Thursday, January 21, 2010

Saudi Arabia takes step backward in treating AIDS patients

Saudis always have struggled with the issue of AIDS with debates over treatment and our penchant to treat victims like criminals. The first Saudi AIDS case appeared in 1984 and for many years we simply locked up people in prison hospital wards.

Times have changed and we have become more humane, although belatedly compared to the rest of the world. Yet the stigma of AIDS remains in our society and the most important rule that victims follow is to keep the disease a secret from friends, acquaintances and even family.

Jeddah’s King Saud Hospital and its little-known volunteer clinic perhaps have done more than any other Saudi medical facility to provide medical services, counseling and privacy to AIDS sufferers.

Now, it’s scheduled to be shut down and its AIDS patients distributed all over the Kingdom for treatment. It appears that just when Saudi Arabia achieves parity in treating AIDS sufferers with the rest of the world, as it has with its organ transplant policies and with its specialization in separating conjoined twins, it takes a step backward.

The closure of AIDS services at King Saud threatens the privacy and consistent treatment of patients. It also increases the likelihood of spreading the disease because the trust built by King Saud doctors, nurses and support staff must be rebuilt with strangers at another medical facility. This is not an easy task.

According to Saudi media reports, the Health Affairs Administration, which is
affiliated with the Ministry of Health, announced earlier this month that King Saud employees and patients will be “distributed” to other hospitals to prepare for the closure of the AIDS clinic.

The clinic will be transferred to another location and change its focus as a center for medical checkups for non-Saudis with the financial means to pay for services.
Earning revenue from paying customers, I mean patients, comes at the expense of patients with AIDS, Hepatitis C, pneumonia and other infectious diseases.

Saudi health officials say that 51 percent of all AIDS patients in the Kingdom live in Jeddah and are treated at King Saud. Now these patients must go to other hospitals, if not other regions, no doubt a great hardship, to be treated by medical personnel that are likely not AIDS specialists.

The transfer of patients also begs the question of what will other medical centers do with them. Will these patients be grouped with non-AIDS patients or be treated in a specialty ward? Will their privacy be protected?

The beauty of the clinic at King Saud Hospital and what made it a success was that its chief concern second to treatment was privacy protection. Patients who believed they may have AIDS were questioned by clinic personnel, assigned a number (no names are involved in the process), tested and given the test results two days later.

The hospital also provided financial aid referrals and connected patients with charity organizations. They counseled patients on the religious implications of the illness to ease their fears. They helped patients solve tricky employment and family problems associated with finances and the virus itself. If a patient with no financial means asked a hospital employee for taxi fare, it was given without strings attached.

The emotional bond among hospital employees was strong. A trust existed between the patient and employee. Unlike many Western AIDS patients who don’t hide their illness, Saudis insist on it because it means being judged by one’s family and friends. The trust between patient and hospital employee meant their secret was safe.

One AIDS patient said recently of King Saud Hospital: “When we go there we feel like we are treated like human beings. I know people will listen to me. But I don’t tell anyone else.”

That secret is now at risk as these patients are shuttled to different facilities. Ensuring proper treatment and taking precautions to prevent AIDS from spreading is now at risk.

The Saudi government reported that in 2008 the number of AIDS patients in Saudi Arabia was 13,926 with 3,538 Saudis. An estimated 505 were Saudi females and 769 non-Saudi women. About 80 percent got the virus through sexual activity, 15 percent through blood transfusions and 5 percent unknown. Most AIDS victims are between the ages of 15 and 49, which is a disaster in a young country like ours.

These numbers are conservative at best. It’s likely the number of AIDS cases in Saudi Arabia is far higher than the official figure.

We can’t afford to be casual about what we do with these patients.

1 comment:

Chiara said...

Thanks for this excellent, informative, and compassionate post. You covered all the downsides of disbanding this clinic.

The added psychological burden on AIDS patients is immense, and of course their mental status impacts their physical one and also their interpersonal relationships.

Very sad news.