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Regaining our humanity to protect children

© UNICEF Malaysia/2007/Nadchatram
Leadership by Malaysia's Minister of Health, Dato Dr. Chua Soi Lek has resulted in the implementation of scientifically proven and humane programs to prevent the spread of HIV in the country.

By Indra Nadchatram

International Day Against Drug Abuse, observed annually on 26 June, is a reminder to all of us to play our part to create momentum towards a world that is free from the harm of drug abuse.

KUALA LUMPUR, 26 June 2007 - Imran sits on his shabby sofa feebly eating a piece of fried banana. He manages a weak smile, looking up at his uncle gratefully. Three hundred miles south, Mei Mei pores over her sums, eyes downcast as she desperately attempts to solve a question, hoping a correct answer will earn her a hug from her guardian.

Both share a similar and painful history with thousands of other children in Malaysia, having lost one or both parents to AIDS. The root cause of their grief – injecting drug use. Without warning, HIV has stormed into homes and delivered a terrible blow to these children, robbing them of mothers and fathers, and leaving in its wake, shattered childhoods.

In the two decades since HIV started its merciless march across the country, it has killed 9,155 and infected some 76,000 Malaysians. In recent years, approximately 6,000 people in Malaysia get infected annually. While most are injecting drug users, there is a worrying rise in infections among women through heterosexual transmission. In 1997, there was one HIV positive woman for every 20 infected men. A decade later, the ratio has whittled to a frightening ratio of one woman to every six men.

Efficient transmission

“HIV is sneakily trying to gain a stronghold on the country, using injecting drug use as its main vehicle to deliver a fatal strike,” says Malaysia’s Minister of Health, Dato Dr. Chua Soi Lek adding that injecting drug use is one of the higher risk associated to HIV transmission.  

© UNICEF Malaysia/2007/Nadchatram
HIV has dealt Imran a painful blow, robbing him of his mother and injecting drug user father.

“There is an extremely high chance for an infected drug user to transmit HIV to a non-infected user by sharing needles. Turning our backs to this deadly reality is equal to killing the dreams and futures of even more of Malaysia’s children.”

Despite the Government’s efforts to achieve a drug-free Malaysia by the year 2015, the incidence of drug abuse in Malaysia, particularly amongst the poor and marginalised sections of society appear to be increasing.

Soaring infection rates

The National Drug Agency has recorded around 300,000 drug users in the country, the majority being male between the ages of 25 and 29 years old. Tragically, these are the most productive years for a young adult as they seek to establish the foundations for a job and a family. The Ministry of Health says HIV infection rates among injecting drug users have soared from zero in 1986 to 30 percent in 2006. Heroin, injected intravenously, has been the drug of choice for many years. 

While Malaysia is not a producer of illicit drugs such as heroin, domestic use of this drug is significant. The geographical proximity of Malaysia to the heroin producing Golden Triangle provides a variety of smuggling routes across the Malaysian borders. A 2002 report titled “Revisiting the Hidden Epidemic: A Situation Assessment of Drug Use in Asia in the Context of HIV/AIDS” suggests that fishing boats from neighbouring countries in the north use to land at Pulau Langkawi, Penang and Kuala Perlis to trade but also to traffic in drugs. 

The twin problems of drug abuse and HIV are closely linked to poverty, population mobility and livelihoods, often occurring when people are away from their normal support systems, looking for a new life and work in cities and towns. Unemployment as well as demeaning and dangerous work can contribute to the vicious cycle of drug abuse and increased HIV risk.

Death, a regular visitor

Children are often the silent sufferers when a parent who injects drugs gets infected with HIV. Hidden from the rest of the world, they suffer intense mental and economic distress living through their parent’s illness and eventual death. Most are forced to live with the stigma and discrimination attached to their parent’s addiction and disease. Their suffering is deafening in its very silence.

For 12 year old Imran and 8 year old Mei-Mei, death has visited their home more than once in their young lives. Imran and Mei-Mei’s mothers were both infected with HIV by their injecting drug user fathers. Their mothers died first, then their fathers. Both have also lost siblings to AIDS.

Impoverished and without parents to educate and protect them, orphans and affected children face every kind of abuse and risk, including HIV infection. Without the support of a family, some children feel pressured into exploitative and dangerous work – including exchanging sex for money, food, ‘protection’ or shelter.

Twin problems

Dato Dr. Chua Soi Lek sees drug abuse as both a health as well as a legal problem.

“Accordingly, we must strike a balance between the need to curb illicit drug use and the reality that drug use cannot be eradicated overnight, so it must be made safe. If for no other reason, then at least to keep families alive and together and to ensure children grow up with the support of their parents. If not, more and more children will be orphaned. It’s too huge a tragedy to comprehend.”

But Dato Dr. Chua believes there is hope. “Injecting drug users are one group for whom we know how to successfully reduce HIV through education, counselling, drug treatment, substitution programs, and other measures that have been proven to reduce the harmful consequences of drug abuse,” he says.

Credible, visible and audible leadership by individuals who have the public’s trust is the one single factor that has made the greatest difference in countries that have cut spiralling infection rates.

Leadership in the face of the HIV/AIDS crisis means breaking the silence that keeps the disease hidden. And breaking the barriers of discrimination that persecute people and spread infection. Leadership works towards prevention of HIV and towards treatment and care for those living with and affected by the disease.

Light of science

According to UNICEF’s HIV/AIDS Advisor for East Asia and the Pacific, Ms. Wing-Sie Cheng, society needs to move forward, pass personal fears and prejudices to be able to make a difference in the lives of children.

“In responding to HIV/AIDS, we must be guided by the light of science and not the darkness of ignorance and fear.  For us to be effective in fighting HIV and doing right by our children, we need to treat drug users in a more humane way, respecting them as people with needs, and with families,” she says.

“When we help drug users remain free of HIV, we also protect their sexual partners, their children and the general community from the source of AIDS,” adds Ms Cheng.

Names of children have been changed to protect their identities. 



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