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Inter Press Service
HEALTH-VIETNAM: Lessons from HIV/AIDS Not Learned Enough
Tran Dinh Thanh Lam
October 10, 2001
HO CHI MINH CITY, Oct 10( IPS) - Vietnam has had a national anti- HIV/AIDS programme since the early 1990s, but indications are whatever lessons have been imparted have not been learned well.

Indeed, one of the results of this is that this South-east Asian country now has more and more children getting HIV, which causes AIDS. Experts say many of these youngsters are getting the virus from their HIV- positive mothers, while others are getting infected because they have become part of the sex trade.

Vietnam had its first reported HIV case in 1990. Official statistics show that as of Jul. 31, Vietnam has a recorded cumulative total of 38,359 people with HIV/AIDS. Of these some 2,500 of them are very young people, including infants. If unrecorded cases are taken into account, Vietnam may actually have had as much as 180,000 people who have been infected with HIV since 1990, say experts. HIV-positive mothers can infect their children while they are still in the womb, during labour and delivery or through breast-feeding. According to government data, Vietnam had a cumulative recorded total of 19 pregnant women with HIV in 1998.

This rose to 46 in 1999, and 108 in 2000. The figure has since climbed to 260. There are no statistics to show how many among the children of Vietnamese mothers with HIV have tested positive. But officials and social workers say that orphanages and child shelters are reporting that more and more of the children brought to them have HIV.

They add that a large number of these children have been abandoned.

The institutions themselves report that they have also been taking in more children who have been rendered orphans by the fatal disease.

Typical of such effort is the work done by the Vietnam Women's Union (VWU), the United Nations Children's Fund (UNICEF), and the Fellow Traveler, a non-governmental organisation. They have launched a project to care for children infected with HIV.

There are 93 children infected with HIV being cared for in the Phu Tan district in the Mekong Delta province, says Tran Ngoc Anh, who heads the VWU in the Phu Tan district. "They receive a 130,000 dong ( 8.65 dollars) per month subsidy, but it only lasts for three months. We would like the government to issue further policies regarding HIV children."

Similar stories are coming in from correctional institutions for minors. According to some observers, though, the children with HIV brought to these places are likely to have been involved in sex work.

Here in Ho Chi Minh City, local authorities say that about 20 percent of the sex workers are less than 18 years old, and that many of these minors are now infected with HIV.

The deputy director of Ninh Binh Rehabilitation School No.2, Nguyen Thanh Binh, says about 20 percent of the 700 students at correctional schools are HIV infected. "That's a high percentage," he remarks.

What is worsening such a situation is the fact that the managers in children's shelters, orphanages and correctional institutions all say they are unsure what kind of care is needed by the children with HIV/AIDS who are under their supervision.

They also admit to having personnel who are unwilling to take responsibility for the children who have the virus.

Children's shelter and orphanage authorities say that while the State has issued specific social assistance policies for orphans and abandoned children under 15, there are no regulations covering those with HIV. They also complain that they simply do not have the funds required to take care of these children.

In truth, some orphanages have even turned away children with HIV/AIDS, saying that they need special care and "might infect the other children".

Binh has similar complaints, saying that regulations governing these schools do not cover the HIV problem, making it difficult for the management when it comes to schooling HIV children.

"The regulations don't identify exactly what the school's responsibilities and obligations are, in terms of looking after HIV infected pupils," he says.

It has also become evident that some staff members were uneasy about the presence of HIV-infected people at the school, and were distancing themselves from the students. Says Binh: "This makes it hard to manage, care for and educate all the students, and particularly the HIV- infected students."

And as in the case of orphanages, correctional schools need funding. "We haven't yet received any funds to look after HIV-infected pupils," Binh says.

"When one of the kids has to go to hospital, we have to foot the medical bills."

At the very least, the attitude of the authorities and personnel in these institutions indicate poor understanding of HIV/AIDS. Many, for instance, seem to assume that the virus could be passed on by sheer proximity to someone who is infected, which is not the case.

There also seems to be a perception those who have the disease should be segregated from other people. In the case of children, experts say that so long as their health allows it, children with HIV/AIDS should be allowed to attend school with little fear that they will pass on the virus to others.

So far, they say, there has yet to be a report of a child with HIV infecting someone else as a result of day-to-day activities in school.

Such a situation, however, is not surprising in the light of studies indicating that Vietnamese health personnel do not have adequate understanding of the disease.

A 2000 survey conducted among 1,178 Vietnamese doctors and nurses, for instance, found that 93.3 percent of them do not even know to diagnose the disease.

Last July, a workshop sponsored by UNICEF recommended that Vietnam sharpen its legal and regulatory framework concerning the care given to HIV /AIDS children.

This would include setting out the children's rights and also the obligations and responsibilities of public institutions and society at large. .