Bangkok - Well-balanced meals are a key ingredient to survival forthe millions of HIV/AIDS patients in South and South-East Asia, WorldHealth Organization (WHO) experts said Tuesday.
"Nutrition and HIVare closely related," said Samlee Plianbangchang, WHO's regionaldirector for South-East Asia."HIV affects nutritional status, and poor nutrition in turn leads tofaster progression of HIV to AIDS," Samlee told a seminar of healthworkers and experts who gathered in Bangkok this week to findsolutions to fighting the two epidemics of malnutrition andHIV/AIDS. "Scaling-up care and antiretroviral therapy cannot beaddressed without appropriate support for nutrition.
"There are an estimated 4 million people suffering from HIV/AIDS inBangladesh, Bhutan, India, Indonesia, Nepal, Myanmar, Thailand, SouthKorea and Sri Lanka, the area defined by the UN agency as South-EastAsia.The good news is that most Asian diets are well-suited to providingthe nutrition HIV/AIDS patients require."I think Thai food is well-balanced and has all the nutrientssomebody needs, but it depends on keeping the right balance of carbohydrates, proteins and fats," said Ranga Saadeh, a scientist working for WHO's nutrition department in Geneva.Evidence has established that people living with HIV have higher energy needs than those who are HIV-negative.
Asymptomatic HIV-positive adults or children need 10 per cent more energy than those who are not HIV-positive, and those at advanced stages need 20 to 30 per cent more energy to maintain body weight,Saadeh said.HIV-positive children who are losing weight need 50 to 100 per centmore energy, she said. Providing a balanced, nutritious diet in countries where malnutritionis endemic poses an added challenge to their health services.
"This HIV/AIDs epidemic is being superimposed on the already existing malnutrition problems," Saddeh said, "so if we want to make a difference, we should really deal with both challenges at the sametime.
"http://www.earthtimes.org/articles/show/121064.html
Wednesday 31 October 2007
Saturday 27 October 2007
"Impact of AIDS on children remains under-researched and poorly
(Speech Check against Delivery) Dr Peter Piot UNAIDS Executive
Director's speech at the JOINT LEARNING INITIATIVE ON CHILDREN AND HIV/AIDS: International Symposium. Harvard Medical School. 24 September 2007.
I first want to thank Jim Kim, Peter Bell, Agnes Binagwaho for
inviting me here today, and to pay tribute to the tremendous work
they – and all of you – are doing. It is a privilege to be here today
with so many experts and activists. The issue of children and AIDS
was overlooked for far too long. UNAIDS was one of the first to
welcome the creation of the Joint Learning Initiative on Children and
AIDS, and I look forward to hearing about the progress you've made.
Let's start by looking at progress on AIDS in general. It's a mixed
picture, but there definitely is progress.
Today, 2.5 million people in developing countries are taking anti-
retroviral treatment up from 100,000 in 2001.
And in some populations in East Africa, the Caribbean, and Asia, HIV
infections are falling.
But if HIV is declining in some populations, it is rising in others.
In some Asian countries there's an upsurge in HIV infections among
men who have sex with men, but infections are declining in other
groups. The most striking overall increases have taken place in East
Asia, Eastern Europe, and Central Asia: the number of people
living with HIV went up by one fifth here between 2004 and 2006.
Globally, young people (15-24) accounted for 40% of new HIV
infections last year.
One in seven new HIV infections last year occurred among under-
fifteens. By the end of 2006, 2.3 million (1.7-3.5 million) children
(under 15) were living with HIV.
Let's just remind ourselves that the United Nations Convention on the
Rights of the Child defines children as people up to the age of 18.
But AIDS epidemiologists compile information for under fifteens and
for 15-24-year-olds. Lack of disaggregated data for children makes it
even harder to take effective action on their behalf.
One reason for this is the feminization of the epidemic: almost half
of all adults living with HIV are women. Only one in ten pregnant
women with HIV in low and middleincome countries receives anti-
retroviral prophylaxis to prevent transmission of HIV to their
children. Every year, more than 500,000 children are infected via
transmission from their mothers.
But this is just one way children become infected with HIV. Sexual
abuse is another.
The second (and main) way is through sex – whether it's between young
girls and older men, sex between adolescents, or sex between
trafficked girls or boys and clients, sexual violence and rape, or
incest.
A third cause of infection is injecting drug use, which often starts
in adolescence. In Russia, 76% of all people living with HIV are or
have been injecting drug users.
