In aid of AIDS

By Feizal Samath

Military personnel and migrant workers have been identified as new high risk groups in Sri Lanka's fight against HIV/AIDS as the ethnic conflict drags into the 16th year and large numbers of women migrate abroad, officials said.

Manel Silva, senior programme officer at the United Nations Development Programme (UNDP) office in Colombo, says these two categories were getting a lot of attention in most HIV/AIDS programmes in Sri Lanka.

Non-governmental agencies working in this field said new projects had been started in the army to educate soldiers on AIDS issues, sexually transmitted diseases (STDs) and avoidance.

"There is great acceptance of these programmes and the army has made a request for more of this kind for their officers," said Swarna Kodagoda, executive director of Alliance Lanka, which started projects at two army camps in Sri Lanka's southern region last year.

She said most of the soldiers were unaware of STD's but were able, through these awareness programmes, to widen their knowledge of safe sex and other issues connected to AIDS.

The two camps are training units supplying personnel to the battle zones in the north and the east. Health workers say that though Sri Lanka is a low prevalence country as far as the AIDS epidemic is concerned, the rate of infection could rise due to the protracted civil war and the country's close proximity to India.

India is predicted to be the AIDS growth centre of the world in the new millennium, according to UN officials.

"The continuing ethnic conflict and our proximity to India makes Sri Lanka very vulnerable to the AIDS epidemic," says De Silva, who handles the UNDP's HIV/AIDS programme.

According to the state-run National STD/AIDS Control Programme, the number of deaths from AIDS up to the end of August this year was 73 while HIV positive cases totalled 286 and AIDS carriers were 100.

De Silva said according to UN estimates there are between 7,000 to 8,000 people living with the HIV/AIDS virus but the figure could be much higher.

"It is difficult to obtain figures and proper statistics because it relates to sexual behaviour," she told The Sunday Times.

But she agreed there was a much better awareness of the virus now against 1986 when Sri Lanka's first AIDS case was reported in a foreign visitor, and since then a string of HIV/AIDS programmes undertaken under the aegis of the UN and other NGOs have shown positive results.

Military personnel are a high-risk group as they mingle with local populations and have, often temporary, liaisons with local girls, AIDS workers said.

In Anuradhapura where soldiers gather at a transit base, there has been a proliferation of brothels in recent times. Police have occasionally raided the brothels, which are temporary housed in small hotels or restaurants, but these places still exist with soldiers being the biggest clientele.

Many soldiers frequent these places, putting them at the risk of HIV/AIDs if safe sex precautions are not taken.

Anuradhapura has a large military base and airfield which provides temporary shelter to soldiers going to the war zones or returning from a tour of duty.

Some NGOs and UN agencies like the UN Population Fund(UNFPA) provide condoms to soldiers, promoting the safe sex concept.

"Soldiers leaving the war zones periodically on home leave were provided with information on reproductive health and condoms," UNFPA said in the just-released 1998 UN annual review for Sri Lanka.

Migrant workers who are at risk are mostly females who travel to the Middle East as housemaids, said De Silva adding that Sri Lanka was the only Asian country where the number of female migrants far exceeded male labour outflows.

A UNDP note says that each year about 160,000 people go abroad on employment of which 70 to 80 percent are women mostly in the 18 to 40 age group.

"In their place of work, primarily as domestics in the Middle East, they have low social status and are extremely vulnerable, experiencing many forms of exploitation, including sexual abuse," it said.

It said that according to available statistics, 50 percent of reported HIV cases are housemaids who have returned from the Middle East.

Alliance Lanka's Ms. Kodagoda said her Colombo-based NGO, established in 1995, works through a string of village-level and community based groups with the long-term objective of "slowing the spread of HIV and reducing the impact of the AIDS epidemic."

Since 1995, Alliance Lanka has provided technical and financial support to 151 projects of 98 local NGOs based in 14 districts in Sri Lanka. "One of our biggest achievements has been to mobilise the support of NGOs which hitherto worked only in general fields of health and development not in HIV/AIDS work per se," she said.

Kodagoda said the work of Alliance Lanka, connected to the London-based International HIV/AIDS Alliance, went beyond mere awareness programmes on safe sex and STDs.

"Our programmes also deal with how to respond to behavioural changes for specific targets that are vulnerable," she said.

An Alliance project in the northcentral town of Dambulla is aimed at truck drivers, commercial sex workers and three-wheel taxi drivers. Dambulla is a large rice and vegetable-growing centre where many outsiders congregate for business purposes.

Kodagoda said they were targeting a small group of 30 people. "It is a sensitive project as we have to talk to truck drivers, three-wheel taxi drivers and sex workers on issues like safe sex. There has to be a strong element of confidentiality and trust in tackling these people otherwise they don't respond," she said.

UNDP's De Silva says the agency's HIV/AIDS two-year programme worth US $ 300,000 was launched last year and is intended to supplement the main ongoing national programme that is funded by UNAIDS.

She said the project was aimed at sensitising the people on HIV/AIDS. "AIDS is not only a health issue but a socio-economic problem that affects the whole family. It can drain the health of the nation by affecting productivity," De Silva said.

The UNDP programme targets high risk groups like the military, migrant workers - both internal and external -, taxi and truck drivers, commercial sex workers, school leavers and members of the tourist trade.

"We are conducting programmes to strengthen existing STD/AIDS projects and in capacity building while asking provincial councils to set up their own awareness programmes targeting vulnerable groups in their regions," she said.

At a national level, De Silva said UNDP was supporting ministries to educate employees particularly on issues like how HIV/AIDS is transmitted.

"You may be surprised but there are still people who are unaware as to how one gets infected with HIV/AIDS," Alliance Lanka's Kodagoda said.

She said that in the past 18 months her organisation and its partners had made considerable progress in enhancing the quality of prevention efforts.

Simple awareness raising activities were now being supplemented with behaviour change communication, promotion and referrals to STD diagnosis and treatment facilities and organisation of vulnerable communities, she said.

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