COTE D'IVOIRE: More than half the patients tested in rebel hospital HIV positive
Abidjan, 27 January 2004 (IRIN) - There is no reliable data on the extent to which AIDS has increased in the rebel-held north of Cote d'Ivoire since civil war broke out 16 months ago, but recent informal studies by one haematologist working at the main hospital in the northern town of Korhogo showed alarming results.
Dr Assad Ouattara told IRIN on Monday that he had tested 60 patients at the Korhogo hospital for HIV/AIDS so far this month. Of these, 35 - more than half - were found to be infected with the fatal virus.
Dr Ouattara said he had tested for HIV/AIDS all those patients from whom he had taken blood samples for other forms of blood testing. Some of those who tested positive appeared to be suffering from diseases associated with AIDS, such as tuberculosis. Most simply thought they had malaria. Seven were already so ill with AIDS that he recommended they go to seek treatment in the economic capital Abidjan.
Ouattara said HIV/AIDS appeared to be spreading rapidly in Korhogo, which is a major rebel military base and market centre for the north. He blamed rampant prostitution among girls of school age who had been made idle by the closure of most schools in the north since the civil war began in September 2003.
"Thank God classes are about to resume because here in town we are seeing young girls abandonned by the education system indulging in these undesirable activities," Dr Ouattara said.
Although Cote d'Ivoire remains divided after nearly nine months of ceasefire, the Ministry of Education has announced plans to start reopening schools in the main towns in the north from 3 February.
According to Health Ministry statistics, 10.2 percent of the population of Korhogo was HIV positive in 2001 before the start of the civil war, putting the town pretty much in line with the national average.
But no-one doubts that war has pushed that figure much higher. "When a country is at war, the risk of HIV/AIDS spreading automatically goes up," said Alain Manouan, the head of projects at UNAIDS in Cote d'Ivoire.
Korhogo used to have its own AIDS testing centre, but it closed down at the start of the conflict. Dr Ouattara's testing of selected patients is all that has been done since.
One problem in the north is the patchy availability of condoms. But even where they can be brought, many people cannot afford to use them.
A condom generally costs 100 CFA (20 US cents), but according to Suzanne Fanth, the secretary of a committee that is trying to relaunch education in the rebel-occupied city of Man in western Cote d'Ivoire, that is all that some girls earn from offering to have sex in the first place.
"With their families displaced, most of these young girls don't earn enough to cover their needs," Fanth said, noting that they generally sell their bodies for 100 or 200 CFA (20 to 40 US cents) a time, or 500 CFA (US$1) if they are very lucky.
She said most of these young girls had sexually transmitted diseases which they mistook to be malaria.
Diomande Amara, the president of the same education committee in Man, told IRIN by telephone that he reckoned about 2,000 girls aged between 12 and 15 had taken up prostitution in the rebel-held area of Western Cote d'Ivoire since the schools there had closed.
Fanth said another problem was that the rebel fighters, who were the prime customers of these sex workers, are often reluctant to use condoms even if they are available, either through machismo or plain ignorance.
The World Bank has earmarked US$35 million to combat HIV/AIDS in areas of Cote d'Ivoire affected by war as part of its post-war package of aid to help rebuild the country. But pending progress on issues such as legal reforms demanded by a French-brokered peace agreement and the disarmament of rebel forces, the money has not yet been disbursed.