CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
by Alpha R.Jalloh, Sierra Leone, September 1998
THEME = AIDS
In the midst of a raging war,
the AIDS epidemic is slowly spreading
throughout Sierra Leone,
contributing to a reduction in the population
Reports from the National AIDS Control Program (NACP) state that about 250,000 people are infected with the HIV virus. Considering the population of Sierra Leone - which has been reduced from 4.5 million to about 3.8 million in eight years - the epidemic poses a serious threat to the health status of a once buoyant nation.
Dr.Andrew Kosia is the NACP's co-ordinator. He says said that in 1986, in response to the World Health Organisation (WHO)'s appeal to African governments, to create programs for the prevention and control of AIDS, Sierra Leone's government established the NACP, which was mandated to investigate the existence of AIDS in the country. He says the first case of AIDS was diagnosed in Bo, the country's second largest city, in 1987. Ten cases of AIDS and seventeen cases of HIV were also recorded the same year. Dr. Kosia says: "By 1988, we had established the presence of HIV/AIDS in Sierra Leone and it was found to be prevalent in the urban areas." Most people in Sierra Leone, however, are not perturbed by the spread of AIDS because they believe that it is not a disease that has a local origin. Dr.Kosia says that even when the first cases were reported, people had the same perception.
In recounting the history of AIDS in Sierra Leone, Dr. Kosia says that by the end of 1997, the number of AIDS cases recorded had reached 291, with 520 people infected with HIV. "The picture this year is worse. Recent screening of a cross-section of pregnant women to represent the general population, shows that 5.8% of them are HIV-positive. This indicates the percentage of infection among the population. If we are to make any projections or estimations, Sierra Leone has around 250,000 people infected with HIV."
Dr.Kosia points out that prostitution, unsafe blood transfusions, rape and promiscuity among men and women, are all causes of AIDS. He also reminds us of the special circumstances which existed in Sierra Leone during the period, May 1997 to February 1998, when the military junta was in power, as a contributing factor to the present scenario. During that period, there was a breakdown of law and order with a high incidence of rape. Thirty-five out of forty-six girls who were raped in the capital, Freetown, and subsequently screened by the NACP, were found to be HIV-positive. "If we are to apply these figures to the situation in the rural areas, where there was no sign of law and order during that period, then HIV infection in the rural areas could be very, very high," says Dr. Kosia. Unsafe blood transfusions also took place during that period, with contaminated blood being used.
Dr. Kosia says that prostitutes are the most vulnerable target group for contracting AIDS. He states that the rate of infection among them is very high. He also observes that the rate of infection in the sexually active population increased from 26% to 36% during the military rule. "All this put together, gives us an insight to the magnitude of the AIDS problem in the country."
It should be noted that prisons are places where AIDS lurks. On 10 July 1998, the Standard Times newspaper reported that Olando Lewis, a convicted prisoner, died of AIDS at the Pademba Road Prison in Freetown. The report stated that tests carried out by the NACP proved that the prisoner was HIV-positive.
Dr. Kosia affirms that the government has been very co-operative in combating the epidemic. He says that the establishment of the NACP itself has been a great help in controlling the disease.
The Planned Parenthood Association of Sierra Leone (PPASL) has been very active in AIDS prevention. It has been promoting the use of condoms. Mrs. Kultumi Karim is the program officer. She says: "We usually educate rural residents through audio- visuals on Sexually Transmitted Diseases (STDs). Whenever they see any symptoms of the disease, they remember what we have shown them and they come to us. The epidemic is very high among the 15-45 age group."
But even with the efforts made by the NACP and the PPASL, the epidemic may still be spreading to every corner of the country, especially in the midst of the present precarious security situation. The NACP which is the pivot of AIDS control, is presently financially handicapped.
Dr.Kosia says most of the infrastructures built for the purpose of counselling and treatment in the rural areas, have been destroyed by rebels. "Our program depended totally on donations. We cannot function effectively if we do not get them," he says. But in spite of the financial constraints, he is convinced that the ongoing educational activities on AIDS will produce the desired effect. This, he says, has been done through the print and electronic media, posters and sign boards.
One set of people who have been reticent over the AIDS issue are religious leaders. Dr.Kiosa says there are plans to get church and religious leaders actively involved in education on the AIDS epidemic. In the present scenario, there is a need to exert more effort to contain the epidemic.
Dr.Kosia suggests:
- Government financial commitment without which the NACP cannot function effectively
- The need to strengthen AIDS awareness campaigns, from the grassroots upwards, using the most effective means of communication
- The need to strengthen the system of investigating AIDS
- The need to have a safe blood transfusion system
- The need to have a decentralised system of government, without which agencies set up in the interior of the country cannot effectively function, because they are subject to supervision and other bureaucratic ordeals by the Health Ministry in Freetown.
If implemented, these steps will go a long way to curb the spread of AIDS in every corner of Sierra Leone.
Dr.Kosia suggests the following methods which have been effective in the past:
To be an AIDS victim means to be an outcast in society, suffering humiliation and victimization from society in general. Dr.Kosia says: "Because of this, we had problems in the past to deliver support services to HIV/AIDS victims. But we are planning to establish community-based AIDS support services. This will entail the fullest co-operation of those who help form opinions in the various communities."
The international community, especially the United Nations, realises that Sierra Leone cannot be left to tackle the problem on its own. Dr.Kosia says the World Health Organisation (WHO), the United Nations Development Program (UNDP) and the World Bank have greatly helped the NACP in combatting the epidemic.
But, the AIDS epidemic from all clear indications, is threatening to further reduce the population of Sierra Leone. It has become an unseen killer, roaming the length and breadth of the country is search of victims.
END
CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
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