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No friends, few drugs and little expertise for AIDS patients

[oPt] A Palestinian woman approaches Israel's wall at Al Ram, Jerusalem. [Date picture taken: 11/06/2006] Tom Spender/IRIN
The Israeli Barrier extends repeatedly into the West Bank, and Palestinians are worried it may serve as a de-facto border in the long run
The manner in which 14-year-old Mahmoud (not his real name) was infected with HIV was unusual - but the subsequent reaction of Palestinian society was all too predictable.

"I got it from a blood transfusion when I was 12. Now, no one talks me. My friends all left me when they knew that I'm AIDS patient. I feel I'm alone in this world. They are afraid to get infected from me, as I was infected, but it is not my fault that I have AIDS now," said the youngster from the West Bank.

"I'll never finish college. I'll never have a family like the others. I will never have babies. I also believe that it will not be long before I leave this world," he added.

Mahmoud is one of 36 people known to be living with AIDS in the Occupied Palestinian Territories (OPT), according to the Palestinian National Authority (PNA). Altogether, there have been 61 recorded cases in the West Bank, Gaza and East Jerusalem since 1987, with five times as many men infected as women, according to Ezzat Gouda, a doctor and director of the sexually transmitted diseases (STD) unit at the Palestinian Ministry of Health.

Twenty-five of those infected have already died, Gouda said. More than half the existing patients are described as being heterosexual, two as bisexual and one, homosexual. A further 11, including Mahmoud, were infected during blood transfusions. Three were infected from injecting drugs.

Gouda added that efforts by Palestinian health care providers and institutions to help patients, were not coordinated, and provided patchy cover. "It is necessary and urgent to have a national plan for STD and HIV services in Palestine," he said.

Social stigma

Gouda heads the Palestinian National AIDS Programme (NAP), established in 1998. He told IRIN/PlusNews that officials may not know the true scale of the problem in OPT because the social stigma attached to AIDS in the Arab world prevents people from reporting to the medical authorities.

In a situation unique in the Middle East, the stigma attached to AIDS in the OPT means positive Palestinians are both automatically denied entry into Israel for security reasons, and identified by Israeli intelligence services as potential informers, according to an Israeli non-governmental group, Physicians for Human Rights Israel (PHRI).

The Shin Bet, Israel's security agency, believes that the stigma of having AIDS in Palestinian society means people living with it are more likely to be coerced into carrying out an attack to reestablish their family's reputation, PHRI said.

"There have been instances where the weakness and desperation of sick Palestinians were exploited in recruiting them to carry out attacks within Israel," PHRI wrote in a report in October. "The Shin Bet also exploits exactly these things to recruit them as collaborators and to wring information out of them."

Israeli security sources denied to IRIN/PlusNews that they employed such broad profiling criteria when dealing with sick Palestinians wanting to enter Israel.

Islam a shield to AIDS

Many Palestinians believe they will not be infected by HIV because Islam takes a hard line on some of the practices by which the virus can be spread, like homosexuality, sex work and intravenous drug abuse. "The Islamic religion stands as a shield to AIDS. If we follow Islam's instructions, AIDS will never be a problem at all," said Sheikh Taysir Tamimi, the Palestinian Chief Justice.

According to Palestinian health director, Gouda, Palestinians who travel to Israel and abroad are more exposed to the virus - there are an estimated 4,000 people living with HIV/AIDS in Israel, according to a UNAIDS survey in May, which did not include an estimate for OPT.

Some efforts to spread AIDS awareness have been made by the Palestinian authorities and the United Nations Works Relief Association (UNRWA), which looks after Palestinian refugees. But both organisations spend most of their time grappling with the more immediate crises affecting Palestinians, Gouda said.

Though HIV-positive Palestinians are treated for free, antiretroviral drugs are not always available, he said. "We depend on the donation of drugs, national and international. So we have many problems in view of Israel's siege and repeated closures of the Palestinian territory. In some cases, patients were suffering unnecessary illness because they had no drugs or were denied access to Israel."

Mahmoud and Palestine's 36 other HIV/AIDS patients continue to suffer from a lack of expertise among medical staff, Gouda said. "The lack of trained medical staff and social workers for counselling and psychological support in the field of HIV/AIDS also stands as a grave constraint," he added.

Israel and Western nations slapped an aid embargo on the Palestinian government, after Palestinians democratically elected Hamas in January – the pressure is aimed at getting Hamas to renounce violence, and to recognise Israel's right to exist.

Israel says Palestinians have their own government to blame for the aid crisis.

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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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