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Guianas: AIDS accompanies social decline
Latinamerica Press / February 16, 1995

By Larry Luxner

PARAMARIBO, Suriname -- Nailed to the door of Dr. Rubén del Prado's office are red, pink, yellow and blue condoms, a colorful display promoting the fight against a major social problem in his country -- AIDS.

Prado is director of the National AIDS Programme in Suriname, a small country that once enjoyed South America's highest per-capita income.

Today, however, the former Dutch colony is in economic shambles -- a victim of uncontrollable inflation, a civil war that lasted for much of the 1980s and continuing social unrest. This has led to burgeoning social problems and rising prostitution.

Like its two small neighbors -- Guyana to the west and French Guiana to the east -- and its huge neighbor to the south, Brazil, Suriname faces a spiraling AIDS crisis. At the end of 1994, the country had 441 HIV carriers out of a population of only 400,000.

About 90% of those with AIDS picked up the HIV virus through heterosexual contact, though as in other countries, Surinamese gays often hide their homosexuality.

"We have a lot of different ethnic groups here, and sex is part of the culture," said Dr. Julia Terborg. "With each group, we need a specific approach. You can't use the same approach for Creoles or Hindustanis as for Bush Negroes (also called Maroons)."

The Maroons have high infection rates, partly because of their cultural and sexual beliefs.

According to Prado, "if a Maroon husband dies, the eldest brother of the dead man has to sleep with the widow. If the cause of death was AIDS, the possibility of the widow being infected and passing the virus onto the brother is real."

Since 1989, the National AIDS Programme (NAP) has staffed an AIDS Hotline, run condom-use courses with prostitutes and conducted HIV testing. Once diagnosed with HIV, however, there is little Prado can do except refer patients to seek medical care using Suriname's existing, inadequate services.

"Minimal general home care is provided in Suriname by a small number of nurses employed by religous-based NGOs," he said, "but there is no special home care for people with HIV/AIDS."

In neighboring Guyana, as in Suriname, there are no special hospital wards for AIDS patients. Because of hard-currency shortages, AZT and other anti-AIDS drugs are unavailable.

Of the three countries, French Guiana has the highest incidence of AIDS -- 2.017 per thousand, according to the World Health Organization. But people with AIDS here have access to better care than their regional counterparts.

Dr. Roger Pradinaud, head of the AIDS prevention program in Cayenne, said one reaons for the high incidence of AIDS is French Guiana's proximity to Brazil, where the disease is rampant.

Pradinaud says that, thanks to French Guiana's status as a department of France, its 114,000 residents are entitled to the same standards of health care as any French citizen. For that reason, he says, "if we have a patient with AIDS in the hospital, social security pays for everything, including AZT, if the patient needs it."

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