HEALTH: Indigenous People Speak Out Clearly on AIDS

Daniela Estrada

MEXICO CITY, Aug 7 2008 (IPS) – In my community, living with HIV is synonymous with death, Fernando Solís, a 34-year-old member of the Cuna ethnic group in Panama, told IPS. Solís, who was diagnosed four years ago, is now working in prevention efforts among other young indigenous people, which he described as the key to eradicating the epidemic in our communities.
HIV reached my community 10 years ago. I never thought I would get it, Solís said, at this week s 17th International AIDS Conference, or AIDS 2008 , which ends Friday in the Mexican capital.

First I went through a process of denial, and I hid the disease. But later I decided to look for information, said Nandín , as he likes to be called.

Today he is active as a volunteer in the New Men and Women Association of Panama, the first group of gays, lesbians, bisexuals and transgender people in the country.

His aim is to set up the first organisation of indigenous people living with HIV in Panama. He has focused on young people because he says they are more open-minded to information about HIV/AIDS.

When a Cuna Indian in my district starts to show symptoms, he is called boni , which means he has a bad spirit in his body, he explained. Then we go to our healers, who tell us what herbs to take to strengthen our immune system, but HIV is much stronger, much more resistant.
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Solís was not rejected by his community, something that occurs frequently in other ethnic groups, but he says that the Cuna elders tend to deny the existence of the disease. And in health centres in his country he has felt segregated, he said.

He has had to get used to the side effects of the three antiretroviral pills he takes every day, like headaches, nausea and severe weight loss.

Information is needed to curb the spread of HIV, but efforts to bring information to indigenous communities must come hand in hand with our customs and beliefs, and our own languages, he said.

The second world AIDS conference for indigenous people and people of African descent was held Jul. 30-Aug. 2 in Mexico City, ahead of AIDS 2008, with the participation of representatives from Argentina, Australia, Brazil, Canada, Chile, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Mexico, New Zealand, Nicaragua, Panama, Uruguay and Venezuela.

Only five countries were represented at the first such gathering, a satellite session held in the run-up to AIDS 2006 in the Canadian city of Toronto.

The work that began at the gathering for indigenous and black people continued at AIDS 2008, which has drawn more than 20,000 scientists, government officials, donors, activists and people living with HIV from around the world.

At the multi-coloured Global Village, a huge tent next to the Centro Banamex, where the international conference is taking place, indigenous groups have a presence among the civil society organisations dedicated to the fight against AIDS.

The countries participating in the indigenous peoples conference have realised that the epidemic has now also become a rural phenomenon, that the virus is in the bodies of indigenous people, which makes it necessary to design culturally sensitive prevention strategies, Amaranta Gómez, a transgender Zapoteca Indian from the southern Mexican state of Oaxaca, told IPS.

The main problem facing indigenous people living with HIV is access to treatment and health care because of poverty, marginalisation, stigma and racism, said Gómez.

Achieving recognition of ethnic minorities in the constitution is indispensable for improving their situation, Willi Morales, an HIV-positive indigenous chief from Chile, commented to IPS.

Morales belongs to the Huilliche ethnic group, who live on the island of Chiloé off the coast of southern Chile. The Huilliche are a branch of Chile s main indigenous group, the Mapuche.

Gómez wondered How can we break down the communication barriers to ensure access to information and timely prevention? How can we bring about an intercultural dialogue between traditional and western medicine? How can we guarantee that the voices of indigenous people are heard by public policy-makers, and that they participate in the decision-making processes in every country?

One of the great challenges we face as indigenous people because we must be able to engage in self-criticism is the question of traditional customs and habits, which clearly hurt women the most, said the transgender Zapoteca Indian.

Indigenous people complain that outside of our communities we suffer discrimination. But within our communities we don t want to recognise sexual diversity, like homoerotic practices, for example, she said.

Our aim is to build a Latin American strategy to create epidemiological indicators that allow us to gauge the number of indigenous people living with HIV, and map out the spontaneous responses that are emerging in the communities, she added.

We are going to create an international secretariat for indigenous people, to train leaders, influence public policies, and make sure we are included in the declarations of the U.N. General Assembly Special Session on HIV/AIDS, said Gómez.

Major efforts are needed to determine the intensity of the epidemic in indigenous and Afro-descendant communities, Joint United Nations Programme on HIV/AIDS (UNAIDS) regional director César Núñez told IPS.

We need data in order to carry out this advocacy work and defend indigenous people living with HIV. We need concrete statistics on prevalence rates, particularly among indigenous populations, he said. There is more information on Afro-descendants, particularly in the northern part of Central America.

For example, the Garifuna community, (Afro-descendants) who live on the coast of Belize, Guatemala and Honduras, and who migrated 200 years ago from the Lesser Antilles, had an average HIV prevalence rate of eight percent in 1998, which is very high in the regional context, said Núñez.

According to a study carried out last year in Honduras, the prevalence rate among the Garifuna dropped five percent. It is encouraging that it has gone down somewhat, but that is not a significant reduction, he said.

We believe that programmes should be designed that are adapted to indigenous and Afro-descendant communities. They must be culturally sensitive, involving the participation of traditional healers, for example, said the UNAIDS official.

At the indigenous meeting ahead of AIDS 2008, I committed myself to increasing the visibility of the epidemic in these communities, said Núñez. I have already started talking to my colleagues on the regional U.N. team for Latin America to see how we can identify ways to strengthen the available information and the necessary prevention efforts.

The number of people living with HIV in Latin America and the Caribbean rose to 1.7 million in 2007, 44,000 of whom were children under 15. Although antiretroviral coverage has risen to 62 percent in the region, there are still 240,000 people in need of the life-extending medications, and 140,000 new infections were reported last year.