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Friday, August 25, 2006

AIDS in Saudi Arabia: An Unspeakable Threat


By Alix McKenna

Since the first reported AIDS case in Saudi Arabia in 1984, the kingdom repeatedly claims that a remarkably low number of people are suffering from the disease. However the figures have gone up dramatically increased from a reported 436 cases between 1984 and 2000 to 6,787 cases in 2003[1] and it continues to climb to a reported 10,120 in 2006.[2] Given the fact that scientific surveys are not allowed in Saudi Arabia, the government’s severe censorship and the stigma attached to deadly diseases, these figures may only represent a fraction of the spread of AIDS in Saudi Arabia.

While on the surface, these figures seem insignificant in comparison to the astronomical AIDS rate in other parts of the world such as Africa, the speed at which the infection is spreading has resulted in a disturbing response from policy makers and society at large. The government’s efforts to curb the epidemic focus on controlling the behavior of AIDS victims, emphasizing Islamic sexual morals and preventing panic amongst the population. Unfortunately, this approach has proved heavy-handed, insensitive to human rights and from all sides ineffective.

The most disturbing component of the Saudi government’s approach to dealing with the spike in AIDS cases is its treatment of the AIDS victims themselves, particularly if they were born in other countries. Saudi officials view the epidemic as a foreign threat. Of the 10,120 AIDS victims, 7,804 are foreign nationals.[3] This could be due to the fact that Saudis have learned to become secretive people and are afraid to report AIDS cases in fear of being stigmatized or even punished for their sexual behavior. In response to higher numbers of AIDS victims in Saudi Arabia, all foreigners are required to take an AIDS test upon entering the country, and every time they use the public health system. If it is discovered that they are infected with the AIDS virus, they are locked up, often six at a time, in caged hospital rooms awaiting deportation.

Although the Kingdom is a phenomenally wealthy welfare state and provides its own citizens with anti-retroviral treatment free of cost, foreign nationals are denied medication. Depending on their country of origin, the deportation process often takes up to six months to a year. A 2005 article in the Canadian Globe and Mail newspaper described the plight of a Palestinian national who had been confined to a cell for six months without being administered retroviral drugs. In another instance, a man born in Saudi Arabia to parents of Burmese origin languished for a year without medication before being deported.

The Saudi policy of locking up HIV positive foreigners is not only inhumane; it reveals a lack of understanding for the true nature of the problem. Immigrants comprise nearly 25% of the population in Saudi Arabia. In addition to performing jobs that Saudis view as demeaning, they are forced to live in run down and repressive compounds where prostitution and drug use are rampant.[4] The Saudi government and businessmen, who import millions of expatriates to keep their economy afloat, should be concerned with improving the living conditions of immigrant workers rather than confining and deporting those who are afflicted with HIV.

While Saudi nationals are coerced into abiding by absolute laws regarding their sexual behavior, the government exonerates itself from its obligations toward poor expatriates. Furthermore, female immigrant workers are provided with no protection from sexual abuse at the hands of employers. Of the millions of foreign women who work as domestic servants in the homes of Saudis, many of them are subjected to repeated sexual assault without any protection or recourse. The Saudi ruling family, who controls every aspect of people’s lives, behaviors and sources of income, rarely concerns itself with these matters.

Although AIDS victims from the expatriate community, who are looked down upon by Saudis, are treated particularly inhumanely, Saudi citizens with an HIV status are also disrespected. In Saudi Arabia, any sexual conduct outside wedlock is viewed as sinful and therefore the government severely restricts any form of contact or communication between the sexes. This form of control and repressive method of dealing with issues of sexuality adversely affects the AIDS epidemic within the Kingdom. To begin with, the lack of sexual education prevents people from becoming aware on how to avoid STDs and stigmatizes those already infected as sexual deviants – explaining why few people voluntarily get tested resulting in a low number of diagnoses. Although citizens are provided with treatment, they are treated in a humiliating and often abusive way by health officials and society at large. In 2003, BBC reported on a tragic story in which a terminally ill AIDS patient was thrown out of a hospital in Jeddah and literally dumped in the street. Since the hospital did not specialize in treating AIDS patients, the Red Crescent was asked to transfer the patient to another hospital. The Red Crescent refused, on the grounds that it does not transfer AIDS patients, and so the patient was placed in the clinic’s pick up truck and dumped on the side walk in front of his employer’s office, where he was left bruised and bleeding. [5]

