly. Others in the session though were grateful for the care they had received.
“We are lucky to be under the care of the infectious diseases department: we are well cared for compared to others, considering the lack of funding and disrepair in Moroccan hospitals,” said another participant.
‘Victim of own success’
The emergency room at Ibn Rochd is sometimes overwhelmed with doctors each seeing up to 40 patients a day. But the infectious diseases department is always spotlessly clean, providing personalised support as ALCS staff liaise with the medical teams.
But how much money Morocco will receive to continue its fight against HIV will be determined at a three-yearly conference for the Global Fund in October. With funding declining globally and controversy surrounding the management of UNAIDS, ALCS president Mehdi Karkouri fears financial cuts.
“We are a victim of our own success: because our results are good, we risk losing funding,” he said.
Nigeria’s “Street Doctor”, Samson Shonowo provides free healthcare for the poor
From free maternal healthcare to caesarian sections and more, Dr. Samson Shonowo opens his doors to whoever needs help
Illnesses are no fun for anyone, but imagine being seriously ill with a serious condition that requires not just visits to the hospital, but surgery.
Now, imagine being too poor to afford the visits and the treatment necessary to get better.
This is where “The Street Doctor” comes in. Dr. Samson Shonowo of Shonowo Hospital is popularly called ‘The Street Doctor’ because he’s made it his mission to care for the sick in local communities who, otherwise, would not be able to afford their medical bills.
The 37-year-old started his career as a young medical officer at General Hospital in Agege Lagos, where he found himself in constant turmoil, having to attend to several patients who could not afford to pay for their healthcare.
“Every time I had to break the news to a patient or their loved ones that they would be needing surgery and I see their shoulders sag in despair and hopelessness, my heart broke.”
“These are people that can barely afford money to pay for hospital registration cards or recommended lab tests. I decided to do something about it,” he said.
What Dr. Shonowo did was to open his own hospital about 4 years ago and take on as many charity cases as he possibly could.
From free maternal healthcare to caesarian sections, breast lump removals, fibroid removals, hernia repairs and other procedures, Dr. Shonowo opened his doors to whoever needed help.
“It’s not easy, I have to tell you,” he says.
“It’s hard running a hospital where over 60 per cent of your patients cannot afford their care. Bills need to be paid, staff need to be taken care of and medication needs to be supplied, yet, we do it all without external funding or grants”.
“Standard healthcare is not negotiable. It is a right that everyone deserves to have and I believe that as a private healthcare practitioner, it is my duty to humanity to do my part.”
On government’s responsibility, Dr. Shonowo says the Nigerian government must pay better attention to Primary Healthcare.
“When the primary health care system does well, it meets people’s health needs, and that is essential if we are to make progress toward the country’s health goals.”
“Primary Health Care should be free for everyone to access. It will help with preventive medicine and it will handle most people’s health needs before it becomes a major problem.” he further added.
Dr. Samson Shonowo is making good on his commitment by opening up the Shonowo Free Surgery program again. This November, 100 hernia patients will be screened and treated for free.
Intending patients can register and book appointments via the hospital’s website.
The views expressed in this piece are the author’s own and do not necessarily reflect News Central TV’s editorial stance.
UN to tackle measles outbreak in DR Congo with emergency vaccination
The campaign aims to vaccinate around 825,000 children in 24 regions, over a period of nine days, the body said.
The UN health agency on Wednesday said it would carry out an emergency vaccination campaign in six DR Congo provinces to counter an outbreak of measles that has killed 3,600 since the start of the year.
Authorities have registered more than 183,800 suspected cases of the disease, preventable with a vaccine, from the start of the year until September 17, the World Health Organization said.
It said 3,667 people had died in the outbreak, most of them children. That is more than the number who have died in an outbreak of Ebola in eastern parts of the Democratic Republic of Congo.
The campaign aims to vaccinate around 825,000 children in 24 regions, over a period of nine days, the agency said.
“The DR Congo is facing this situation because a lot of children don’t get routine vaccinations,” WHO representative Deo Nshimirimana said in a statement.
In the country’s east, Ebola has claimed more than 2,100 lives since erupting last August.
Measles is a highly contagious disease caused by a virus that attacks mainly children. The most serious complications include blindness, brain swelling, diarrhoea, and severe respiratory infections.
Last year, cases more than doubled to almost 350,000 from 2017, according to the WHO, amid a rise in “anti-vaxxer” sentiment in some countries that can afford the vaccine, and lagging resources for the preventative measure in poorer countries.
Scientist say these self-lubricating condoms may boost use, and prevent STDs
A perpetually unctuous, self-lubricating latex developed by a team of scientists in Boston could boost the use of condoms, they reported Wednesday in the journal Royal Society Open Science.
Protective sheaths made with the specially treated membrane take on a slick and slippery quality in the presence of natural bodily fluids, lab experiments showed.
And unlike water- or oil-based lubricants added to commercially available condoms, the hydrophilic — or liquid-loving — latex retains its “slippery sensation” almost indefinitely.
“A majority of participants — 73 percent — expressed a preference for a condom containing the lubricious coating, agreeing that an inherently slippery condom that remains slippery for a long duration would increase their condom usage,” the study concluded.
“Such a coating shows potential to be an effective strategy for decreasing friction-associated pain” — for women and men — “and increasing user satisfaction.”
Condoms prevent pregnancies and the spread of sexually transmitted diseases. Some are made of lambskin but most are synthetic, manufactured from latex or polyurethane.
Without lubricants, however, all of these materials will chaff during “repeated articulations,” the term of art used by the researchers to describe thrusting motions. Added emollients wear off with use.
Discomfort during intercourse and reduced pleasure — noted by 77 percent of men and 40 percent of women in a nation-wide survey in the United States — are often cited as reasons for not using condoms at all.
Researchers at Boston University led by Mark Grinstaff addressed these problem by adding a thin polymer coating of moisture-activated molecules that entraps liquid rather than repelling it, as latex does.
The polymer-treated condoms did not affect the latex, and “provides consistently low friction even when subjected to large volumes of water, or 1000 cycles of articulation,” the study reported.
In touch tests, volunteers expressed a strong preference for condoms that were “inherently slippery” and remained so for a long time.
Because the material has yet to be approved by the US Food and Drug Administration (FDA), the liquid-loving latex has yet to be tested during intercourse.
But more than 90 percent of the volunteers said they would consider using the coated condoms, and more than half said they would likely use condoms more frequently if the perpetually slippery ones were commercially available.
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