This is all fuelled by ignorance about HIV transmission. It's amazing
how prevalent this still is in 2007. I've just come back from China
where most young people have barely a clue about how HIV is
transmitted.
At the same time, only one in ten children needing HIV treatment can
get it – even though paediatric drug formulations are much more
widely available, and the price of antiretroviral drugs for children
has dropped – in some cases to less than 16 US cents per day. Just 4%
of children born to HIV-positive mothers receive cotrimoxazole, which
WHO recommends providing to children when early diagnosis of HIV
infection is unavailable. In Botswana and Zimbabwe, child mortality
rates have nearly doubled since 1990.
Last eek UNICEF reported some remarkable declines in child mortality
throughout the world, for the first time fewer than 10 million
children under five died – except in countries with high HIV
prevalence and those in conflict.
More than 15 million children worldwide have now been orphaned by
AIDS – over 12 million in Southern and East Africa. Orphan
populations are increasing in some populations in Asia, Latin America
and the Caribbean, and Eastern Europe too.
This much we know. Now let me turn to what we don't know.
We are constantly striving to know more about the AIDS epidemic,
through better and more accurate data collection. But there's still a
long way to go.
Today's surveillance categories are too broad and too blurred.
Collecting data for children up to the age of 15 and then for young
people between the ages of 15 and 24 doesn't give us the sort of
information we need: there's a huge difference in terms
of action between HIV infection at 15 and acquiring HIV at 24.
We need much more refined data about different age groups. We also
need to distinguish between the different categories of orphan –
"double", "one parent", maternal and paternal. And we need to become
much more systematic in pinpointing the differences between epidemics
within countries.
We also need to re-evaluate the way we perceive the issue of children
and AIDS. As so often happens, we have tended to only do this through
the medical lens, with a primary focus on mother to child
transmission. But this is to over-simplify, and to
ignore critical social and rights-related issues.
One problem is that we don't know enough about what these issues are.
We sense that AIDS is breaking up families and communities and
challenging traditional safety nets. We know that the impact on
household welfare is greater on the poor than on the better off, and
that gender inequities make girls more vulnerable than boys. We
are aware that it is threatening children's rights - civil,
political, economic, social and cultural.
And then there's the new reality: older children living with HIV. In
recent years, I've been meeting increasing numbers of HIV positive
adolescents and young adults.
But we often still lack hard, empirical data: the impact of AIDS on
children remains under-researched and poorly understood. We simply
don't know enough about what is happening. That's why the Joint
Learning Initiative is so badly needed.
Now let's look at what action is being taken today.
It's nearly 20 years since world leaders decided that people under 18
needed their own convention. That convention - the 1989 United
Nations Convention on the Rights of the Child, famously ratified by
all UN Member States except the US and Somalia – stresses the
importance of making the "best interests of the child" a
primary consideration and lists a series of rights. These include
such basics as information, education, non-discrimination, health,
social security, an appropriate standard of living, to be protected
from violence and different forms of exploitation, and the right not
to be separated from their parents. All are critical if children are
to grow up to live safe and healthy lives in a world with AIDS.
Since then, a series of international meetings and declarations have
highlighted the urgent need to address the issue of children and
AIDS. But to what extent are these declarations being acted on?
A few countries have substantially increased access to services to
prevent transmission of HIV from parents to children. For example, in
Argentina, Botswana, Jamaica, and Ukraine, more than 85% of HIV-
positive pregnant women received antiretroviral drugs to prevent
transmission of HIV to their children.
Some countries - including Botswana, Rwanda, and Thailand - have
scaled up HIV treatment for children by integrating it into treatment
sites for adults. Thailand is getting antiretrovirals to more than
95% of the under-15s in need.
Several countries in southern Africa have provided child grants and
other benefits on a national scale. Kenya, Malawi and Mozambique have
piloted cash-transfer programmes in poor areas.
In 58 countries surveyed last year, 74% of primary schools and 81% of
secondary schools said they were providing AIDS education. This is
critical if adolescents are to protect themselves from infection. To
be effective, AIDS education must fulfil the right to information (as
required in the Convention on the Rights of the Child). It must
provide information about all risks, and offer a broad palette of
prevention options – including abstinence, condoms, and measures to
address inequalities between girls and boys.
More efforts are being made to see that children get a fair share of
AIDS funding. A number of donors including the US and UK have
earmarked at least 10% of their AIDS money to go towards services
for children.
