Feds call for AIDS, blood system inquiry: Some seniors infected

By David South

Today’s Seniors (Canada), July 1993

HIV-tainted blood transfusions given in the early 1980s have left some seniors with AIDS, but it is feared many are unaware of their HIV-positive status. 

Between 1979 and 1985 - before testing of blood products for HIV became mandatory - 266 transfusion recipients and over 677 hemophiliacs are known to have been infected in Canada, according to the Centre for AIDS Statistics. 

But the final numbers are unkown - estimates range from 400 to 1,000 cases of HIV transmission among the 1.5 million Canadians given blood products during this time. 

This uncertainty is fueling public concern. With such a serious public health danger, many are shocked by the confusing messages being sent by governments, the Canadian Red Cross Society and hospitals. 

But it took the report of an all-party Parliamentary subcommittee on health, released at the end of May, to shock the federal government into calling for a public inquiry into the blood system. The report is highly critical of the decision-making process involved in blood collection and distribution. 

“We have members of our group who are seniors,” says Jerry Freise, spokesperson for advocacy organization HIV-BT (Blood Transfusion) Group, whose wife was infected with HIV due to a blood transfusion. “And many of them went for years being misdiagnosed and treated for something other than HIV. Others have gotten sick, and one died without knowing it because nobody told him. 

“A classic case is Kenneth Pittman who was infected in 1984. The Red Cross found out in 1985 and they allegedly took two years to tell The Toronto Hospital. The hospital took two years to tell his doctor, and his doctor decided not to tell anybody. 

Infected

“Another couple, a lady of 59 and a man of 64, called us April 1. She found she was infected, and the reason she took a test is because her husband turned out to be HIV-positive three weeks before a transfusion in 1983. He had gone for years without a diagnosis from doctors.” 

This runs counter to the Red Cross’s story. 

“Whenever a blood donor tests positive for HIV antibodies, we go back and trace the prior donations,” says spokesperson Angela Prokoptak at the Society’s national office. “The Red Cross supplies blood to hospitals, so we know which units went to which hospital. But the hospital must go through their records to find who they transfused. 

“After identifying the recipient, the hospital contacts the recipient’s physician, and then they have them tested. There are of course limitations.

“Since 1987, the Red Cross has been advising people who may be concerned to consult their physician for counselling and advice.”

But subcommitte member Chris Axworthy, an NDP MP, found that hospitals and the Red Cross hesitated to notify former patients for fear of lawsuits. He says the federal government should show some leadership and stop passing the buck to other agencies and departments. 

Only two hospitals in Ontario - Toronto’s Hospital for Sick Children and Princess Margaret Hospital - have tried systematically to contact former patients. 

Ontario health ministry spokesperson Layne Verbeek says it is a laborious and costly task for hospitals to notify former patients. “We’ve always informed people if they are thought to be at risk, but many hospitals aren’t in the position to trace. If people are at risk or have doubts, they should be tested.”

Verbeek says recent media coverage has caused an increase in the number of people seeking HIV blood tests - requests for the test doubled after the Sick Kids hospital went public. The provincial government’s lab went from 700 tests per day to 1,300, but Verbeek says that has started to taper off. 

The ministry of health is happy with the number of people coming forward to be tested, says Verbeek. 

But Friese says the different players are more concerned about lawsuits than informing the public. He is especially upset at the Red Cross for not taking a leadership role in disseminating information. 

“The Red Cross and the medical system have failed miserably to contact people. Even today they are reticent to tell people they were part of a risk group and should get treated.” Friese feels the various governments and the Red Cross are leaving the job of informing the public to his group and the Canadian Hemophiliacs Society. 

Beat the drums

“It’s my job to beat the drums for the media while I’m dealing with my wife being infected? That’s my job, when these are the ministers of health?”, Friese says with anger.

The effect of AIDS on seniors isn’t new to US-based National Institute on Aging researcher Marcia Ory. She and colleagues helped sound the alarm back in 1989 with the book “AIDS In An Aging Society: What We Need To Know.” In the US, over 10 per cent of AIDS cases have occurred in people over 50. 

“Surprisingly, people have ignored older people and the AIDS issue,” says Ory. “You had older people in hospitals who might have complained about fatigue which was thought to be age-related. Older people aren’t as likely to be diagnosed as early because of the assumption that they are not at risk from AIDS.

“We don’t want older people in general to be overly fearful, but we want them to acknowledge the possibility, and to engage in good preventative practices if they are at risk.” 

