PHA-Exchange> SAFE HEALTH- A FULL PARTNER IN HIV/AIDS PREVENTION

[stephen minkin]

Safe health - a full partner in HIV/AIDS prevention

After attending the East Africa PHM meeting 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 significant 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 observe 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 improved at the hospital, but she is certain that HIV transmission remains 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 funding cuts. 

She now works as a senior researcher and has written a detailed proposal 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 hospital. 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.

Please let me know what you think?

Regards to all, 

Steve Minkin

 







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