And lastly, more is being done to integrate services – to forge links
across diseases and sectors and bring partners closer together. In
Kenya, Rwanda, Tanzania and Zambia, strategic investment of AIDS
funding is improving services such as immunization and antenatal
care. And Norway's Women and Children First Initiative sets out to
provide a continuum of care for mothers, newborns, and children.
Many organizations are providing support to help countries look after
their children better. UNAIDS co-sponsor UNICEF, for example, has
made tackling children and AIDS one of its top priorities.
In 2005, UNAIDS joined UNICEF to launch "Unite For Children, Unite
Against AIDS", which sets targets for scaling up "The Four Ps":
prevention of HIV transmission from mother to child, paediatric
treatment for HIV, prevention of HIV among adolescents and young
people, and protection and support for children affected by HIV.
And as Peter mentioned earlier, civil society groups –the Elizabeth
Glaser Paediatric Foundation, the Ecumenical Advocacy Alliance and,
of course, the Francois-Xavier Bagnoud Association – are doing
tremendous work.
But most importantly of all, communities are responding and adapting
to the new realities around children and AIDS – often with tremendous
resilience.
So how do we build on this progress and intensify its impact?
We're here today because there are no simple answers to these
questions.
AIDS, as many of you have heard me say before, is an exceptional
issue – in terms of its threat to humanity and its complexity. The
Joint Learning Initiative was itself born out of recognition that the
issue of children and AIDS is immensely complex – and that it
requires a complex response.
I would like to suggest seven elements that I regard as key to making
that response effective.
First, it must be firmly grounded in human rights principles – in
line with the 2003 Comment on the Convention on the Rights of the
Child that "the child should be placed at the centre of the response
to the pandemic, and strategies should be adapted to children's
rights and needs". To be effective, those strategies have to
work equally well for seven-year-olds as seventeen-year-olds.
Second, it must involve a wide range of actors – not least the
children concerned, their parents, grandparents, and members of the
communities they live in. This means bringing children and family
members – including those living with HIV - to the table when
programmes are designed.
Third, it must prevent new HIV infections – for example by scaling up
access to services to prevent mother to child transmission and by
making HIV prevention more available and accessible to adolescents.
By addressing vulnerability and – though I know this is
controversial – by preventing sexual transmission. Universal Access to
HIV prevention, treatment, care and support is not only for adults!
Fourth, it must provide treatment for children. This will mean
scaling up testing and counseling, and making antiretroviral drugs
and cotrimoxazole more easily available.
Fifth, it must provide adequate levels of social welfare to children
infected and affected by HIV, and to their families and communities –
for example through cash transfers.
Sixth, it must be fully funded at international and national level.
This means more money for children and AIDS from international donors
and a higher priority for children in national development plans. At
UNAIDS, we estimate that $2.7 billion will be needed for programmes
for orphans and vulnerable children in 2008.
And finally, as I mentioned earlier, it must be based on more
accurate information.
This means not just improving surveillance but also clarifying how
children become vulnerable, looking more closely at socio-economic
contexts, and intensifying research into psychosocial impacts and
responses. It means looking at children in the contexts of their
families and communities, improving monitoring and evaluation
systems, studying how households cope and what local care-giving
practices involve.
To turn this wish-list into reality, high levels of political will
and commitment will be required. To inform and drive the process
forward, we will need a growing body of knowledge about children and
AIDS. We will need evidence from successful
interventions to show what can be done. And we will need sustained
activism to make sure the right action is taken – now and in the
years to come.
This brings me to my conclusion: it is time now to bite the bullet
and start thinking and acting in the context of the longer term –
something we have repeatedly failed to do up to now. Here, children
clearly have a major role to play.
We need to be confident that what we are doing now works on two
levels – both now and in the years to come. We must take steps now so
a girl born today doesn't grow up to produce an HIV positive baby and
so children born with HIV get anti-retroviral treatment and live
longer, healthier lives.
This means doing what you are doing in the Joint Initiative: taking a
long, hard look at what we are doing, identifying what works and
coming up with new approaches and new research to address new trends.
It means working together in a coherent fashion, on long-term,
integrated programmes: the day of the short-term, ad-hoc project is
over.
And it means ensuring that our response is comprehensive, flexible
and anticipatory - tailored to different epidemics and ready to
change as epidemics evolve: AIDS doesn't stand still, and the world
around it is not standing still - nor can we.
Thank you.
http://www.jlica.shuttlepod.org/Default.aspx?pageId=27417
Director's speech at the JOINT LEARNING INITIATIVE ON CHILDREN AND HIV/AIDS: International Symposium. Harvard Medical School. 24 September 2007.
