Living with HIV an uphill battle

Mohana Rosario is like many people living with HIV in the world today. The 30-year-old mother of four from Manikganj District, 75km from the Bangladeshi capital, Dhaka, faces an uphill battle caring for herself and her family.

But her story is also one of intense tragedy. In September 2005 and pregnant with her fourth child, her husband, a local car mechanic, went for a swim in the sea and never returned.

"It was as if I drowned in the sea and not my husband," Mohana said in the waiting lounge of Ashar Alo (Light of Hope) Society - one of a handful of local non-governmental organisations (NGOs) in Bangladesh working to provide counselling, psychosocial and medical support to those living with HIV.

"First, there were itches on the skin. Then in a month or so, the itches turned into boils. For more than three months, I suffered from intermittent fever, coughing and a burning sensation on my palms and feet," she recalled.

Then in February 2006 she gave birth to a baby - a child only later she would learn was also HIV positive - while she continued to suffer. "I lost my appetite and threw up anything I ate. I suffered from persistent diarrhoea," she said of the time.

By June 2006 her weight had dropped from 50 kg to just 30 kg in just four months. "Simply I was dying," she said.

Facing the truth

It was only in September 2006, when her sister-in-law, a medical nurse, took her to Ashar Alo that she was finally diagnosed with HIV.

"I regularly visited Ashar Alo for three months. I was given free medicine and advice which I still get. I began to improve fast. By the end of 2006 I had regained my lost health. More importantly, I regained my faith in life. From 30 kg in June 2006, I am now 50 kg again," Mohana said.

Equally important, Mohana was also saved from the stigma that often accompanies the virus in this largely conservative Muslim society of over 150 million inhabitants.

"I am lucky that I did not have to face discrimination or suffer social stigma," she said, conceding that many are not so fortunate.

"I know of women who were beaten by members of their families for being HIV-positive. I know people who were ostracised by their communities. Their beds and belongings were burnt. Their children were denied entry into schools," she said.

To this day, Mohana remains oblivious as to how her husband might have contracted the disease. Faithful to his memory, she prefers to believe that he contracted the virus through a blood transfusion after a traffic car accident he supposedly had in India in 2000.

Dubai connection

Such stories in Bangladesh, where open discussion of HIV remains largely taboo, are not unusual, but continue to prevent many from securing the awareness they actually need.

For instance, Abdul Barik Howladar from Khulna District now cares for his elder sister Rabia Khatun, 50, who has also been tested HIV-positive. He takes his sister to Ashar Alo twice a week, where she is already showing signs of improvement.

"None of our relatives know that we come here," the 42-year old said. "We tell them that my sister is being treated for pneumonia at a private clinic in Dhaka. My sister and her husband are highly respected," he said, a fact belying the real challenge at hand, but duly noted by those on the ground.

"I dream of a society where HIV-positive people will get the right treatment both medically and socially," said Habiba Akter, the founder of Ashar Alo Society.

Mukto Akash (Free Sky) Bangladesh is another HIV prevention, care and treatment centre run exclusively by people living with HIV. From August 2003 to date, Mukto Akash has provided support to 485 HIV-positive people.

"Many of our members have died. Some left the country. Some shifted to other NGOs. At present we have 294 members who receive regular counselling, training and treatment from us," said Mukti, executive director of the NGO, currently the only centre of its kind working directly with commercial sex workers, she said.

More needs to be done

Although the prevalence rate for the virus remains low in Bangladesh - below 1 percent - officials are aware that they cannot afford to be complacent.

"We have only 1,207 proven cases of HIV-positive people, with an estimated 7,500 cases in the country. But that does not give us the option to sit idle," Mohammad Hanifuddin, deputy director of the government's national HIV/AIDS programme, said.

In at least two places in Dhaka, a concentrated epidemic of the virus has been identified among injecting drug users (IDU), with a 10 percent prevalence rate among IDUs in one part of the city.

"Recent experience shows that concentrated epidemics may trigger large-scale outbreaks of HIV/AIDS in a country," Hanifuddin explained, citing commercial sex workers, men who have sex with men, IDUs, and other vulnerable groups, as potential bridges to mainstream heterosexual society.

sa/ds/cb