Hinterland pregnant women are not receiving HIV tests

Dear Editor,

I read with horror the fact that pregnant women in the hinterland of Guyana are not receiving HIV tests. Before anyone accuses me of making that up, please note that that is one of the official findings of a study on the condition of indigenous women and children in 12 hinterland communities that was conducted by UNICEF in collaboration with the Government of Guyana, as quoted in a release from the Ministry of Public Information (http://gina.gov.gy/ study-on-\vulnerable-indigenous-groups-handed-over/).

Now, I’m not sure what the specific reason for this deplorable situation is; if it’s a lack of availability of HIV testing kits, some breakdown in communication or transportation of said kits into the interior, a lack of trained counsellors, or some other issue, but what I do know is that this is a completely unacceptable state of affairs.

Antenatal HIV testing of pregnant women has been recognized for over two decades as one of the best ways of preventing the vertical transmission of HIV. Treatment of a HIV positive pregnant women with antiretroviral medication can prevent disease transmission to the infant, and such routine testing by health care providers is the standard of care in most, if not all, developed nations of the world.

While HIV prevalence rates in Guyana have thankfully never reached epidemic levels, a recent report, Health @50, done by the Pan American Health Organization (PAHO) last year, revealed that HIV infections were on the increase, compared to previous years.

The situation for people in the hinterland is especially concerning as there are already fewer resources and facilities in that area, compared with the coastal regions of Guyana (a fact corroborated in the report cited above). In fact, research project after research project has clearly and repeatedly described the increased vulnerability of women and girls in the interior regions to sexual abuse and predation, trafficking, violence, and other societal ills.

It is beyond alarming then, to hear that pregnant women in the hinterland are not receiving HIV tests on a regular basis. To repeat: this research was conducted in multiple communities, and this finding was provided to the public by a Monitoring and Evaluation Specialist on staff at UNICEF. I hope to soon be able to receive a copy of the report so I can review it in its entirety, but I am compelled to write now to call for an immediate remedying of this appalling state of affairs and to demand that systems be put in place immediately to ensure that there is never any recurrence.

I know, from personal experience seeking HIV tests in Guyana over the years, that the consistent availability of testing kits has been a problem, even on the coast.

However, I had been reassured by a previous Minister of Health ‒ Dr George Norton ‒ that this situation had been resolved, and I hoped that the authorities at the Ministry of Public Health were sufficiently committed to safeguarding the health and wellbeing of pregnant women and infants ‒ universally recognized as especially vulnerable groups ‒ to ensure that such a basic but critically important service such as antenatal HIV testing would have been carried out in an exemplary manner. This report reveals that this is clearly not the case and that the delivery of basic primary preventive health care seemingly remains beyond the capability of these entities.

I realize there are regional bodies with responsibility for these matters, in additional to the national ministries and HIV/AIDS Secretariat; all of them bear culpability for this massive failure, in my opinion. I noted also that the Ministry of Indigenous People’s Affairs was the one that the report was handed over to; however accountability for solving these and the other problems highlighted by the report requires collaborative work by multiple agencies and arms of government.

Indigenous women and children, and others living in the hinterland of Guyana deserve to have access to quality healthcare, just like all Guyanese. I acknowledge the challenges posed by our terrain but I also know that alcohol, Coca Cola, chips, and sweets are accessible in every community in Guyana. So too should be HIV testing kits!

Yours faithfully,

Sherlina Nageer

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