Ron deBurger, director of AIDS prevention for the Canadian Public Health Association, would like assurances that the security of the blood supply has improved. 

“The subcommittee came to the right conclusion asking for a public inquiry,” says deBurger. “I would hope the terms of reference are broad enough to take a look at the whole issue of the safety of the blood supply, not only in terms of what happened in the past, but, more importantly, what’s happening today.”

Other than hemophiliacs, who require large quantities of blood, deBurger believes anybody who received one transfusion has a small risk. “If you had blood once, I think the odds are pretty long that you are going to end up with tainted blood. But AIDS does take eight to 10 years to manifest itself, and we might still be picking up pieces for the next four to five years that we don’t know about yet.” 

Friese recommends that anybody who received blood or blood products between 1979 and 1985 get an HIV test. If their doctor says it isn’t necessary, they should call the AIDS Hotline about anonymous testing. 

Anybody who has tested positive for HIV and would like support and counselling can call Robert St-Pierre of the Canadian Hemophilia Society at 1-800-668-2686.

For information on anonymous testing call the Ontario government’s AIDS Hotline in Toronto at 416-392-2437. For support write HIV-BT Group, 257 Eglinton Avenue W., Suite 206, Toronto, Ont., M4R 1B1. 

Rainforest Rubbers Save Lives

Two development goals are being achieved with one innovative business in Brazil. By using natural rubber tapped from trees in the Amazon rainforest to make condoms, Brazil is able to afford the cost of distributing condoms to tackle its HIV/AIDS crisis. Brazil currently imports more than 120 million condoms every year from China, Republic of Korea and Thailand, making it the world’s biggest single buyer of condoms. The government gives them away for free as part of a national campaign to combat HIV. More than 620,000 people in Brazil are living with HIV out of a population of more than 186 million (UNAIDS, 2005).

The Natex company, co-owned by the public health ministry and the north-western state government of Acre, has established a factory to turn rubber from the world’s biggest rainforest into condoms. The business has created 500 jobs at the factory and 150 jobs for the local indigenous population – the Xapuri – who are traditional rubber tappers.

The factory hopes to produce 100 million condoms a year from local rubber – just 20 million shy of all the condoms the country currently has to import – and could even reach 270 million at full capacity.

“This product will allow people to make love with security and to better plan their futures,” said Raimundo Barros, vice president of the local agricultural association.

The 15,000 Xapuri people who live on the Chico Mendes reserve – named after a conservationist and rubber tapper murdered by ranchers in 1988 – tap seringai trees, which produce rubber that is said to be a more effective barrier to the transmission of sexually transmitted diseases (STDs), than synthetic rubber condoms.

The factory’s 500 employees will earn a total of Reais $2.2 million (US $1.3 million) while the tappers will see their income increase by 250 per cent as demand goes up for the rubber, according to Natex.

“Because of this I’ve managed to buy a few cows and give my family a better life,” rubber tapper Hugo Paz de Souza, 43, told local newspaper Pagina 20. Paz de Souza said the factory will double his income to US $394 a month.

The fact the trees will be saved because of their value as sources of rubber is a great boon to the world’s environment. The trees in the Amazon rainforest – the “world’s lungs” as some call it – face the threat of being chopped down to make way for Brazil’s booming agricultural economy. Official figures released in January 2008 showed that between August and December 2007, about 2,700 square miles were chopped down illegally in the Amazon rainforest. It was the first increase in deforestation after three years of declines and coincided with a rise in global food prices.

Marina Silva, Brazil’s environment minister, told the Guardian newspaper the Natex condom would help create “a new pattern of production and a new process of inclusion that would value the forest being left standing”.

By David South, Development Challenges, South-South Solutions

Published: May 2008

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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Dabbawallahs Use Web and Text to Make Lunch on Time

The developing world’s rapidly growing cities are bringing with them whole new ways of living and working. One rapidly expanding category of citizen is the office worker. A symbol of growing prosperity, the office worker also tends to be a time-poor person who often must commute large distances between home and workplace.

These long commutes mean that many workers have lost the old ability to go home for lunch. This has led to an expanding new field of business: catering to all these office workers’ appetites.

Every morning Mumbai’s legendary dabbawallahs (it means “box-carrier” or “lunchpail man”) fan out across the city to collect freshly prepared lunches from people’s homes and restaurants. They then efficiently use the transport network to quickly deliver lunches to the customers’ workplaces. Once just for the elite, the dabbawallah lunch has become the norm for Mumbai’s middle class office workers. Lunches are packed into small, metal tiffin boxes, ingeniously organized so each component of the meal is sealed in its own section and kept warm.

