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Last Updated: Wednesday, 1 December 2004, 00:28 GMT
Battle to beat Pakistan's Aids taboo

By Paul Anderson
BBC correspondent in Islamabad

Mosque sermon
Sermons preach it is not right to ostracise HIV sufferers
Pakistan is a good example of a country that is learning fast but late about the threat of HIV/Aids.

Unlike India, recorded prevalence in Pakistan is small and the authorities are working to keep it that way.

However, there are still plenty of complaints that government departments and NGOs have done little to help those infected or indeed have any idea of the full extent of the problem.

Pakistan's hosting of a big Aids conference this week to mark World Aids Day on Wednesday may help.

The conference is focusing on the effects of Aids on women and young girls.

Delegates from south and south-east Asia have converged on Islamabad for three days of ministerial and expert discussions.

On the brink

For Pakistan, like most Muslim countries, HIV/Aids remains a taboo subject.

Shukria Gul (left) with her daughter
The doctors treated me as if I had an illness you get from just touching people
Shukria Gul (left)

The official count of the number of people infected, just under 3,000, is dismissed by experts as an irrelevant distraction which masks the true extent of the challenge ahead.

The problem is where to start. There is little testing, tracking or counselling, let alone treatment, of those most at risk.

Some health experts, like Dr Asif Mirza from the Family Planning Association of Pakistan, believe that the country is on the brink.

"This is definitely going to explode and we are afraid of that day and we must prepare ourselves for that," he says.

"We are not actually diagnosing people. The people are not coming to the surface. The first case was diagnosed in '87. Even after 17, 18 years we still talk about stigma and discrimination.

"And the people who are already diagnosed, we don't look after them properly. We don't provide them proper information. We don't even test their families. Of course, government is doing a lot but still I think there's work which needs to be done."

Highly critical

Shukria Gul, the first woman with HIV in Pakistan to come out publicly and campaign on behalf of fellow sufferers, now counsels those who have nowhere else to turn.

She contracted the disease from her husband who received a contaminated blood transfusion and later died.

When we give [condoms to clients] they say 'what's this?' But I send people away if they refuse to use them
Sayeda, sex worker

"The doctors treated me as if I had an illness you get from just touching people. In my neighbourhood people started pointing at me, saying 'she's the one with Aids'."

Shukria set up one of Pakistan's few direct support groups and her experience has made her highly critical of government departments dealing with HIV.

"They give money to agencies who do nice work on paper. Maybe they do work but I haven't seen any of it on the ground.

"Aids will never be contained unless small grassroots groups like mine are supported, so we can spread the message of prevention by direct contact."

Same message

In recognition of the unique reach of religious leaders, the message is also being spread in mosques across the country.

Aids activists have mobilised them for sermons and impromptu sessions.

One such cleric, Maulana Shams ur-Rehman, says: "The Prophet Mohammed said most of the plagues that afflict man occur when he strays from God's path.

"But it's not right to ostracise anyone with HIV. It's the duty of every Muslim to help other Muslims. We have to increase awareness and prevent the spread of Aids."

There is the same message from a vastly different quarter.

Pakistan's sex workers say clients know little about Aids and even less about safe sex.

Sex worker Sayeda in Lahore says most clients do not even know what a condom is.

"When we give them to them they say 'what's this?' But I send people away if they refuse to use them."

Prevention of HIV infection is clearly Pakistan's best hope but it only works through collective awareness and effort, and that is still a long way off.

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