The stigma against sex outside of marriage affects not only the treatment of AIDS patients, but also the manner in which the AIDS prevention program in the Kingdom is administered. In order to prevent the dissemination of the illness, it is vital that information regarding safe sex and the sexual nature of the epidemic is made available. It is also imperative that an AIDS prevention program bases its strategy not on the sexual ideals of Islam, but on the sexual reality of modern life, which includes homosexuality, prostitution and other activities that are frequently connected to the spread of HIV. Even discussing aspects of sexuality not condoned by Islam can sometimes lead to punishment. In 2003, a General Court in Riyadh sentenced high school and middle school teacher Muhammad al-Sahimi to three years in prison and 300 lashes for declaring that Islam permits (among other things), adultery, homosexuality, and masturbation.[6] AIDS is seen by politicians, clerics and even medical researchers not as a unique problem that requires a reality-based solution, but as another excuse to impose conservative morality on the populace. In 2004, researchers from the Ministry of Health and the King Abdulaziz University published an 18 year surveillance report on AIDS in Saudi Arabia. The authors suggest that in order to limit the spread of the infection, the Kingdom should encourage people to “follow and implement the Islamic rules and values that prohibit adultery, homosexuality and intravenous drug use, and to practice safe sex only through legal marriage.”[7]

In the last two years there have been some signs that the Kingdom is becoming more open to other views on the topic of prevention, but the general attitude has not dramatically changed. In 2005, the UN was given permission to launch an AIDS awareness workshop for 25 students in a Riyadh private school. UN Coordinators stated that it was their hope that similar workshops would be allowed in other private schools, followed by the widespread implementation of workshops in government schools. Additional workshops have been held, but a nation-wide initiative is nowhere in sight.[8] Other developments in recent years imply that the Kingdom is regressing in their handling of the epidemic. The fact that the number of reported AIDS cases has been increasing at such an alarming rate in the past few years suggests that the Kingdom’s techniques for measuring the crisis are either not entirely accurate or not entirely honest. Last February, an article in Asharq Alawsat raised questions about the accuracy of Saudi statistics. The expose revealed that an official from the Ministry of Health criticized Dr. Aisha Metwalli, a female consultant at King Abdulaziz hospital in Jeddah, for her statement at a women’s conference that the latest statistics show 72,380 AIDS cases in the Kingdom. While this number is disturbingly higher than other reported figures, the government’s response to her claims was equally frightening. Rather than denying Metwalli’s claims, the official declared that they were not necessarily true and stated that her comments were inappropriate because only administrators within the Agency for Preventive Medicine, a branch of the Ministry of Health, are entitled to deal with that information.[9]

Rather than seeing AIDS as a pressing problem requiring a reality-based solution, Saudi politicians, clerics and even medical researchers view the epidemic as another excuse to impose conservative morality on the populace. In 2004, researchers from the Ministry of Health and the King Abdulaziz University published an 18 year surveillance report on AIDS in Saudi Arabia. The authors suggest that in order to limit the spread of the infection, the kingdom should encourage people to “follow and implement the Islamic rules and values that prohibit adultery, homosexuality and intravenous drug use, and to practice safe sex only through legal marriage.”[10]

Over the last two years, there have been some signs that the kingdom is becoming more open to other perspectives on prevention, but the general attitude has not changed drastically. In 2005, the UN was allowed to launch an AIDS awareness workshop for 25 students in a Riyadh private school. UN Coordinators stated that it was their hope that similar workshops would be allowed in other private schools, followed by the widespread implementation of workshops in government schools. More workshops have been held, but a nation-wide initiative is nowhere in sight. Moreover, other recent developments suggest that the kingdom is moving backwards in their handling of the epidemic. Although undeniably low, the number of reported AIDS cases has been increasing at such an unstable rate in the past few years, that one might suspects that the kingdom’s techniques for measuring the crisis are either unreliable or not entirely honest.

Last February, an article in Asharq Alawsat raised some questions about the accuracy of Saudi statistics. This expose reported that an official from the ministry of health criticized Dr. Aisha Metwalli, a female consultant at King Abdulaziz hospital in Jeddah. Dr. Metwalli was singled out for stating at a women’s conference that the latest statistics counted 72,380 people with AIDS in Saudi Arabia.[11] Although this figure is significantly higher than official statistics, other reports by AIDS workers support her claim. According to a recent New York Times article, one Saudi doctor estimates that 80,000 people are infected.[12] The government response to Dr. Metwalli’s statement was almost as disturbing as her findings. Rather that refuting Metwalli’s figures, the official simply declared that they were not necessarily true. He also condemned her comments as inappropriate because only administrators within the Agency for Preventive Medicine, a branch of the Ministry of Health, are entitled to use that information.

