Reality Check

As much as the government and NGOs tried to campaign and educate the people about HIV/AIDS, the reality of the situation in Tanzania is still very bleak. Every pregnant woman who comes into the labor ward is required to test for HIV. However, not all are compliant or willing. Tests for other STIs, such as syphilis and gonorrhea, are not mandatory and therefore not routinely provided. The knowledge that every patient who comes in for prenatal care or deliveries may carry STIs makes health care providers fearful for their own health and well-being. I recall the times when I became anxious after performing an exam or delivery because I came in contact with the patient’s bodily fluids and was not informed of her HIV status. Even after double gloving, I was still nervous the first time I examined an HIV positive patient.

According to Dr. Quaker, the Russian doctor who works in the pre-mature unit, the vertical (mother to child) transmission rate of HIV at Mt Meru hospital is about 45%. This is mind-blowing since HIV testing is readily available. However, women are afraid to get tested because of the stigma surrounding HIV and the fear that they would be outcasted by their families and friends. Even innocent newborns of HIV positive mothers are subjected to poor treatment. While working in the pre-mature unit, I've witnessed infants being left behind by their own mothers or by other family members because they were considered unwanted burdens. They were abandoned at the hospital and left to the care of the nurses.

Even with attempts of education on STIs and family planning, the country's population continues to grow at a rapid rate. The average woman has five children in her lifetime. It is ingrained in the culture. The women value fertility because it defines their role and status in society. It reflects their self-worth. So despite poverty and poor health status, women will continue to have children. The knowledge and availability of contraceptives are not effective since women cannot ask their husbands to use them. And wives cannot turn their husbands away. It is still very much a man's world, unfortunately.