I first want to thank Jim Kim, Peter Bell, Agnes Binagwaho for
inviting me here today, and to pay tribute to the tremendous work
they – and all of you – are doing. It is a privilege to be here today
with so many experts and activists. The issue of children and AIDS
was overlooked for far too long. UNAIDS was one of the first to
welcome the creation of the Joint Learning Initiative on Children and
AIDS, and I look forward to hearing about the progress you've made.
Let's start by looking at progress on AIDS in general. It's a mixed
picture, but there definitely is progress.
Today, 2.5 million people in developing countries are taking anti-
retroviral treatment up from 100,000 in 2001.
And in some populations in East Africa, the Caribbean, and Asia, HIV
infections are falling.
But if HIV is declining in some populations, it is rising in others.
In some Asian countries there's an upsurge in HIV infections among
men who have sex with men, but infections are declining in other
groups. The most striking overall increases have taken place in East
Asia, Eastern Europe, and Central Asia: the number of people
living with HIV went up by one fifth here between 2004 and 2006.
Globally, young people (15-24) accounted for 40% of new HIV
infections last year.
One in seven new HIV infections last year occurred among under-
fifteens. By the end of 2006, 2.3 million (1.7-3.5 million) children
(under 15) were living with HIV.
Let's just remind ourselves that the United Nations Convention on the
Rights of the Child defines children as people up to the age of 18.
But AIDS epidemiologists compile information for under fifteens and
for 15-24-year-olds. Lack of disaggregated data for children makes it
even harder to take effective action on their behalf.
One reason for this is the feminization of the epidemic: almost half
of all adults living with HIV are women. Only one in ten pregnant
women with HIV in low and middleincome countries receives anti-
retroviral prophylaxis to prevent transmission of HIV to their
children. Every year, more than 500,000 children are infected via
transmission from their mothers.
But this is just one way children become infected with HIV. Sexual
abuse is another.
The second (and main) way is through sex – whether it's between young
girls and older men, sex between adolescents, or sex between
trafficked girls or boys and clients, sexual violence and rape, or
incest.
A third cause of infection is injecting drug use, which often starts
in adolescence. In Russia, 76% of all people living with HIV are or
have been injecting drug users.
This is all fuelled by ignorance about HIV transmission. It's amazing
how prevalent this still is in 2007. I've just come back from China
where most young people have barely a clue about how HIV is
transmitted.
At the same time, only one in ten children needing HIV treatment can
get it – even though paediatric drug formulations are much more
widely available, and the price of antiretroviral drugs for children
has dropped – in some cases to less than 16 US cents per day. Just 4%
of children born to HIV-positive mothers receive cotrimoxazole, which
WHO recommends providing to children when early diagnosis of HIV
infection is unavailable. In Botswana and Zimbabwe, child mortality
rates have nearly doubled since 1990.
Last eek UNICEF reported some remarkable declines in child mortality
throughout the world, for the first time fewer than 10 million
children under five died – except in countries with high HIV
prevalence and those in conflict.
More than 15 million children worldwide have now been orphaned by
AIDS – over 12 million in Southern and East Africa. Orphan
populations are increasing in some populations in Asia, Latin America
and the Caribbean, and Eastern Europe too.
This much we know. Now let me turn to what we don't know.
We are constantly striving to know more about the AIDS epidemic,
through better and more accurate data collection. But there's still a
long way to go.
Today's surveillance categories are too broad and too blurred.
Collecting data for children up to the age of 15 and then for young
people between the ages of 15 and 24 doesn't give us the sort of
information we need: there's a huge difference in terms
of action between HIV infection at 15 and acquiring HIV at 24.
We need much more refined data about different age groups. We also
need to distinguish between the different categories of orphan –
"double", "one parent", maternal and paternal. And we need to become
much more systematic in pinpointing the differences between epidemics
within countries.
We also need to re-evaluate the way we perceive the issue of children
and AIDS. As so often happens, we have tended to only do this through
the medical lens, with a primary focus on mother to child
transmission. But this is to over-simplify, and to
ignore critical social and rights-related issues.
One problem is that we don't know enough about what these issues are.
We sense that AIDS is breaking up families and communities and
challenging traditional safety nets. We know that the impact on
household welfare is greater on the poor than on the better off, and
that gender inequities make girls more vulnerable than boys. We
are aware that it is threatening children's rights - civil,
political, economic, social and cultural.