With a plethora of religious and cultural practices, Indians are particular about what they eat. In Mumbai there are 200,000 office workers receiving cooked lunches every day delivered straight to their desks. This is done by an army of 5,000 dabbawallahs. While their delivery accuracy was already impressive – only six deliveries in a million go astray – they realized they had to adapt to the city’s rapid changes. In addition to their network using trains, hand-carts and bicycles to get the lunches to desks, they have turned to the internet and mobile phone SMS text messaging to take orders.

It is a 125-year old industry that has grown at the rate of five to ten per cent a year and all are paid the same no matter what their function in the business.

With foreign direct investment into developing countries surging – according to the United Nations Conference on Trade and Development (UNCTAD), it rose by 12 per cent from 2005 to 2006 – the number of office workers is on the rise too.

The trend is especially pronounced in India, which is on track to overtake the United Kingdom as the world’s fifth largest economy by 2010, according to investment bankers Goldman Sachs.

India’s cities are booming. Mumbai is one of the top five global megacities as well as the world’s most crowded metropolis. The dabbawallahs are an excellent example of how a business can move with the times.

A key component in India’s new-found success has been a willingness to do things better and become more efficient; the key to this is often information technology. The new technology for the dabbawllahs has been built for them by software engineer Manish Tripathi – he has even been adopted as an honorary tiffinwallah.

“When people move to Mumbai for work, and need a lunchbox carrier, who do they ask?” he said. “They ask their friends, or their neighbour. Now, they just need to go to the website and they can find out how to get in touch with us. They can also get in touch with us via SMS.”

The move online has been a great success said Tripathi: “We get 10 to 15 enquiries more a day via SMS and the website.”

Raghunath Medge from the dabawallahs cooperative said they are also making money by selling advertising on table mats. They have also turned to being a health service: they distribute health advice, beginning with this year’s World AIDS Day. An “AIDS kit”, comprising a car calendar and fliers on testing and counseling tied neatly with a red ribbon, was distributed ahead of World AIDS Day December 1.

“The kit was attached to empty lunch boxes and delivered to about 100,000 clients’ homes,” said Raghunath Megde,

Targeting hungry office workers is a goldmine for others too: in Saigon, Vietnam, the Ben Thann restaurant capitalised on its proximity to an area with a fast-growing office worker population to increase its profits. “Since our restaurant began serving lunch for office workers our business has increased by 60 per cent. This increase in number of guests enjoying the new menu was the main reason for Ben Thanh’s decision to introduce a buffet lunch,” said Nguyen Thi Thu Thao, deputy manager of Ben Thanh Restaurant.

In the past, the dabawallahs were visited by Prince Charles and British entrepreneur multimillionaire Richard Branson, to study their working methods. It looks like this next round of innovation will equally grab the world’s attention. 

By David South, Development Challenges, South-South Solutions

Published: December 2007

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

Follow @SouthSouth1

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Lamas against AIDS

By David South

UB Post (Ulaanbaatar, Mongolia), November 5, 1997

Manila, Philippines – Since HIV is contracted through sex, the disease has always been a difficult subject for the world’s religious leaders. When there is sex to be discussed, no religion can do it without bringing up morality.

This moral debate about bedroom behaviour has tainted discussion of AIDS in many countries. At the extreme end of the spectrum, some evangelical Christian leaders in the US have painted AIDS as an apocalyptic disinfectant for humanity.

Not surprisingly, this attitude has not helped in educating the faithful that AIDS can happen to anyone and its victims should be treated like any other ill person.

The Philippine conference heard that the standoff between the world’s leaders and public health authorities must stop. Dr Peter Piot, executive director of UNAIDS, pointed to the numerous delegates from the world’s religions and called on others to follow their example.

“In Myanmar, the Myanmar Council of Churches, the YWCA and other community-based organizations have joined hands with local authorities, health workers and Buddhist groups for community-based prevention, care and support programmes,” he told the assembly.

“This is the best practice in action.”

Mongolian delegate Dr Altanchimeg thinks a similar approach could work in this country.

“Now every Mongolian goes to see lamas. It’s a good channel to advocate for AIDS education. In Thailand, lamas are very experienced at this. People believe in lamas.”

Like their colleagues in Thailand and Myanmar, Cambodian lamas have been in the forefront of AIDS education.

Lamas there use festivals and ceremonies to raise the issue.

