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Maura Elaripe, HIV activist from Papua New Guinea
By CEDRIANN J MARTIN
Don't worry," her husband told her. "They made a mistake. It
wasn't your blood." Then he asked: "What is HIV?"
Maura Elaripe is the first person from Papua New Guinea (PNG) to
go public about having the virus. The activist addressed a
gathering of scientists and clinicians at the opening of the
International AIDS Society (IAS) Conference on Pathogenesis
Treatment and Prevention in Sydney last month. She put
four-days-full of scientific notions and numbers into
perspective.
PNG has the highest incidence of HIV infection in the Pacific
region, with about two percent of its adult population infected.
A recent AusAID-commissioned report concluded that unless
interventions to address the impact of the virus are scaled up
by 2025 there'll be thousands of difficult stories: 500 000 of
the country's five million people will be living with the virus
and 117, 000 children would have lost their mothers to AIDS.
Elaripe's story with the virus began in 1997. She was 22. She'd
been married for a few months. She was having her first child.
And she'd graduated from nursing school a couple years before.
But she knew only a little more about HIV than her husband did.
"At the college we were just introduced to it" she says. "All I
learned was that there was no cure."
Papua New Guinea is the largest of the Pacific Islands. It's a
remote, isolated place full of remote, isolated places.
"Our country is beautiful. There are rivers and oceans,
untouched rain forests, mountains, nice sandy beaches. The main
method of traveling from one province to another is by plane.
There are few connecting roads because the terrain is so
rugged," she explains.
So it took a relatively long time for HIV to get there. Although
the first case appeared in 1987, the epidemic didn't begin to
take hold until the 1990s. While the rest of the world sized up
a mystery disease, PNG was oblivious. While strides in treatment
were being made, they stood still. And when Elaripe was given
the results of an HIV test that she didn't know she had been
given, there was neither care nor support for people living with
the virus. (The PNG government's official response to HIV didn't
start until 1999.)
"Nurses told me the doctor wanted to see me. I saw that my card
had a red dot on it for high risk patients. I thought maybe my
baby wasn't okay. The doctor just said: 'I have some bad news to
tell you. Your blood was tested for HIV and it's positive. Come
back in two weeks to confirm the result." Her husband was wrong.
They were both infected. They were told to sit. A social worker
would be with them shortly. No one ever came.
Four years of marginalisation and depression followed. Her
family wondered why she was so ill during pregnancy. She didn't
say.
With no drugs to reduce the risk, Elaripe's baby was born with
the virus. The thought of an HIV positive child so horrified
nurses that when she brought the three-month-old to the hospital
to be treated for a respiratory infection she was refused. They
remained in the Emergency Room for an entire day. Then her
daughter died.
When she became pregnant a second time hospital staff let her
have it.
"The nurses and doctors were so angry with me. They said I was
so stupid to have a baby. I felt like I was doing something
wrong illegal. Pregnancy is supposed to be happy but I was so
depressed," she says in a soft voice.
Her son contracted polio after receiving a vaccine. She waited
for him to die, opting to nurse him at home rather than leave
him at the hospital. He passed away, finally, on Christmas Eve.
Elaripe moved to a rural hospital to escape it all but wound up
overworked and contracting tuberculosis. Emotionally and
physically broken, she returned to her village. It was then that
her late husband introduced an Australian activist who would
change her life.
"She took me and looked after me and treated me like a daughter.
It was the first counseling I'd had in four years. When I told
her the story she was so shocked. She said I would not go
through those things again," Elaripe remembers.
Her mentor opened the window of the world wide web and for the
first time she was exposed to the concept of positive people
living positively. And to treatment possibilities. And to
support networks. Elaripe found her purpose: she'd make sure
infected people in PNG had access to the same kinds of support
and services.
She first spoke publicly on World AIDS Day in 2001. Elaripe was
frightened but the audience responded unexpectedly humanly.
"When I spoke I saw all the mothers and women crying. They said
'we didn't know this is happening in our country. If they don't
treat you right come back here.' I saw how the people responded.
And I knew there was work to do," she says.
Along with nineteen other people living with HIV she launched
the Association of Positive People in 2005. Advocacy and
international aid have led to the operation of an AIDS clinic,
voluntary counseling and testing (VCT) sites and referrals for
peer support. She's encouraged but far from satisfied.
Stigma is so profound that families often refuse to claim bodies
at the hospital morgue. So there are mass burials ever so often.
And there are still issues surrounding access to life-saving
antiretroviral treatment.
"We still need to roll out the drugs into rural provinces. There
are challenges with the management system of the health
department," she says bluntly. "It's not functioning. They don't
think about people. They think about filling their pockets."
She says that while there's funding for the HIV response from
entities ranging from the World Health Organisation to
Australian Aid, money isn't being spent optimally.
"There are so many millions of dollars coming into PNG and
they're spending it flying here and there. They have workshops
in the most posh hotels you can think about when we should be
saving the money for programs to care for people," she sets out.
Then second line treatments aren't available in PNG. This
directly affects Elaripe who is on antiretrovirals but recently
discovered that she's developing a resistance.
"I did a viral load test and it's high. I don't know where I'll
get my second line medicines. I've been on drugs since 2002 and
the way I travel sometimes I forget or get confused with the
time and don't take my drugs. I feel well. But the viral load
test "
Last year she formed a support group to address the specific
needs of women living with the virus. She says unsafe sex,
infidelity and rape are fuelling the HIV epidemic. Young women
bear the brunt.
When she was a girl she wanted to be an airhostess. It was her
ailing father who sent in the application for nursing school.
"I was so angry," she says with a laugh. "I didn't want to dress
sores and treat sick people."
Now she's updated her ambition. She wants to be a politician.
But as courageous as Elaripe has been she's still dogged by
doubt.
"I'm thinking about a political career," she says. "I'd like to
go and study project management or women in politics in
Washington with an organization called We Lead. But I know it is
not possible."
Then she adds, a little more quietly: "And I'm hoping that I get
married again."
 
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