And then there's the new reality: older children living with HIV. In
recent years, I've been meeting increasing numbers of HIV positive
adolescents and young adults.
But we often still lack hard, empirical data: the impact of AIDS on
children remains under-researched and poorly understood. We simply
don't know enough about what is happening. That's why the Joint
Learning Initiative is so badly needed.
Now let's look at what action is being taken today.
It's nearly 20 years since world leaders decided that people under 18
needed their own convention. That convention - the 1989 United
Nations Convention on the Rights of the Child, famously ratified by
all UN Member States except the US and Somalia – stresses the
importance of making the "best interests of the child" a
primary consideration and lists a series of rights. These include
such basics as information, education, non-discrimination, health,
social security, an appropriate standard of living, to be protected
from violence and different forms of exploitation, and the right not
to be separated from their parents. All are critical if children are
to grow up to live safe and healthy lives in a world with AIDS.
Since then, a series of international meetings and declarations have
highlighted the urgent need to address the issue of children and
AIDS. But to what extent are these declarations being acted on?
A few countries have substantially increased access to services to
prevent transmission of HIV from parents to children. For example, in
Argentina, Botswana, Jamaica, and Ukraine, more than 85% of HIV-
positive pregnant women received antiretroviral drugs to prevent
transmission of HIV to their children.
Some countries - including Botswana, Rwanda, and Thailand - have
scaled up HIV treatment for children by integrating it into treatment
sites for adults. Thailand is getting antiretrovirals to more than
95% of the under-15s in need.
Several countries in southern Africa have provided child grants and
other benefits on a national scale. Kenya, Malawi and Mozambique have
piloted cash-transfer programmes in poor areas.
In 58 countries surveyed last year, 74% of primary schools and 81% of
secondary schools said they were providing AIDS education. This is
critical if adolescents are to protect themselves from infection. To
be effective, AIDS education must fulfil the right to information (as
required in the Convention on the Rights of the Child). It must
provide information about all risks, and offer a broad palette of
prevention options – including abstinence, condoms, and measures to
address inequalities between girls and boys.
More efforts are being made to see that children get a fair share of
AIDS funding. A number of donors including the US and UK have
earmarked at least 10% of their AIDS money to go towards services
for children.
And lastly, more is being done to integrate services – to forge links
across diseases and sectors and bring partners closer together. In
Kenya, Rwanda, Tanzania and Zambia, strategic investment of AIDS
funding is improving services such as immunization and antenatal
care. And Norway's Women and Children First Initiative sets out to
provide a continuum of care for mothers, newborns, and children.
Many organizations are providing support to help countries look after
their children better. UNAIDS co-sponsor UNICEF, for example, has
made tackling children and AIDS one of its top priorities.
In 2005, UNAIDS joined UNICEF to launch "Unite For Children, Unite
Against AIDS", which sets targets for scaling up "The Four Ps":
prevention of HIV transmission from mother to child, paediatric
treatment for HIV, prevention of HIV among adolescents and young
people, and protection and support for children affected by HIV.
And as Peter mentioned earlier, civil society groups –the Elizabeth
Glaser Paediatric Foundation, the Ecumenical Advocacy Alliance and,
of course, the Francois-Xavier Bagnoud Association – are doing
tremendous work.
But most importantly of all, communities are responding and adapting
to the new realities around children and AIDS – often with tremendous
resilience.
So how do we build on this progress and intensify its impact?
We're here today because there are no simple answers to these
questions.
AIDS, as many of you have heard me say before, is an exceptional
issue – in terms of its threat to humanity and its complexity. The
Joint Learning Initiative was itself born out of recognition that the
issue of children and AIDS is immensely complex – and that it
requires a complex response.
I would like to suggest seven elements that I regard as key to making
that response effective.
First, it must be firmly grounded in human rights principles – in
line with the 2003 Comment on the Convention on the Rights of the
Child that "the child should be placed at the centre of the response
to the pandemic, and strategies should be adapted to children's
rights and needs". To be effective, those strategies have to
work equally well for seven-year-olds as seventeen-year-olds.
Second, it must involve a wide range of actors – not least the
children concerned, their parents, grandparents, and members of the
communities they live in. This means bringing children and family
members – including those living with HIV - to the table when
programmes are designed.
Third, it must prevent new HIV infections – for example by scaling up
access to services to prevent mother to child transmission and by
making HIV prevention more available and accessible to adolescents.
By addressing vulnerability and – though I know this is
controversial – by preventing sexual transmission. Universal Access to
HIV prevention, treatment, care and support is not only for adults!
