CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
by Samba Demba Barry, Mauritania, October 1998
THEME = AIDS
In Mauritania, people don't know much
about statistics concerning HIV/AIDS
and the subject is still taboo.
Any action which is taken can be summed up in two words:
"prevention" and "discretion"
Officially, between 0.5%-1% of the population have contracted the HIV virus, which means anything between 5,000-7,000 are HIV- positive. The number of people with AIDS since 1988, has risen to 532 (statistics taken from a 1996 report). Dr Mohamed Nezhir Ould Ahmed, is UNAIDS' advisor in Mauritania. Commenting on these statistics, he says: "Even if these figures are still low, the fact that this disease does exist even in the farthest corners of the country, must make us concerned about a situation which will become even more serious in the not too distant future". Moreover, the fact that only those who are in hospital or who visit a doctor because they've got a Sexually Transmitted Disease (STD), and those who are blood donors (and there's not many of these), can be tracked down, makes the situation even more disturbing.
A situation which could be accelerated by a number of factors coming together. First of all, in spite of the furore the disease has caused on an international level, the subject of AIDS is still taboo in Mauritania. Any initiative which could be taken to prevent the disease or to inform people about the disease, is stamped on. Furthermore, there's a number of factors which could lead to an uncontrollable situation, if things remain as they are: The lack of any government determination to do anything about the HIV/AIDS virus; poverty; the high illiteracy rate especially among women; the unfavourable attitude of religious leaders vis à vis the use of condoms; the prohibition of prostitution in Mauritania (but it's carried on illegally in the major centres); polygamy; the high divorce rate and the frequency of remarriages; the recurrence of STDs among the population of a certain age; contaminated blood used in blood transfusions; people are continually moving about.
Towards the end of the 1980s, the first AIDS cases came to light in Mauritania. Faced with the disease's rapid spread throughout the world and the alarming reports reaching Mauritania about its progress in Africa, the government has been forced to take, albeit paradoxically, a number of measures to block the spread of AIDS in Mauritania. One of the first decisions taken (and certainly one of the most important), has been to establish in 1990, a National Programme for Fighting Against AIDS and STDs (PNLS/MST). This Programme was placed under the control of the Ministry of Health and Social Affairs and aimed to deal with matters concerning the fight against HIV/AIDS in Mauritania. The Programme coordinator's terms of reference were: To work with various donor nations and organisations in order to draw up a national strategy for combatting the disease; to decide on the best means of putting the plan into action.
Following on the establishment of the PNLS/MST, a medical team was set up to help hospitals cope with caring for AIDS cases. Also, six screening centres were opened: two in the north-west (Nouakchott, Nouadhibou); two in the south-east (Kiffa, Aioun); two in the south (Kaédi, Selibaby). These regional screening centres were functioning, more or less well, until 1996. Today, four of these centres are closed because of lack of use. Only the centres situated in Nouakchott (the capital) and Nouadhibou (the economic capital) are still operating. The PNLS/MST's new coordinator, Mr Menna Ould Tolba, was appointed in July. He says he intends to "put right what's gone wrong and once again inject some enthusiasm into the PNLS/MST's image, so as to get the help and support Mauritania needs from international donors, to combat AIDS".
People are now tending to work together in the present situation, and a number of initiatives have got off the ground. Today, there are at least five national associations involved in combatting AIDS: Stop AIDS; Hope; The Mauritanian Family Welfare Association; The Living Earth; and the Mariem Diallo Institute. In November 1997, so as to better coordinate their work, these associations formed themselves into a network headed by the non- governmental organisation (NGO), Stop AIDS. Also, a number of international NGOs such as World Vision, the Peace Corps, and CARITAS-Mauritania are taking part in the common effort.
An invaluable contribution is made by informing the public, and conducting awareness campaigns dealing with HIV/AIDS issues. These campaigns usually take place on World AIDS Day (1 December) and during the weeks following. Use is made of the multimedia: To drive home the point that AIDS is a serious matter; to explain how it is passed on from one person to another; and to show how it can be prevented. Not much is said about the use of condoms. (Neither on national radio or television). Informal chat sessions are held in health centres, schools and at the University of Nouakchott. Officially, the fight against AIDS can be summed up in two, almost contradictory, words: "prevention - discretion".
Another salient point which must be mentioned, is that of the confrontation between science and religion when it comes to talking about AIDS. The scientific fraternity say condoms should be used more, and made available to the public; the religious point of view opts for conjugal fidelity and refraining from sexual intercourse. But religion cannot be excluded when it comes to curbing the spread of HIV/AIDS in Mauritania. Stop AIDS, one of the most active associations in the country, is aware of this, and so has appointed a senior religious personality, Hamden Ould Tah, a member of the High Islamic Council of the Republic, to head their association. Mrs Vatimetou Mint Maham, is Stop AIDS' secretary- general. She says: "To talk about AIDS in a strongly Muslim country like Mauritania is somewhat of a paradox. However, if the scourge of AIDS is to be defeated, then it must be recognised that religion and science complement each other. Our aim is to convince our religious leaders that they should be able to talk about AIDS and the use of condoms, without offending people. Stop AIDS has partly succeeded in this, because AIDS is now mentioned during the Friday Prayer in the mosques.
Who looks after those with AIDS? A very real problem because in this country, you can become infected with HIV/AIDS and die without ever knowing you've got AIDS. People just won't tell you. The PNLS/MST's co-ordinator says: "The fact that someone has the HIV virus remains a confidential matter. Neither family, friends and sometimes even the patient have the right to know". Mr Lo Baidi is departmental head of the Nouakchott National Hospital's laboratories. He says: "If we were to reveal that such and such a person has AIDS, we'd be afraid of the consequences from the patient's own family and immediate acquaintances. The doctors have no legal protection in this sphere". Isn't "prevention better than cure"?
In any case, the survival of thousands of women and young Mauritanians, depends on whatever action the government takes in the near future. They are in danger of being wiped out by HIV/AIDS! The PNLS/MST has recently taken a number of decisions: Condoms should be made available on demand in certain target areas; there should be a training programme for religious leaders and women in charge of women's cooperatives; awareness campaigns must be decentralised. But will the PNLS/MST manage to carry through these decisions? Whatever happens, it shows the government does want to do better.
END
CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
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