In Somalia, Diagnosing AIDS Can Be Risky

Officials with the UN and charities note the difficulties of fighting HIV/AIDS in Somalia, which has been without a central government for 15 years. Some dangerous areas are off limits to UN and Western agencies, but screening someone for HIV can be risky even where they do operate.

"If we tell someone that they are HIV-positive, they might take revenge," said Josef Prior Tio, general coordinator for Doctors Without Borders (DWB) in the central city of Jowhar and Mogadishu.

"You could get killed," said Halima Hasan Osmani, who supervises DWB's clinic for pregnant mothers. The clinic does not test for HIV, and though a nearby hospital will, DWB staff here will not even ask if a patient knows their serostatus.

The problem is echoed in a story related by Faiza Narbeth, a Somali native and consultant with the UN Development Program's HIV initiative. At an HIV/AIDS seminar in early February, she heard of a birth attendant in Kismayo who had tested a pregnant woman for HIV. The patient was diagnosed HIV-positive, and "the husband accused the birth attendant of infecting his wife," she said. "The birth attendant was hidden by the community and had to flee from Kismayo. But the husband found her and shot her dead. These stories are commonplace."

Among the 30 participants at Narbeth's seminar, some strongly voiced opposition to condom use, saying it promoted promiscuity, which is against Islamic teaching.

"We agreed to disagree," said Narbeth. "It raises the problem of how do you fight against the spread of disease. We are at the beginning, beginning, beginning stage, where everything is based on fear."

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