Fourth, it must provide treatment for children. This will mean
scaling up testing and counseling, and making antiretroviral drugs
and cotrimoxazole more easily available.
Fifth, it must provide adequate levels of social welfare to children
infected and affected by HIV, and to their families and communities –
for example through cash transfers.
Sixth, it must be fully funded at international and national level.
This means more money for children and AIDS from international donors
and a higher priority for children in national development plans. At
UNAIDS, we estimate that $2.7 billion will be needed for programmes
for orphans and vulnerable children in 2008.
And finally, as I mentioned earlier, it must be based on more
accurate information.
This means not just improving surveillance but also clarifying how
children become vulnerable, looking more closely at socio-economic
contexts, and intensifying research into psychosocial impacts and
responses. It means looking at children in the contexts of their
families and communities, improving monitoring and evaluation
systems, studying how households cope and what local care-giving
practices involve.
To turn this wish-list into reality, high levels of political will
and commitment will be required. To inform and drive the process
forward, we will need a growing body of knowledge about children and
AIDS. We will need evidence from successful
interventions to show what can be done. And we will need sustained
activism to make sure the right action is taken – now and in the
years to come.
This brings me to my conclusion: it is time now to bite the bullet
and start thinking and acting in the context of the longer term –
something we have repeatedly failed to do up to now. Here, children
clearly have a major role to play.
We need to be confident that what we are doing now works on two
levels – both now and in the years to come. We must take steps now so
a girl born today doesn't grow up to produce an HIV positive baby and
so children born with HIV get anti-retroviral treatment and live
longer, healthier lives.
This means doing what you are doing in the Joint Initiative: taking a
long, hard look at what we are doing, identifying what works and
coming up with new approaches and new research to address new trends.
It means working together in a coherent fashion, on long-term,
integrated programmes: the day of the short-term, ad-hoc project is
over.
And it means ensuring that our response is comprehensive, flexible
and anticipatory - tailored to different epidemics and ready to
change as epidemics evolve: AIDS doesn't stand still, and the world
around it is not standing still - nor can we.
Thank you.
http://www.jlica.shuttlepod.org/Default.aspx?pageId=27417
Monday 1 October 2007
Racism hits non-English speakers' health
Published in Aids_Asia Mailing List, September 17, 2007
Racial discrimination is putting at risk the mental health of manyVictorians, a new government report has found.
The VicHealth report, More Than Tolerance: Embracing Diversity ForHealth, was based on a survey of more than 4,000 people.
It found almost two-in-five Victorians from non-English speakingbackgrounds reported they had been treated with disrespect, insultedor called names because of their ethnicity, with a small proportionof those saying they experienced discrimination often.
Of those who reported racial discrimination, 40 per cent said theysuffered discrimination at work, while 30 per cent were discriminatedagainst in an educational setting, the report said.Almost 45 per cent said they had a bad experience with racism at asporting or public event, while 19 per cent said they experiencedracism at the hands of police.
About one-third of Victorians said they could identify cultural orethnic groups they believed did not fit into Australian society.
The report revealed that those who suffered discrimination were morelikely to suffer poor mental health, smoke and misuse drugs oralcohol.
The findings tally with previous studies that showed an associationbetween discrimination and heart disease, diabetes and low infantbirth rate, VicHealth chief executive Todd Harper said.
People from migrant and refugee backgrounds continued tosuffer "unacceptably high levels of discrimination, in turn affectingtheir health and well-being", he said.
Former Australian Medical Association president Dr Mukesh Haikerwal,who is a GP in Melbourne's west, and who will help launch the report,said the report found a strong connection between racism and poormental health.
"The results of discrimination are a feeling of greater isolation andfeeling less connected with society," he said."That isolation and the very fact that they are racially abused means that they suffer ill-health including mental illness.
"We see this all the time in the west, of course, that people are newto the country, having trouble with the language and setting into anew life."They feel very upset and very much under the gun because of whattheir perceive as discrimination and poor support.
"Mr Harper said while the statistics on racism were striking, therewas also good news in the report."About 90 per cent of Victorian agreed that it was good to have asociety made up of different cultures, so I think that there is afair bit of support that we can build upon here," he said.
The report recommends a range of interventions, including furtherstudies, a range of communication and education campaigns andcommunity development programs to build networks between groups andcommunities.http://au.news.yahoo.com/070916/2/14ftb.html?=mvhttp://www.vichealth.vic.gov.au/discrimattitudes/
Racial discrimination is putting at risk the mental health of manyVictorians, a new government report has found.
