Aids epidemic laps our shores

By THERESA GARNER

Aids epidemic is a concept most New Zealanders mentally quarantine within the boundaries of disease-ravaged Africa. With just over 7000 people infected with HIV, the tally for the Pacific Islands is indeed a blip on the international Aids roll-call, which has 40 million living with the disease. But what is significant is the rate of growth in an region where Aids was rarely detected a decade ago.

In nations where talk of sex is often taboo, and the word condom is a swear word, Aids has a hold. In the words of Tahitian woman Maire Bopp-Dupont, addressing 9000 people at an international Aids conference in Barcelona: "It has broken on our shores, it is flowing in our blood". After she gave that speech, Nelson Mandela called her and invited her to his home. Bill Clinton gave her his card and urged her to call.

Bopp-Dupont's speeches have been making an impact since the day in 1998 when she announced she was HIV positive. The 23-year-old journalism student delivered the news to a shocked gathering of colleagues visiting her island for a regional journalism conference.

"I told them the story of what had happened to this girl from this village on this island who went to study at university." The girl checked into hospital for blood tests and found she had contracted the Aids virus. She felt she should keep the dreadful secret to herself and knew it would shame her family. But she realised that through her story she could help to create greater awareness.

"And at the end I told them that it was me," she says. "I knew there was a need for it to happen. If we wanted to get somewhere in terms of addressing HIV, we had to make people start talking about it and demonstrate what the life of someone with HIV can be."

As the first Pacific Islander to go public with the disease, Bopp-Dupont has given it a human face, one that is beautiful, glowing and shining with optimism. She has dedicated herself to fighting Aids to stave off a crisis of African proportions.

Bopp-Dupont says examples of discrimination against sufferers range from restaurateurs wondering aloud whether to throw away someone's knife and fork after they have eaten to people exiled beneath the family home to live on scraps like a dog, or being beaten to death at the mere suspicion they are infected.

Convinced of the greater role people who are living with the illness should play in awareness campaigns, Bopp-Dupont set up the Pacific Island Aids Foundation, a non-governmental organisation based at the Cook Islands Red Cross and funded in part by the Nelson Mandela Foundation.

While most Pacific Island countries count their numbers of Aids cases in single figures, and some proudly say they have none, Bopp-Dupont says most Island nations ignore the problem. "Mostly, they don't want to know. They're too scared. Because if they find out how many cases they have, then they have to deal with the question of treatment."

Fiji's Laisenia Qarase is the stand-out leader in the Pacific Islands for raising Aids awareness. "I don't see much leadership in the other countries, really," Bopp-Dupont says.

Ingredients contributing to an Aids epidemic include a high incidence of teenage pregnancies and sexually transmitted disease, mobile populations and economic instability.

There is also complacency because so far there have been relatively few cases. Traditional cultures avoid talk about sex, and churches encourage abstinence rather than safe sex.

Under-reporting in the islands is rife because of limited testing and surveillance facilities, poor access to testing sites, and a perception among the population that they are not at risk. The high number of reported Aids cases relative to HIV suggests the known HIV cases are part of a wider reservoir of infection.

Bopp-Dupont, who is in Auckland to speak at the Pacific Islands Media Conference, says lack of education is the main concern. The media contribute to discrimination and misconceptions, such as the belief that Aids can be transmitted by contact that is in fact safe, or that patients need to be isolated.

"I took the stand to open the discussion with the media back in 1998, and five years down the road I still don't see the media actually discussing it among themselves and finalising whether they do have a role."

She says many journalists sensationalise stories and reveal their subconscious fears of their subject.

Health providers are also a problem. A recent experience in the dentist's chair, when she struggled to have anyone look in her mouth, makes her doubly frustrated because of the efforts being put into anti-discrimination programmes among health providers.

In Rarotonga, nurses attending an education forum suggested Aids patients have isolated rooms and have their linen burned. "At the end, they found their approach ridiculous and unfair. But only time and experience will show whether they will practise what they learned."

Despite the frustrations, she has no regrets about embarking on the journey, or revealing her condition, saying it "opens people's minds to discuss the issue honestly and with confidence, rather than hide behind their ignorance and prejudices".

She knew little about Aids when she began sleeping with her now ex-boyfriend, who did not tell her of his illness even when she nursed him in hospital, or after her own infection was revealed.

With the love and support of her family, since that fateful day in 1998, her achievements have been remarkable. She has travelled extensively, taking the message of HIV/Aids awareness and the need for compassion and access to treatment to Pacific audiences.

Her awards include a media freedom award and a United Nations Race Against Poverty award. She is the head of her own foundation dedicated to improving the quality of life of people living with HIV/Aids and their families, and preventing further spread of the disease.

Nelson Mandela, who told his wife his failing hearing stopped him taking in Bopp-Dupont's speech at the Barcelona conference, invited her to South Africa.

"He came out of jail, became president, and one of his first priorities was HIV/Aids and educating his people," Bopp-Dupont says. "I use his example a lot in the Pacific Islands where there are a lot of strong traditions. He took those steps not only as the president of the country, but also in his own traditional system."

Stalling the advance of Aids in some cases can seem simple. In Tuvalu, which has 49 cases among 10,000 people, the seafarers would go from port to port, then return home and infect their wives.

"Now they have education and training. Every time they leave they have a reminder session, on the boat they have condom supplies, and when they return they have a blood test," Bopp-Dupont says.

By contrast, Papua New Guinea, with its jungle communities, polygamy and multiple languages, accounts for 80 per cent of HIV cases in the Pacific. Aids is now the leading cause of death at Port Moresby General Hospital.

The number of women who have tested HIV positive at the hospital's antenatal clinic is increasing, and the United Nations estimates the true incidence of HIV infection may be four times the official tally.

Bopp-Dupont says it is vital that the spread of the virus be slowed down "otherwise in 10 or 15 years, with limited prospect of treatment and our small resources, our families will be swept away, leaving behind hundreds of orphans."

Australia and New Zealand are upping the ante on Aids in the Pacific with the Pacific Forum, chaired this year by New Zealand. A regional strategy will be presented to next year's forum. Australia is contributing $12.5 million over five years targeting the spread of HIV.

A few days ago, New Zealand Foreign Minister Phil Goff addressed the United Nations General Assembly's high-level meeting on Aids on behalf of our Pacific neighbours, saying, "It is hard to think of a greater threat to international well-being on the UN agenda."

And working together, 11 Pacific Island countries submitted a successful bid to the Global Fund on HIV-Aids, TB and Malaria for a US$6 million ($10 million) regional programme on HIV-Aids.

For her part, Bopp-Dupont will continue to travel around the Pacific, talking to everyone from presidents and prime ministers to school children.

"It is difficult," she says, "but we all have our own challenges in life, and mine is this one."