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Dear Ethiopians and friends of Ethiopia:
Greetings. This is to invite you all, no matter what your background is
(nationality, race/ethnicity, gender, age, field of interest, employment),
to join a discussion group on HIV/AIDS in Ethiopia. We all have something
to contribute to reducing the burden of this horrible epidemic. Here are
the facts:
• By end of 1997, 2.6 million Ethiopians were LIVING with HIV or AIDS; of
these 2.5 million were adults ages 15-49 and 140,000 children;
• ~20% of pregnant women (most representative of the general population) and
~95% of prostitutes in Addis Abeba have HIV or AIDS;
• 80% of deaths among adults ages 15-49 currently are due to AIDS;
• 700,000 children, currently living, have lost their mother or both parents
to AIDS;
• 60% of males ages 15 to 49 could die by 2009 if current trends continue;
• 87% of new HIV infections are due to the practice of multiple partner
sexual contact;
• In urban areas, 22% males, 8% females, 24% female high school students,
and 53% female high school students engage in sex with multiple partners;
~25% of farmers engage in extra-marital sex and most with prostitutes;
• Only one condom is available for one person for a year;
• Only 48% of the 15-49 age group admitted to using condom during last
intercourse;
We can not be ignorant of the scale of this disease and our bleak future
given:
1. Current deaths reflect infections that occurred several years earlier
because of the 3-10 years lag between HIV infection and deaths.
2. The policy of NOT notifying people with HIV/AIDS that they have the
disease; persons with HIV/AIDS transmit the infection to others without even
realizing it.
3. Health officials also know only about a tiny fraction of the people
who have the disease because of our population's poor access to health
service units (only 40% population does) and HIV testing capability of these
units (especially in rural areas).
4. Setbacks in economic development (30-240 work days lost per year for a
person, healthy workers time off to attend funerals,...) health care,
social structure (women forced upon husband's death to sell sex to obtain
income with less time devoted for the children) and child survival (become
devoid of proper care and supervision so critical during that period of
their lives) caused by the epidemic. Ethiopia is being robbed of both her
present and her future as the disease primarily affects children and the
economically productive age group, the age when people are also forming
families and having children. The staggering health care costs (425-3140
birr during course of the illness given their higher hospital admission rate
and longer average length of stay ) has caused a strain in the
already inadequate and limited Ministry of Health budget.
The statistics on the human toll was very visible when I visited Ethiopia in
December ‘98. Unfortunately, prevention and control efforts were much less
visible. The problem also has hit home and now neighbors, friends and
relatives are succumbing to this scourge of our time. These are the reasons
for initiating this discussion group.
The discussion group may initially focus on what we can and should do
about the epidemic individually and together. Here are some suggestions:
1. Collect the latest information that will allow understanding of the
burden of HIV/AIDS and prevention/control efforts. Is the population
receiving information on the risks of HIV/AIDS and encouraged to practice
responsible sexual behaviors? Are condoms, HIV counseling and testing and
blood screening readily available? What interventions are targeted at
prostitutes who are the focal sources of spread of the disease and at the
youth who tend to engage in high risk sexual behaviors? What are the
reasons for NOT granting people's right to know about their HIV status and
how do we justify NOT doing it given the public health implications of
mainly spread of the disease? What special efforts are exercised to
improve blood product safety and to prevent the spread of the disease to
the rural population which constitute 90 percent of our population? Given
the cost of the war, will HIV/AIDS become more or less of a priority
meaning funded more or less?
2. Disseminate information via all forms of media in as many languages as
possible and person to person;
3. Establish a foundation or an organization to provide funds to assist
in the control and prevention efforts;
4. Raise funds;
5. Create a resource directory including local and international
organizations working on HIV/AIDS as a first step to establish
collaborations and networks;
6. Write to policy-makers including U.S. Senators and Representatives to
increase funding for HIV/AIDS.
Even the short list above requires the talents and energies of many
individuals. For instance:
-- Is there someone going to Ethiopia in the near future who will be
willing to collect the latest
information on the epidemic?
-- Is there someone with a good grasp of languages who can translate
English write-ups into various languages?
-- Can someone help design posters and/or create a web site?
-- Has anyone gone through a process of setting up a
foundation/organization? Does anyone know of a lawyer who can donate
his/her time for this effort?
-- Can our musicians and singers be willing to write a song about the
problem, to be spokespersons, help in fund-raising, and/or dedicate
percentage of sells from records or shows to the cause?
I hope you can see why I said we need everyone. Are these the right
things to do? What should our role be? One thing I have come to
understand and believe is that we can not afford to be complacent in the
face of HIV as with each passing day, the problem gets worse.
Well-designed, carefully-focused and sustainable prevention efforts, that
have worked in places like Uganda, Senegal and Thailand, are needed
urgently. We should be asking questions like: why does the HIV/AIDS
epidemic continue to explode at a time when we know prevention works and of
prevention measures that work? We must examine the gap between what we know
how to stop the disease and what is being done. The moment has arrived for
the death toll among young adults have become very visible. I don't think
we need to wait, like in some other African countries, to see villages get
wiped out before we join the fight.
In any and all of our efforts, as much as possible, I suggest that we
avoid trying to find scapegoats or someone to blame and politicizing of the
situation but make people focus their attention on the problem.
Whatever happened has already happened and we should deal with what is
happening now. Join us and invite others who have genuine interests to
help to join the group.
Sincerely,
Tadesse Wuhib, MD, MPH
1643 Josephine Street, #512
New Orleans, LA 70130
twuhib@hotmail.com