The VicHealth report, More Than Tolerance: Embracing Diversity ForHealth, was based on a survey of more than 4,000 people.
It found almost two-in-five Victorians from non-English speakingbackgrounds reported they had been treated with disrespect, insultedor called names because of their ethnicity, with a small proportionof those saying they experienced discrimination often.
Of those who reported racial discrimination, 40 per cent said theysuffered discrimination at work, while 30 per cent were discriminatedagainst in an educational setting, the report said.Almost 45 per cent said they had a bad experience with racism at asporting or public event, while 19 per cent said they experiencedracism at the hands of police.
About one-third of Victorians said they could identify cultural orethnic groups they believed did not fit into Australian society.
The report revealed that those who suffered discrimination were morelikely to suffer poor mental health, smoke and misuse drugs oralcohol.
The findings tally with previous studies that showed an associationbetween discrimination and heart disease, diabetes and low infantbirth rate, VicHealth chief executive Todd Harper said.
People from migrant and refugee backgrounds continued tosuffer "unacceptably high levels of discrimination, in turn affectingtheir health and well-being", he said.
Former Australian Medical Association president Dr Mukesh Haikerwal,who is a GP in Melbourne's west, and who will help launch the report,said the report found a strong connection between racism and poormental health.
"The results of discrimination are a feeling of greater isolation andfeeling less connected with society," he said."That isolation and the very fact that they are racially abused means that they suffer ill-health including mental illness.
"We see this all the time in the west, of course, that people are newto the country, having trouble with the language and setting into anew life."They feel very upset and very much under the gun because of whattheir perceive as discrimination and poor support.
"Mr Harper said while the statistics on racism were striking, therewas also good news in the report."About 90 per cent of Victorian agreed that it was good to have asociety made up of different cultures, so I think that there is afair bit of support that we can build upon here," he said.
The report recommends a range of interventions, including furtherstudies, a range of communication and education campaigns andcommunity development programs to build networks between groups andcommunities.http://au.news.yahoo.com/070916/2/14ftb.html?=mvhttp://www.vichealth.vic.gov.au/discrimattitudes/
Asia's fishermen at risk for unwanted catch: HIV
BALI, Indonesia (AP) — In appearance, they couldn't be more different.Ririn, with her warm brown skin and plump face, simply glows. Youngand sweet, just two months after giving birth to a baby girl.
Edi stands out as the roughest in a circle of men on the fishingdock. Streaks of motor oil mix with sweat on his chest and weather-beaten face as he puffs on a cigarette and talks loudly, not caringthat his frayed cutoffs are unzipped.
The two are part of an expanding nexus that's spreading HIV and AIDS.He's a deep-sea fishermen who spends his short time ashore prowlingfor sex; she's a woman in port who gets paid to provide a warm body.Bali is a famed tourist playground, but there's a side to the islandmost foreign visitors never see. Indonesian fishermen who oftenhaven't seen land for months put in at Benoa Harbour and makestraight for the closest bar with two things in mind: getting drunkand finding women.
These habits have put fishermen at high risk of getting HIV or AIDS -especially in Asia, because it's home to 2.5 million fishermen, orabout 85 per cent of the world's total. Yet fishermen have beenlargely overlooked since the virus began raging 21 years ago, withonly a handful of surveys focusing on them.
One report found that out of 10 poor countries, all but one hadfishermen with HIV rates four to 14 times higher than the generalpopulation.
Two studies of fishermen on big commercial vessels found over 15 percent were HIV-positive in Thai and Cambodian ports. That's more thanfive times the rate of other migrants at high risk for infection,such as truck drivers.A few programs in Papua New Guinea, Thailand and elsewhere in theregion are now working to reach fishermen, and the UN Food andAgriculture Organization earlier this year urged that they berecognized as high risk. But fishermen weren't even mentioned inUNAIDS' 630-page 2006 global report.
"I don't think there's been much targeting of treatment and healthservice availability," says Edward Allison, of The WorldFish Centerin Malaysia, who has researched HIV in fishermen.
The bulk of Asia's fishermen are small-scale operators who return tohome port frequently or stop at coastal fishing camps where women andbooze are readily available. Others work aboard bigger vessels formonths at a time.In Bali, most of the fishermen are bachelors in their 20s and 30sfrom Indonesia's main island of Java. Many come from conservativeMuslim farm families but have traded their traditions for a cultureof danger and machismo.
