Young woman braves stigma to tell all about HIV/AIDS
By Ruth Ayisi
PORT MORESBY, Papua New Guinea, 1 August 2004
Twenty-three-year-old Orange Samilo is wheezing and beads of perspiration drip down her forehead as she delivers an animated message in sweltering heat and humidity.
She stands in front of a crowd of about 30 young men, women and youth gathered at a market place in Burns Peak, a poor settlement on the outskirts of the capital Port Moresby, where unemployment and violent crime are high.
They all listen wide-eyed as Samilo tells them that she is HIV positive. It is unclear how they will react. But Samilo, who is dressed casually in trainers, khaki trousers and T-shirt, continues to chat confidently, regardless.
She talks in Tok Pisin about how she felt alienated after her father, an accountant, was wrongly sent to prison, and how her mother could no longer afford to send her to school, although she had been doing well. She says that she began to smoke, drink and had an affair with a married man, and that she gave birth to a daughter when she was only 15 years old. She tells the silent crowd that her second child died of an AIDS-related illness.
The group still does not react. She then warns them to practice safe sex and use condoms. Using a dildo, she demonstrates the correct way to put on a condom.
Despite her difficulty in breathing, she welcomes any questions and continues to stand under the blazing sun. At first the group seems too shocked to speak. Then the questions come.
A young, burly man asks without emotion, “Do you have any regrets about publicizing your HIV positive status?” Samilo replies with a friendly smile, “I have no regrets. People think it is shameful, but it’s not true. But I also want to show people, especially your young women, not to follow the same path as me.”
The man listens and then just acknowledges the reply, but he offers no reassuring smile in return.
Another man asks, “How did you react when you found out you were HIV positive?” Samilo pauses for a moment. “I thought I would never be able to tell my parents. I wanted to run away. But counselling helped me. My parents supported me and I learnt about positive living.”
Samilo continues, responding to questions until they are exhausted.
Most people in Papua New Guinea are unaware of the threat of the HIV/AIDS pandemic, -the extent of the problem, - and are not used to hearing anyone talking about their status openly.
So far about one to three per cent of all pregnant women, who were tested, were found HIV positive.
Currently there are close to 9,000 people who have been tested HIV positive, but there is little information on breakdown in terms of age and sex. The World Bank estimates the HIV/AIDS prevalence at between 50,000-75,000. Since mid 2000, HIV/AIDS has been the leading cause of death among young adults in the Port Moresby General Hospital. Furthermore, tuberculosis patients occupy 30 per cent of all hospital beds followed by HIV/AIDS (14 per cent).
Conditions in the mainland and surrounding islands of 5.4 million people are fertile for a rapid spread of HIV/AIDS. Development came suddenly to Papua New Guinea, with many people from the rural areas recently flocking to the cities, swelling the poor urban settlements. An increasing number of young people are out of school due to high school fees, with little prospects of a job. Crime is on the increase and gender violence is rampant. Girls with little education are drawn into sex work for survival. Traditional cultural practices too contribute to this rapid spread.
Creating awareness of HIV/AIDS in Papua New Guinea is complex. “The usual ABCD message won’t necessarily work here; we need to look at the culture and traditions and see what practices makes young people vulnerable to HIV/AIDS” says Joe Anang, UNICEF Consultant for HIV/AIDS.
In the urban settlements, the so-called “line-ups” or gang rapes are where some boys get their first sexual experience. Gang rapes are a big problem in the country.
The reactions are usually the same. “People listen. They are anxious to know how you catch the virus. But some are afraid and won’t even shake the hands of those living with HIV.”
It was not easy at first for Samilo to come to terms with her status when she was just a teenager, and to come out publicly last year. Samilo remembers how encouraged she was when she saw an advertisement in the local newspaper announcing a rally to be held on the beach for people living with HIV. Her counsellor had told her that it would be good to get together with other people living with HIV in order to share ideas and problems.
When she got to the beach, she was taken aback. “I was shocked to find that there were only two people, a husband and wife.” Samilo and the married couple now work together, closely with the Special Youth Project, educating the youth about HIV/AIDS.
UNICEF assistance also includes educating young people in school on HIV/AIDS, particularly supporting the training of teachers to integrate HIV/AIDS education in their normal teaching. “We don’t believe that you need to stop all classes and talk about HIV/AIDS,’’ says Anang. “Teachers’ capacity needs to be improved, so they can talk about sexual health, HIV/AIDS and sexually transmitted infections (STIs) in their normal curriculum.” UNICEF has supported the development of school materials on HIV/AIDS prevention and care that are currently used in some selected schools in three provinces in the country. There are plans to scale up this project to cover all schools in the country. HIV/AIDS is also discussed in the school’s quarterly parents and teachers’ meetings.
Kenny says that they still need to do much more work amongst young people, but the problem is transport to reach the more remote areas. She also says they need more sensitization workshops especially for youth leaders to increase their skills, and she would like to see the setting up of Youth Friendly Health Services, where young people can get specialized attention for sexual health matters, including HIV/AIDS and STIs, without having to go to the hospital, which can sometimes be intimidating for young people.
Samilo on her part says she will continue with her HIV/AIDS awareness work. Throughout the interview she continues to wheeze. She explains that she has developed asthma and last year she suffered from tuberculosis and pneumonia. Her weight fell from 55 kgs. to her present 41 kgs. She has recently started to take anti-retroviral drugs, which are free, but presently only available at the central hospital in the capital and in the other major city of Lae.
Besides her commitment to her works, she also has her dreams. She smiles and says, “one day I would like to have a husband. I used to think I would never have a chance, but now I know it is possible with someone, he could even be HIV negative.”