Three days after the 41-year-old man from Cameroon arrived in the semi-autonomous state of Iraqi Kurdistan who was deported. His crime? The man, who wanted to find a job in northern Iraq, had tested positive for the HIV virus.
And he is not the only one. Over the past four years the Ministry of Health in the semi-autonomous state, which has its own borders, military and government, notes that the number of people with HIV/AIDS in the region has risen. Up until 2008, their numbers show that there were only two people living with HIV?AIDS. Between 2008 and 2012, that number rose to 107. And the Ministry of Health say that most of these cases are due to people entering the area from outside.
The regional policy on this is clear: any foreigners wishing to stay in Iraqi Kurdistan longer than ten days must have a blood test. Similar to many other countries in the region, anyone found to have HIV is then deported. And apparently that is exactly what happened to 84 of the 107 individuals. The remaining 23 people are regional residents and of these, four have died. Five of the infected are women, none are children; the individuals with HIV/AIDS get a medical benefit although there are no specialised clinics for them within Iraqi Kurdistan.
The Human Immunodeficiency Virus (HIV) gradually destroys the human body’s immune system, leaving the infected person mortally susceptible to diseases they would normally be able to fight. HIV can only be passed on through infected blood, semen, vaginal fluids or breast milk. It is mainly transmitted through vaginal or anal intercourse without a condom or by sharing a needle or syringe with someone who\'s living with HIV.
In updates to state legislation, dating back to October 2011, any individual who leaves the region for more than 90 days will also need to undergo blood tests upon their return. Official diplomatic delegations and anyone with medical records are not required to be tested and somewhat incomprehensibly to Westerners, neither are those on religious pilgrimages, men over 60 or women over 55.
There are around 5 million people living in Iraqi Kurdistan and compared to other nations – even some Middle Eastern nations - the incidence of HIV/AIDS is not high. However Khalis Qadir, the official spokesperson for the Kurdish Ministry of Health, told NIQASH that it’s not the amount of infections that are worrying, it is the increase within four years.
According to Qadir, they believe the increase is mainly due to the fact that the region has become more open to visitors after 2006. “Thousands of foreign labourers, working in service sectors and in construction projects, came to the Kurdistan region and thousands of companies were created,” Qadir explains.
Research by the United Nations indicates that Iraqi Kurdistan is not alone in its increase. Cases of HIV/AIDS have increased by around 300 percent in the Arab world over three years – and that is compared with increases of around only 20 percent in the US, Europe and Australia.
This makes the Middle East and North Africa among those regions with the fastest growing incidence of HIV/AIDS, Aleksandar Sasha Bodiroza, a specialist on HIV/AIDS with the United Nations Population Fund, said. Yet it’s also true that of the millions living with HIV/AIDS around the world, only an estimated 2 percent of those reside in the Middle Eastern and North African region.
Then again it is hard to say how many people really have HIV/AIDS in the area. Some analysts have even suggested the MENA region may face an epidemic in the future.
Firstly, there are question marks on the way local administrators collect their statistics. Although the disease first came to Iraq through infected blood transfusions, it is hard to find figures on the prevalence of HIV/AIDS here today.
And even if individuals contract HIV, pass it on to others and possibly even die because of the disease, nobody may ever know. At the presentation of the First Regional Report on AIDS, under the auspices of the League ofArab States, in Egypt late in 2011, this was noted.
Because of the stigma involved in societies where sex is hardly ever discussed and where most of those suffering from HIV are thought to be men who have sex with men, sex workers or drug addicts (and therefore sinners), “patients refuse to go to get treatment in fear of losing their jobs or being an outcast due to the misconception of transmission methods," the head of the Arab League’s social development sector, Sima Bahous, noted.
Additionally according to the Arab League report, the overall percentage of people being tested in the Middle East is much lower than elsewhere. Just as it happens in Iraqi Kurdistan, most of the testing focuses on migrant workers rather than those locals who might be at higher risk. Studies indicate these include migratory truck drivers and male prostitutes.
And while some countries like Egypt and Lebanon have started campaigns to increase awareness and decrease stigma around HIV/AIDS, it seems to have made only a minor difference in countries where pre-marital or same-sex intercourse is considered criminal behaviour.
“It is not easy to educate people on how to protect themselves against [HIV/AIDS],” Kurdish MP, Ribaz Fattah, who sits on the parliamentary committee on health, told NIQASH. “Customs and traditional values make it difficult to make people more aware, which means the virus could spread more easily.”
“The state should be held responsible for the treatment of those who suffer from disease but when it comes to HIV, the state should also be held responsible for educating its people about the causes and prevention of the disease,” Fattah concluded. “Basically we should be talking about this topic in an open and honest way. If we don’t there is going to be a huge increase in the number of people infected by the disease.”