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SIERRA LEONE: HIV/AIDS the new enemy

[This report does not necessarily reflect the views of the United Nations]

JOHANNESBURG, 2 November (PLUSNEWS) - Sierra Leone's decade-long civil war is winding down, but HIV/AIDS is a new more deadly enemy that the country is unprepared to tackle, Refugee International (RI) warns in a new report.

"In the past months, there has been a realisation that HIV/AIDS will be one of the biggest challenges facing post-war Sierra Leone. There is an urgent need for the international community to provide additional funding for HIV/AIDS education, counselling, condoms, and health care," the report 'HIV/AIDS: Sierra Leone's newest crisis' released on 24 October observed.

The government of Sierra Leone has only recently begun to consider formulating an HIV/AIDS policy. "Because of the absence of any sort of AIDS strategy or plan, the government and international organisations are faced with the task of carving a national response from nothing," the report added.

In the meantime, there are few reliable statistics on HIV/AIDS prevalence rates. Estimates range anywhere from 0.2 percent in the civilian population to 66 percent among male soldiers. Despite the lack of verifiable data, health NGOs, based on the frequency of their treatment of patients exhibiting AIDS-related symptoms, believe that the prevalence rate will be quite high, RI stressed.

The American Refugee Committee (ARC) recently conducted a survey on the level of awareness of Sierra Leoneans about HIV/AIDS. ARC found that among the different military forces, only 23 percent of the soldiers were able to correctly cite three ways of transmission.

More frightening is that only 7 percent of male youth and 6 percent of female youth knew three correct ways of transmission. For the Sierra Leoneans who had heard of HIV/AIDS, RI found that most of them knew that sexual relations is one cause of transmission. However, other ideas of how HIV/AIDS could be transmitted were smoking marijuana, using a spoon that an individual with AIDS has used, or touching an AIDS patient.

As for means of protection against HIV/AIDS, one of the biggest obstacles is a lack of availability of condoms in most of the country. RI attended an HIV/AIDS meeting at the Ministry of Health, where it was reported that NGOs and the military don't have enough condoms. The ministry of health doesn't have a good supply. And, UNAIDS in Abidjan doesn't have a steady supply of condoms coming into Sierra Leone either. As a result, only Sierra Leoneans in larger towns can buy condoms at the pharmacies or receive reduced-price condoms from different NGOs.

At present, health care for people living with HIV/AIDS is almost non-existent, the report said. Outside of military hospitals, there is one hospital in Freetown where Sierra Leoneans can get tested for HIV/AIDS. Hospital officials explained that there is a large shortage of test kits. There is one counsellor providing pre- and post-test counselling. There are no affordable antiretroviral drugs or drugs preventing mother-to-child transmission available in Sierra Leone.

Once a person is diagnosed with AIDS, they are sent back to their families and are often rejected because of the stigma attached to the disease. According to a doctor working for the ministry of health, most health care workers in Sierra Leone have not received training or information about AIDS and refuse to treat people diagnosed with AIDS.

Thus far, the only tangible and concrete government response to the AIDS epidemic in Sierra Leone is the US $15 million World Bank-funded Sierra Leone HIV/AIDS Response Project (SHARP) that was developed last May. NGOs and government officials whom RI interviewed expressed concern that SHARP would not begin implementing programmes until May 2002.

"While SHARP is an important first step in developing a government response to HIV/AIDS, the funding levels are sorely inadequate to accomplish this monumental task - especially when one considers that this government response must be carried out simultaneously with massive reconstruction of the health, education, and information infrastructure throughout most of the country," RI said.

To curb the spread of the HIV/AIDS epidemic and bolster current initiatives in Sierra Leone, Refugees International recommends that:

- Donors give priority to HIV/AIDS programs when developing reconstruction and development aid packages for post-conflict Sierra Leone;
- Donors consider supplementary funding of the World Bank's SHARP project to strengthen the government's response to HIV/AIDS;
- Donors increase support of reproductive health programs, particularly in newly-disarmed areas, to address the high rate of STIs;
- Donor governments make low cost test kits and anti-retroviral drugs available to the government;
- The government strengthen its efforts to educate people about HIV/AIDS, and consider contracting a social marketing firm to increase condom availability and usage;
- UN agencies send adequate supplies of male and female condoms to prevent transmission of HIV/AIDS;
- UNHCR provide condoms in areas with high concentrations of returnees;
- International NGOs partner with local NGOs to train community health educators to travel to newly-disarmed areas of Sierra Leone to carry out sensitisation campaigns;
- NGOs include an HIV/AIDS education component in reintegration activities for former combatants;
- Medical NGOs work with the Sierra Leonean Ministry of Health to educate health care workers about HIV/AIDS;
- Religious organizations in Sierra Leone be given support to carry out HIV/AIDS awareness programs and outreach and care.

[ENDS]