whose rights?
on Pak'd Off (Pakistan), 14/May/2008 05:03, 34 days ago
I know it’s only been a short interlude after my previous blog entry but something happened last week that shocked me to the very core and I felt the need to share it here.As happens regularly in the office, one of the HIV+ members of the organisation came in to visit on Monday. He brought with him his two young daughters and wife wearing a full“shuttlecock” burkha, which consists of a fitted head compartment with a mesh over the eyes, the rest of the material billowing out from the chin. The husband went into the Director’s office while the woman sat facing the wall in the room where I sit and tended to her grizzly 18-month old. Some of the female staff chatted to her while the men talked among themselves in the other room.I didn’t see anything unusual in this but then a colleague came over and told me in a whisper what was going on, the husband has been an HIV + member of the organisation for years but has never disclosed his status to his wife. Now their 18 month old daughter was very sick and the man feared that the virus had been passed on to her. He had brought the girl to us to be taken for testing, having told his wife that we were "doctors". If the child was HIV positive, this would mean that the mother was too. Unless some unspeakable abuse had happened to the girl, the most likely way she could have contracted the virus was through mother-to-baby transmission in the womb, during delivery (the most risky time) or through breast feeding. Therefore, the mother must also be HIV positive.Now, given that the man had been a member of the organisation for years, I am assuming that he will have been equipped with all of the knowledge about the modes of transmission and methods of prevention. He will also have been encouraged to disclose his HIV status to his wife. However, somehow his wife and therefore unborn children had been put at risk. I was confused as to why the organisation were working with a man who would put his wife and child at risk like that, however apparently disclosure rights include the right not to tell the person with whom one is having sex. This applies in the UK as well. I find this surprising given the level of risk involved and the legal ramifications involved in putting another person’s life at risk in any other way. I read somewhere that the UK recently brought in a law that made it possible to prosecute people who knowingly transmit HIV. The booklet in question condemned this, claiming that it added to stigma and discrimination against people living with HIV. The issue is adifficult to assess. I agree that this could lead to “witch hunts” or unfair prosecutions, likely to get nowhere with evidence so difficult to provide and achieving nothing but adding to the stress of living with HIV. And if we start prosecuting for HIV transmission, it probably wouldn’t stopthere, I can imagine the situation spiralling out of control leading to newspaper reports of successful prosecutions for transmissions of the common cold!However, can it really be the case that no responsibility be placed on people knowingly living with HIV to prevent their passing the virus on? Yes, people are responsible for their own sexual health but in a“trusting” relationship or marriage it is much less likely to be a consideration especially when trying for children. Furthermore in countries like Pakistan, people do not have the knowledge or access to services to look after their sexual health. STIs are not seen as a problem in a culture where people are expected to “save themselves” for marriage. Indeed it is highly unlikely that the woman in the burkha has any knowledge about sexually transmitted diseases (as is the case for the majority of the Pakistani population most of whom do not receive even basic education) and her husbanddid not deem it necessary to educate her either. Furthermore in Pakistan many women do not even have a say in their own health as it is seen as the responsibility of her family or husband.Indeed, the sad and shocking end to this story is that a few days later, I found out that both mother and baby were tested, without explanation as to the purpose of the test. Both tested positive and from what I have heard, the lady has still has not been informed about the status of her baby or herself.