If Saudi Arabia is going to effectively combat the spread of AIDS, it is imperative that the public and all members of the government comprehend the scale of the epidemic. The lack of transparency on this issue shows that the Saudi leaders are afraid of the disease, but not for the right reasons. The government should be worried about the health of its people and the prevention of further infections. Unfortunately, officials are more worried about the political and religous implications of the illness. AIDS symbolizes the failure of the Kingdom to impose Islamic sexual morality on its people and to keep out a destructive foreign influence. Although it is low, the AIDS rate is rising quickly. The government must discontinue its denial of the reality of AIDS and the reality of its citizen’s sexual behavior or the number of casualties could skyrocket.

Sources:

  • “U.N. Launches HIV/AIDS Awareness Campaign in Saudi Arabia With Workshop for Teenagers” Medical News Today. http://www.medicalnewstoday.com/medicalnews.php?newsid=31776 October 10, 2005
  • Fattah, Hassan M “Saudi Arabia Begins to Face Hidden Aids Problem” in The New York Times. http://www.nytimes.com/2006/08/08/world/middleeast/08saudi.html?pagewanted=1 August 8, 2006.
  • Madani, Tariq A,and Al-Mazrou, Yagob Y, and Al-Jeffri, Mohammed H and Al-Huzaim, Nasser S. Department of Medicine, King Abdulaziz University, Jeddah and Ministry of Health, Riyadh, Saudi Arabia. Epidemiology of the Human Immunodeficiency Virus in Saudi Arabia; 18-Year Surveillance Results and Prevention from an Islamic Perspective. In BMC Infectious Diseases. 2004.

[1] “Saudi Arabia Steps up Measures to Combat AIDS” in BBC News. http://archive.gulfnews.com/articles/06/06/24/10048990.html October 23, 2003

[2] Al Hakeem, Mariam “Saudi Arabia steps up measures to combat AIDS” in Gulf News. http://archive.gulfnews.com/articles/06/06/24/10048990.html June 24, 2006

[3] “Saudi Arabia Steps up Measures to Combat AIDS” in BBC News. http://archive.gulfnews.com/articles/06/06/24/10048990.html October 23, 2003

[4] Mackinnon, Mark “Saudis Jail, Deport Foreigners with HIV” in Globe and Mail. www.globeandmail.com September 8. 2005

[5] “Saudi clinic 'dumps' Aids patient” in BBC News. http://news.bbc.co.uk/2/hi/middle_east/3161648.stm October 3, 2003

[7] Madani, Tariq A,and Al-Mazrou, Yagob Y, and Al-Jeffri, Mohammed H and Al-Huzaim, Nasser S. Department of Medicine, King Abdulaziz University, Jeddah and Ministry of Health, Riyadh, Saudi Arabia. Epidemiology of the Human Immunodeficiency Virus in Saudi Arabia; 18-Year Surveillance Results and Prevention from an Islamic Perspective. In BMC Infectious Diseases. 2004.

[8] “U.N. Launches HIV/AIDS Awareness Campaign in Saudi Arabia With Workshop for Teenagers” Medical News Today. http://www.medicalnewstoday.com/medicalnews.php?newsid=31776 October 10, 2005

[9]

[10] Madani, Tariq A,and Al-Mazrou, Yagob Y, and Al-Jeffri, Mohammed H and Al-Huzaim, Nasser S. Department of Medicine, King Abdulaziz University, Jeddah and Ministry of Health, Riyadh, Saudi Arabia. Epidemiology of the Human Immunodeficiency Virus in Saudi Arabia; 18-Year Surveillance Results and Prevention from an Islamic Perspective. In BMC Infectious Diseases. 2004.

[11] “Saudi Arabia: Ministry of Health Official Angry at Saudi Aids Rate Revelation” in Asharq Alawsat. http://www.asharq-e.com/news.asp?section=1&id=3887 February 22, 2006

[12] “U.N. Launches HIV/AIDS Awareness Campaign in Saudi Arabia With Workshop for Teenagers” Medical News Today. http://www.medicalnewstoday.com/medicalnews.php?newsid=31776 October 10, 2005

Fattah, Hassan M “Saudi Arabia Begins to Face Hidden Aids Problem” in The New York Times.

posted by AhhYes at 2:08 PM

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