You Chan, a 30-year-old lama from Tol Sophea Khoun monestary in Phnom Penh, likes to raise the issue delicately, by referring to diseases in Buddha’s time.

“I feel it is difficult to speak about sexual methods with a large audience – I will not speak to sexual methods.

“At first, it was very difficult. People would ask why a monk would say such things. But I tried and tried and the people understood who is helping them.

“My message to Mongolia’s lamas is this: you have a moral responsibility to educate the people about AIDS, that it is happening all around the world and there is no medicine to cure it.

“You have to take care in the name of Buddhism to help people in this world.”

You Chan teaches lamas at 15 temples in Cambodia, who pass the message along to other lamas and congregations.

Update: Interestingly, two decades after this story was written, it seems the other kind of llama's antibodies can "neutralize a wide range of circulating HIV viruses". From ScienceDaily: How llamas' unusual antibodies might help in the fight against HIV/AIDS

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Philippine conference tackles Asia’s AIDS crisis

Mongolians attend for first time

By David South

UB Post (Ulaanbaatar, Mongolia), October 28, 1997

Manila, Philippines – More than 2,500 delegates have gathered in the steamy hot Philippine capital to renew the fight against HIV and AIDS.

Working up a sweat alongside other participants at the Fourth International Congress on AIDS in Asia and the Pacific are nine Mongolians – a first that isn’t going unnoticed.

The Congress opened Saturday (October 25) to the pounding beat of a theme song performed by teenagers, championing defiance of death and celebration of life.

That tone was echoed by Dr Peter Piot, executive director of UNAIDS, the Joint United Nations Programme on HIV/AIDS. He said the epidemic can be slowed down with the right public health measures – a positive message for Mongolia as it grapples with an STD crisis that many believe leaves the country at risk of an HIV/AIDS epidemic.

The magnitude of that epidemic outside Mongolia is startling. Around the world, 23 million people are infected with HIV, the virus that causes AIDS. Between 5 and 7 million of them live in the Asia/Pacific region.

“The point is that prevention is feasible,” Piot told the Congress. “The results can be seen in those countries in the Asia-Pacific region where the epidemic has stalled or is in retreat.

“A good indicator for unsafe sexual behaviour is the STD rate. I am impressed at the sustained decline in STD rates in Australia, Hong Kong, Singapore and Thailand over the past decade.

“But I am concerned actual declines in HIV in this region have occurred only in Australia, New Zealand and Thailand.”

The countries to Mongolia’s immediate south and north are experiencing exploding health crises. In China, HIV/AIDS is increasing at a rapid rate due to factors including growing prostitution, drug use and travel – all by-products of a booming economy. The infected population is estimated at 400,000 and is expected to reach 1.2 million by the year 2000, according to China’s national AIDS committee.

To the north in Russia, a complete collapse in the public health system has dramatically slashed life expectancy and led to an upsurge in many diseases, including tuberculosis and HIV/AIDS.

With many Mongolians doing business in both these countries, there are numerous opportunities for AIDS to enter the country.

A wide range of topics is under discussion at the gathering, with women, youth and STD-control measures of particular interest to the Mongolian delegates.

For the Mongolians, the Congress is an opportunity to learn from other countries’ successes and failures in the fight against AIDS.

Mongolia’s nine-member delegation includes four doctors – Dr K. Davaajav, head of the AIDS/STD Department of the Research Centre for Infectious Diseases, Health Ministry representative Dr S. Enkhbat. Medical University director Dr Lkhagvasuren and Dr Darisuren from the United Nations Population Fund.

Also in the team are Democrat MPs B. Delgermaa and Saikhanbileg, UNICEF’s B. Bayarmaa and two representatives from women’s NGOs: S. Tsengelmaa from the Women’s Information and Research Centre and N. Chinchuluun, executive director of the Mongolian Women Lawyers Association.

On Sunday, several presentations focused on the difficulties of getting people to use condoms.

In Fiji, studies found the majority of the population was aware of AIDS and had access to condoms, but still chose not to use them.

Lisa Enriquez, a Filipino woman who is HIV-positive, gave a sobering speech on the epidemic.

“One of the most important things I’ve learned from the epidemic is human nature. AIDS is such a humanizing disease. It reminds us of being human, complete with all the weaknesses and imperfections of being human.

“Let us not kid ourselves: changing behaviour is not easy. One doesn’t change because somebody tells him or her to do so.

“We will need to get our act together, institutionalize our efforts and continue working harder with passion and perserverance.”

The Congress continues until October 30.

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