“All of you sit on the floor. Do not dare to sit on the seats,” scolded the ambulance driver, to the handcuffed family of Nazir Masih while taking them to an establishment of the health department for mandatory testing for HIV.
The year was 1992. The whole street shook up, when the government ambulance and the police had come with screaming sirens and screeching brakes to the front door of his house. It marked the beginning of a long nightmare.
“That was the worst day of my life… despite the fact that I had been deported from the UAE in 1990 because of my HIV status, and had worried everyday about what will happen to my family after I am no more,” recalls Masih.
Living in a house arrest of sorts, four months later, he welcomed two gentlemen from a well-known newspaper posing as officers from the Punjab health department. They interviewed the family and photographed them on the pretext of preparing their file for medical treatment on government expense. The next day the countrywide editions of the newspaper carried the news and information on the whereabouts of Masih and his family. The location of his house was clearly marked with a statement that this was the place where an HIV patient lived.
This is the level of stigmatisation that an HIV positive person may face, says Masih while talking to TNS in his office situated in Green Town, Lahore. He was reportedly the first person who declared himself HIV positive publicly and later on established a non-profit organisation, New Light AIDS, Control Society for care and treatment of people suffering from the disease.
The inscription on the main door invites donations for treatment of poor HIV patients but this appeal has largely remained unanswered. “We have never received a single penny out of Zakat or Baitul Mal funds or under the head of private charity. The common excuse has been that these people are sinners and shall be punished in this world as well as in the world hereafter,” says Masih.
All the support for them, he says, has come from The Global Fund to Fight AIDS that also provides financial support to the government.
Masih shares that the prevalence of HIV among deported migrants is one of the highest in the world and reason obviously is unsafe commercial sex. He confesses that he himself contracted it due to this very reason. However, his main concern is that a lot of such migrants hide the reason of their deportation and do not get treatment. This way they risk the lives of others as well. He is unable to provide exact figures but states that the highest incidence of HIV is among Pakistani migrant labour working in Dubai, where prostitution has become too rampant and organised.
“We asked UNAIDS to seek figures of people deported from Gulf countries due to HIV but they said it was difficult for them to make monarchies answer to their requests,” he adds.
“We have never received a single penny out of Zakat or Baitul Mal funds or under the head of private charity. The common excuse has been that these people are sinners and shall be punished.”
A research paper, titled The HIV Epidemic in Pakistan, authored by Adnan Ahmad Khan from Research and Development Solutions, Islamabad and Ayesha Khan from Federal Ministry of Health, published in the Journal of Pakistan Medical Association also confirms this. The paper declares migrant workers to be at sheer risk of contracting HIV. It states: “Nearly all registered patients in HIV clinics in Pakistan are those repatriated after acquiring HIV while working abroad, mostly from the Middle East. Mandatory HIV testing is conducted at recruitment and repeatedly to renew work permits in the Middle East. Those who acquire HIV are quickly identified and deported back — often without being told the reason for the deportation.”
Furthermore, it states: “no national mechanism exists to enumerate or locate HIV positive repatriated workers.”
According to the latest national HIV estimates there are approximately 97,400 cases of HIV/AIDS in Pakistan. The country according to the National AIDS Control Programme is in a ‘concentrated phase’ of the epidemic with HIV prevalence of more than 5 per cent among injecting drug users (IDUs) in at least eight major cities of the country.
A serious matter of concern is that the migrants tested positive for HIV test in the Gulf are dealt with badly and sent back home without even being allowed to collect their belongings. The case of Asif Iqbal (name changed on request) is an example. “They put me in shackles at the hospital. Those chains left marks on my ankles and my soul,” he says as he talks about his last four days in Kuwait. One day he quarrelled with his partner and both of them were sent to prison. There the authorities took blood samples of the detainees in routine and released them once they had reached a settlement.
A week later Iqbal received a call from a local hospital staffer telling him that his blood samples from jail had gone missing and he needed to visit the hospital for a redraw. He went to the hospital where to his shock and disbelief he was immediately arrested, handcuffed and later bound in shackles to a hospital bed. He was quarantined. It was later explained to him that he had been tested positive for HIV and therefore would not be allowed to stay in Kuwait, any longer.
This issue is quite important and needs to be addressed, says Shahzad Bokhari, an ILO consultant and manager at Migrants Resource Centre (MRC) — the first of its kind set up in Lahore, Punjab. The MRC, he says, will have awareness sessions for migrants through posters and flyers on HIV and there will be referrals and linkages with Services Hospital and PAPC for the support of the deported patients. He says the protector office does provide information on HIV to intending migrants but MRC would like to have more detail orientation to be added in the pre-departure orientation. “The orientation will cover information on reasons, symptoms, precautions, safety parameters and cure of HIV,” says Bokhari.
Nazir Masih tells TNS that he was declared HIV positive in 1990 but over the last 25 years he has not let it convert it into AIDS, with the help of medicine, balanced diet and an improved lifestyle. HIV, he says, is the cause and AIDS is the effect. “My point is that the carriers of HIV shall overcome their inhibitions and register for medical treatment at different treatment centres. The government must have a mechanism to automatically cover all such deportees — leaving little or no chance of their being left out.”
He also urges people to give donation for this cause and stop hating these patients. “Out of around 1,400 patients registered with us, 102 are children who inherited the virus. Is there any justification in making them suffer?” he questions.
He says stigma shall also be done away with as in places like KP there is no acceptance for HIV patients or those working for them. They have offices in different parts of the country but cannot function properly here.
Faisal Majeed, Project Director, Provincial AIDS Control Programme, Punjab, tells TNS that the number of deported migrants is around 25 per cent of the total people suffering from the disease. For example, in Punjab, the reported number of patients is 9,100 of which 6,100 are registered and 4,000 are getting free treatment. Almost all these deportees are returning from the Gulf region.
He says there used to be migrants who would hide their disease due to the stigma attached to it but now they have opened up. “We treat them in complete privacy and do not even tell their relatives about their disease without their permission,” he concludes.
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