Some return to home port in Bali at voyage's end. Others fish wellbeyond native waters, docking as far away as South Africa, Sri Lanka,Spain and Panama. Either way, their pockets are filled with money andthe only women waiting ashore are those looking to get paid.
Ririn, who like many Indonesians uses only one name, grew up on arice farm with her parents and seven siblings on the island of Java.She dropped out of school in fifth grade.At 20, she was offered a chance for a better life, working as a maidon Bali, a neighbouring island she imagined was full of hope andmoney."I wanted to help my family back home," she says. "There's a lot ofmouths to feed."But after three months of cooking, cleaning and caring for someoneelse's children, she had only US$20.
Like many young women far from home, she was wooed by a man promising$40 to $50 a month for fewer hours. She would only do it for a littlewhile, she thought. Just long enough to save up for a small businessof her own.After six months as a prostitute, she learned about HIV - when shetested positive. She kept working until her sixth month of pregnancy.
There are no condom machines or AIDS outreach workers on the crowdedwharf in Bali. Some fishermen say they've had a disease "down there"or know someone who has, but many are convinced that certain women,mostly Indonesians, are free of HIV."This area is very safe," fisherman Herman Shokana said above theroar of boat engines. "But when we go abroad, we'll probably get it.
"Most sailors infected with STDs treat themselves with cheapantibiotics. They may take the wrong dose or stop treatment whensymptoms disappear, allowing STDs to linger, which makes it easier tocontract HIV. They also are misled by greedy peddlers.
"When the ships come in, medicine vendors or peddlers are alreadywaiting for them," said Made Setiawan, a doctoral student at theUniversity of Illinois, Chicago, who's researching fishing cultureand the risks of HIV in Bali. The peddlers' typical patterruns, "Here, take this medicine and go have sex in the brothels.
"In Thailand, most commercial fishermen are Cambodian and Burmesemigrants. They change boats regularly and go to different docks,making it difficult to visit clinics or get test results.At some Thai ports, outreach workers from the nonprofit Raks ThaiFoundation distribute condoms and talk to the men about AIDS. Somefishermen also are being trained to provide HIV education and helptreat STDs.
But experts say there's a need to establish STD clinics at ports andbetter educate the fishermen about everything from safe sex togetting infections at tattoo parlors."We're making progress," says Brahm Press, a program manager for RaksThai. "How much of that progress has been able to reduce the spreadof HIV, we're not certain.
"Edi, 20, is the shortest guy on the dock in Bali, but his muscles are the thickest. He's been on shore nearly two weeks after five straightmonths at sea fishing between Indonesia and Australia.
He brags he had sex with up to 10 women a night. His monthly pay ofabout $70 wouldn't have lasted long at the going rate of about $6 for15 minutes.
He usually doesn't use condoms, complaining it's not satisfying. He'snever been sick or tested for STDs, but points to a friend who's hadsyphilis."There's a medicine for HIV. There is a cure," he says. "Maybe itwill take longer to cure, but you will get better."While at sea, the men get little sleep and regularly risk injury or even death. They could be swept overboard in storms, get fouled inlines or cut off fingers while cleaning fish. They live in crampedboats smelling of diesel and gutted fish. Some question why theyshould lessen the little pleasure they get by wearing a condom.Some fishermen also insert BB-sized, glass or plastic pellets intocuts in their penises for enhancement. The wound is sometimes stillfresh when they make shore, but it doesn't stop them from hitting thebars lined with women in miniskirts."They don't have any self-esteem. They are ordered around by thecompany and the captain to do this and that," said Setiawan, who's researching the fishermen. "Sex workers can give them their self-esteem back.
"Ririn, 22, may sleep with up to 10 men a night. Many are fishermen.Worried she may infect a man who could then give HIV to his wife, shesometimes begs customers to wear condoms - which is more than anyonedid for her.
Most refuse.
"I tell them, 'I'm a working girl. There's a chance you might catchsomething from me,"' she says."The man says, 'That's tomorrow's problem.' "She fears, too, that her daughter Meisa may be infected, but it willtake 18 months for the test results.Now, Ririn's back on the street, still trying to earn enough to opena small shop. She hopes she can quit within a year, but realizes itwon't be easy. Especially with a hungry little one at home and asteady stream of fishermen like Edi, all in search of love for sale.
http://canadianpress.google.com/article/ALeqM5jhV4LiKEuDZPb_IOyuQ-FcoUmo_A
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