This kind of article makes my stomach turn. There is nothing about harm reduction. Ethnocentricity aside, it uses seropositivity rates among VCT clients to try to say something about the epidemic. VCT seropositivity rates say a lot about VCT targeting and nothing about the epidemic itself.
HIV professionals in Myanmar today can rest assured that I have nothing critical to say about them.
Jamie
++++++++++++++++++
In peril: Pangsha grapples with HIV/AIDS
Imti Longchar
morungexpress
June 17, 2014
Pangsha, last of Nagaland’s villages under Tuensang district, bordering Myanmar, is silently grappling with HIV/AIDS.
Its people, formerly renowned for their bravery and valour, are on a face-off with a threat far ominous and fatal than the guns and machetes they were used to go to battle with.
In the early 1980’s, this border area, inhabited by the Khiamniungan Nagas, connecting to Lahe and Khamti towns of the Naga areas in Myanmar, was notorious for illicit drug trafficking and gun running. This led to a high rise in the number of Injecting Drug Users (IDU). This was further confounded by unsafe pre-marital sex and an unaware population in an underdeveloped world - it is now taking its toll.
The villagers do not have much of an inkling of what they are up against.
The numbers
Data received from Nagaland State AIDS Control Society (NSACS) on Pangsha’s HIV/AIDS scenario reveals that at least 104 people from Pangsha village area were tested HIV positive as recorded from 2006 till date.
This figure was reported from the four villages under Pangsha area namely Pangsha Old, Pangsha New, Dan village (International Trade Centre) and Wontsoi, with a total population of hardly 6000. The villages are located a few kilometers apart with the nearest town Noklak located 30 km away.
Out of the total tested positive, 58 are female and 46 male. Further, 48 of them are in the age group of 25-34 years of age, 39 between 15-24 years, 11 between 0-14 years and 6 between 35-50 years.
Given the external indicator, the prevalence of HIV is expected to be much higher, keeping in mind that the summary of the data indicated are only records of people coming voluntarily to get tested at the Integrated Counseling and Testing Centre (ICTC), Noklak and Tuensang District Hospital Voluntary Counseling and Testing Centre (VCTC). “If there is to be a compulsory testing of HIV in all the said villages, the figures may turn out to be very frightening,” fears a village youth from Pangsha new village.
Earlier, a blood testing camp held at Old Pangsha during 2004-05 by the Eleutheros Christian Society (ECS) Tuensang and ICTC Noklak reported a total of 54 HIV positive out of 740 villagers tested.
Noklak, a node for the eastern Tuensang region, does not lag far behind in numbers. Latest reports from Noklak ICTC reveal that the HIV scenario in Noklak is spiraling up at a disturbing rate. Out of 1136 tests made from 2013 till date, 82 were tested positive- which includes 22 male and 21 female from the general population and 39 during Antenatal Care (ANC).
A comparison of the HIV prevalence rate with other areas/district in Nagaland State in terms of population and area could reveal that Pangsha area and Noklak town stand out with the highest rates.
Resistance to “new activities”
Pastor of Old Pangsha, Pungom Lam, recalls how the villagers, wary of “new activities” at first, were reluctant to have their blood pricked out and tested. “It was only when we, the Church leaders, led the way for the blood test that they were encouraged to follow suit,” said pastor Lam.
According to the pastor, nearly 30 of them have already died.
Drug users have comparatively lessened- with only ten of them identified in one of the villages, (as per the village council), pre-marital and unprotected sex with low level of contraceptive knowledge and teenage pregnancy remain an issue of great concern and is the main source of contracting and spreading the virus.
Haimong Lam, village council chairman of Pangsha Old, maintains that villagers are gradually becoming more informed on the deadly virus as compared to earlier years, chiefly because of awareness provided by NSACS and other NGOs.
Nonetheless, comprehensive education reaching all sections of the population still remains the need of the hour.
As chairman Lam puts it, “There are villagers who have been tested positive but simply refuse to take medication while some get angry when asked to take medication because of friends telling them they have bad disease (sic).”
“There are also instances of HIV positive people stopping medicine and discarding them because it causes measles-like skin diseases,” he added.
Intervention
The village council, Church and students union have now begun to play a role in the intervention process, the chairman said. “If we suspect that a villager might be HIV positive, we urge him to go for blood test and take Antiretroviral Therapy (ART).”
Chairman Lam admits there have been seminars in the villages but few and far in between. For Pastor Lam too, “concerned NGOs need to hold regular awareness campaigns, educate the villagers on a war footing.” He maintains that a large chunk of the population is still not serious and considers the disease lightly.
“Though people here are aware, they don’t take it seriously. Sensitization and awareness need to be conducted in every household to make them understand, instead of confining to Public Health Centres (PHC) alone,” said T Hosea Meya, Pharmacist at PHC Pangsha New.
Lack of knowledge or the inability to comprehend the gravity of the situation might have to do with lack of proper education among the villagers. Education arrived very late in the area with the villagers still struggling with a first generation of school-going children, many of whom have not passed class ten.
Pinpointing the alarming rate of HIV prevalence at Pangsha area and Noklak, aggravated by lack of proper road communication to avail treatment, pharmacist Meya and chairman Lam pointed out that an ART centre either at Noklak or in the Pangsha range is the need of the hour. At present, ART centres are located at Tuensang town and Longpang village, more than a hundred kilometers away from Pangsha and take two days to reach.
“Majority of the villagers here cannot afford to travel all the way to Tuensang to avail medicine and get treatment. It’s too expensive for them. In addition, there is no public conveyance, and villagers have to hire private conveyance to travel even to Noklak which is too expensive for the farmers,” Meya said.
“Until and unless there is intervention from the outside on logistics and knowledge, HIV scenario at Pangsha will remain a major threat to its population,” Thangoi, an inhabitant of Noklak town said.
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