AFRO-NETS> Safe Health - A Full Partner in HIV/AIDS Prevention

[Claudio Schuftan <aviva@netnam.vn>]

Safe Health - A Full Partner in HIV/AIDS Prevention
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From: Stephen Minkin <sfminkin@yahoo.com>:
 
After attending the East Africa People's Health Movement (PHM) meet-
ing in May 2002 I encountered a range of opinions among physicians on 
the subject of medically transmitted HIV.
 
Clearly sexual transmission was recognized by many as the most common 
source of transmission. This is not surprising given the fact that 
this is virtually the only aspect of AIDS education that is actively 
being promoted.
 
Among physicians I interviewed some do not believe that medical 
transmission is significant. Others see this as potentially signifi-
cant problem that needs attention. Some firmly believe that medically 
transmitted HIV is a major health problem.
 
I was stuck by the viewpoints of 2 Kenyan obstetricians, one working 
in Moshi, Tanzania and the other in Nairobi. The doctor in Moshi was 
incredulous when I asked about medical hygiene. "Do you know what 
conditions are like here?" He told me that it was impossible to ob-
serve universal precautions in the two hospitals where he works. The 
hospitals each deliver about 300-400 babies every month. The doctor 
does not see how conditions can be improved given the realities of so 
many women with so little resources.
 
The doctor in Nairobi stopped delivering babies at Kenyatta National 
Hospital during the 1990s because conditions were so bad, and the 
risk of HIV transmission great. The situation has dramatically im-
proved at the hospital, but she is certain that HIV transmission re-
mains a serious problem at many district and rural hospitals. She 
also worries that the quality of obstetric care at Kenyatta, the 
largest in East Africa, may again suffer because of threatened fund-
ing cuts.
 
She now works as a senior researcher and has written a detailed pro-
posal on assessing the risk of HIV infection in obstetric wards in 
two district hospitals. (Any ideas for funding?)
 
In my opinion medically transmitted HIV/AIDS is both a pubic health 
and a human rights issue. The burden of proof needs to be shifted 
away from those of us who have tried to rise the issue. At a minimum, 
governments the Bank and WHO should be able to say with certainty 
that no woman or infant will contract HIV by giving birth at a hospi-
tal. That's a good starting point. Ultimately, those responsible for 
AIDS prevention should be able to affirm that no one will contract 
HIV because of inferior quality health care.
 
A slogan developed at a meeting of the East African People's Health 
Movement in May 2002, was that "equality equals quality and quality 
equals equality".
 
If so, 'Safe Health Care' must be a full partner in HIV prevention.
 
--
Stephen Minkin
mailto:sfminkin@yahoo.com
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