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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

 

  

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AIDS/HIV IN SIERRA LEONE: THE KILLER IS ALREADY IN OUR MIDST

http://www.focus-on-sierra-leone.co.uk/AIDS_Comment1.htm

 

NOW, at last, we can openly discuss it. HIV/AIDS is no longer a taboo subject in Sierra Leone. There are believed to be tens of thousands of our citizens carrying the HIV/AIDS infection. It is conservatively estimated that in 1999 over 8,000 people died from full-blown AIDS. Now we are told that a significant proportion of recruits in the new Sierra Leone army and large numbers of former and possibly current members of the peacekeeping ECOMOG/UNAMSIL contingents in Sierra Leone were, or are, carriers of HIV. Some people have speculated further that a similar situation exists among the rebel army and in rebel held areas.

 

The killer disease has certainly arrived, and has been in Sierra Leone for a long time.

 

Focus on Sierra Leone will be quick off the mark. But in doing so, we have to confess a sense of shame and failure in having had to wait this long to comment publicly on the incidence (or not) of AIDS in the country. We would be less than truthful to say that we did not suspect it all along. Rumours have been circulating for some time and have intensified in the last five years, that the disease was fast becoming the country's number one killer. Both official secrecy and a disarming fixation for Sierra Leoneans to appear ‘holier than thou’, i.e. it can't happen here, had conspired to discourage public discussion of the subject till now. 

 

The truth is that Sierra Leoneans in general have kept quiet about the incidence of this affliction in their midst for a long time. Few have been brave enough to raise public alarm over it. But if ever there was a good case for openness with the public, this is one that has been begging persistently for the voice and utterance of the experts' tongue. It is only through experts that the lid of official secrecy can be removed from the festering cauldron harbouring the dreaded killer disease.

    

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Although one has occasionally heard some medical doctors privately express their concerns about the spread of the disease, the average Sierra Leonean has been led to believe that the many deaths occurring in their midst, which are painful (especially for the victim’s relatives) to watch and have been preceded, in most cases, by the physical wastage and progressive emaciation of the victims, were caused by diarrhoea, pneumonia, malnutrition, hunger, worries, etc, etc. The 'A' word was never mentioned openly, even when post mortems in some cases allegedly attributed the cause of death to AIDS.

 

We do not possess any expertise on HIV/AIDS but we will nonetheless join others to initiate the process of creating awareness of its presence among our citizens. Thank God, someone has kindly obliged. The article in the UK Guardian newspaper War injects Aids into the tragedy of Sierra Leone, which appeared on Saturday, 12 May 2001 could not have been better timed. It provides an opening salvo to more open discussions of the matter now and in the months to come. It explicitly, and candidly for the first time, describes the situation in the country and raises important issues for the government of Sierra Leone, civil society and the international community, which has been the dominant player since 1997. We also understand that a more detailed report is soon to be released by the UN.

 

In fact, our own research shows that, quite aside from the article in the Guardian, there had already been information at the end of 1999, which indicated a serious trend pointing towards creeping dangers for Sierra Leone with regard to the HIV/AIDS infection. This information has been available for anyone concerned enough, but we are not sure if our government ever used it to mount a campaign of awareness among the population.

 

There are reasons why public reticence about HIV/AIDS is so sharply pronounced in our communities. One is the fear of being stigmatised. Obviously, in addition to the ignorance that exists about the disease, there is also the fear of the social stigma that will attach to a victim, their family and immediate circle of friends and associates. Such is the pervasive nature of the impact of AIDS/HIV. In societies like our own, which are based on extended kinship with very wide family circles, the effect of this can be devastating and disconcerting for those affected. The issue thus becomes one of protecting family honour and, when extended at the national level, protecting State pride and honour. The South African President's current ambivalence and resulting discomfiture over his country's affliction is a case in point.

 

We are concerned that Sierra Leone, too, is in a state of denial about the incidence of AIDS/HIV among the population. It is the same state of denial that once encouraged the belief, which accounted for the disgraceful complacency of previous governments and the entire population, that the civil war was just a minor skirmish by a motley group of bandits and did not merit the concern that others were calling for; that it was merely country people squabbling among themselves …until it finally arrived to hit them in the City; and the arrogant assumption that, unlike other nationalities, Sierra Leoneans were not capable of committing horrific violence on themselves and so blamed other nationalities for their war. Only to discover now that some of the key people involved came from well established household names in Sierra Leone.

    

 

Now the chicken has finally come home to roost. People need to be informed about AIDS. The ravages of the disease are very well documented and there is no reason for national complacency. But if Sierra Leoneans still want to treat this subject lightly as they have tended to deal with other national emergencies before, then we advise that they should again look at some of the harrowing statistics emerging from Southern Africa. There, most of their governments have at least accepted that that there is impending catastrophe and are trying to do something about it. As has been starkly put in a recent article, “One third of the population of Kenya is expected to die in the first few years of this century. In Zimbabwe, it is thought that at least one quarter of all working age adults are affected with AIDS. The United Nations has called it the worst health catastrophe of the century. And life expectancies have dropped drastically in many countries because of the epidemic - from 61 years to 39 years in Zimbabwe, and from 66 to 48 in Botswana.” (The Aids debate: Condoms vs. Development)


We have been moved to go public with our comments in the wake of the publication of the Guardian article because we have been told by one usually reliable source that the unofficial reaction, last week, from government sources in Freetown was that the claims about and HIV/AIDS epidemic in Sierra Leone were exaggerations, and that the matter is not as serious as claimed.

 

If it is true that this thinking is prevalent among members of the present government, then we say categorically to them that that they are wrong and that it is criminally negligent for them to think so.

 

Focus on Sierra Leone will hold fire for now until a UN report, which we understand contains a more detailed account and data, is released. We must press for its immediate release to the public so that it is not sanitised by officialdom as often happens with this type of report.

In the meantime, we challenge the Government of Sierra Leone to come up with an official statement in reaction to the report in the Guardian (UK) article and, generally, on the country’s state of health vis a vis a threatening Aids pandemic. The fact that an article like this about Sierra Leone appeared in a serious international newspaper and a government statement has not been made to acknowledge, rebut or confirm its substance, is clear evidence of the lack of concern which have become the hallmarks of this administration. They must answer some questions:

*  Were they aware of the situation described in the Guardian? If so, how much more do they know, and what have they done to inform and prepare Sierra Leoneans?

*  What, if anything, have they done to alert those who know more about this disease, to help and advise us on the ways of dealing with it?

One person who comes out of this first round of catastrophic news emanating from our beleaguered country, with flying colours, is Major Dr James Samba of the Sierra Leone Army, whose frank and outspoken statements were quoted in the above article. More pips on your shoulders, Major! That's the least we expect from our public officials.