Lee Duffield

Edited by Lee Duffield
Freedom and Truth

Hope for PNG’s HIV Crisis

Madang Provincial Aids Council

Madang Provincial Aids Council

Work being done in Papua New Guinea’s health care systems for prevention of HIV/AIDS, and for encouraging community members from rural areas to come forward for testing and treatment is getting some excellent results.

That’s the view of workers on the front line of the anti-HIV campaign, who concede also, the battle is far from  over.

The human immunodeficiency virus (HIV) that weakens the immune system, ultimately leading to the acquired immune deficiency syndrome (AIDS) was first reported in PNG in 1987.

According to AusAid in 2002, PNG became the fourth country in the Asia-Pacific region to be classified as having a generalised epidemic, as the prevalence rate in the general adult population rose above 1 per cent. It is estimated that 2% of the adult population of PNG, approximately 64,000 people, are now HIV positive, which is the highest incidence of HIV in the Pacific region.

However, current health reports are often unreliable as only selected areas have been studied and laboratory and research capacity is weak in most areas.

Stewart Sarieng Pau, Health Extension Officer at Modilon Hospital Madang says HIV is the cause of most diseases being contracted among the population in villages, because HIV suppresses the immunity of people and leaves them susceptible to contracting and dying from other diseases — like TB or pneumonia. Madang is ranked the sixth highest area of HIV/AIDS cases out of twenty provinces.

“However, these high numbers of people seeking treatment in Madang is not a negative thing. This is good – people are accessing the services available to them. It means people are coming forward to seek our help and treatment services. When more people come to us at Modilon Hospital more of our services are made available and more care can be given to those with HIV/AIDS and providing tests and knowledge to others to prevent transmission occurring,” Stewart said.

“It used to be the case that only the city and more populated areas dealt with treatment, but now those in rural communities throughout PNG are getting education, testing and treatment also. They understand they can fight the disease. A lot of great work is being done by non-government organisations to encourage treatment and testing, not only prevention.

Heterosexual transmission is the predominant means of infection. While approximately equal numbers of men and women are currently affected, young women and older men are disproportionately affected. Significant HIV prevalence rates are found both in large urban areas, such as Port Moresby, and in rural pockets, typically around high risk settings including transport routes, mining and logging sites.

According to World Vision Madang Area Manager Joseph Kapis, HIV is easily spread in areas such as Bogia and Apogee between Highland communities and the village of Madang. This is largely due to the trade of Beetle nut between the communities, along transport routes where different communities interact, and HIV is spread.

“At World Vision we target these areas of trade between communities to educate them about prevention and the severity of the disease. Many people travel through this area so it is a good place to speak to people from cities like Lae and many rural areas,” said Mr Kapis.

“The first HIV and AIDS focused project in Madang is starting in September; it will also target people at Usino Bundi district, Ramu Nickel mine and areas around roads to Manam Island.”

Pathfinder International is a US based organisation operating in Madang since 2006, promoting family planning and contraception to lower the percentage of STIs and HIV-AIDS.

Dick Bart Communications Manager at PathFinder International  says his organisation targets areas with high traffic of people such as highway zones. Their aim is to upgrade health facilities by providing renovations, standard equipment, and safe water supplies for clinics and villages; and improve the quality of reproductive health services and care at health facilities and aid posts.

“We only deal with the areas that are accessible by roads, we evaluate and get the name of the staff, the populations of the village and get someone who can give us the scope of work. We do renovations on the buildings; collaborate with local government parties and health department to fund this.  We went to Kaka Island recently and worked on the district hospital and three medical centres, we focus on facility renovations and training for the health centre workers. We educate them on family planning and community leaders”, said Dick Bart.

In Goroka PathFinder focusers on women’s health, aids schools, and trains students to speak at their home villages. They have implemented a contraception teaching tool, a beaded necklace style of instrument where coloured beads represent days in a women’s menstrual cycle. This is based on a successful program with illiterate people in India. There’s also much focus on encouraging use of condoms; education for children about how HIV-AIDS can start; and in general openess, to fight against stigma borne of misunderstanding and lack of knowledge

“This is the information people must understand. I think what is not seen is the isolation and the loneliness of dying on your own with AIDS and the terrible effects on those in the final stages of the disease. If we can show people the seriousness of the disease they will be more likely to use contraception”, Mr Bart said.

He is also concerned about the high exposure of women, because of social factors  like their economic dependence and lack of access to education:

“Mostly young women are testing positive, almost three times as many women as men. Why don’t people fear the disease? Many men are having vasectomies as a method for birth control, but this creates more incidences of unprotected sex and does not lower the rates of HIV or STIs.”

Experts on the HIV/AIDS epidemic in PNG say they need to keep up the flow of information –  “epidemiological surveillance” they call it.

They are obtaining help from organisations around the world to put in more rapid test kits and other means to keep track of the spread of the disease.