AIDS in the Arab World
Turning a Blind Eye

Even though an estimated 500,000 to 1 million people in the Arab world are infected with AIDS, the problem is still being marginalised. Alfred Hackensberger spoke to Elie Aaraj about opportunities for spreading awareness and prevention

AIDS bow at the UN building in New York (photo: AP)
In large parts of the Arab world, there is still a lack of awareness of AIDS, states Elie Araj

​​Lebanese society is very conservative and is influenced by religion. It is as if anything anormal happens behind a virtual curtain in an illegal twilight zone. In a situation like this, how can one work with people who officially don't - or shouldn't - exist?

Elie Aaraj: We recruit people from the various AIDS risk groups; in other words female sex workers, homosexuals, and people who take drugs. All of these people are "outlaws".

How do you reach them? You don't just find them behind the bus station.

Aaraj: As a matter of fact, you do. You can find them on the streets. Prostitutes and drug addicts can be found in the suburbs of Beirut or Tripoli. There are also "floating areas" for homosexuals. But with homosexuals in particular, you can really see the fear in their eyes when a stranger approaches them and starts asking them questions, or even just gives them a condom.

Why are they "outlaws"? Is there a religious reason?

Aaraj: Not only for religious reasons. It is the law that instils fear in them. Convicted first-time offenders can get between six months and a year; repeat offenders can get up to three years.

What is the point in that?

Aaraj: I once asked someone at the courts exactly the same question. I mean, what is the point in putting a homosexual, whose homosexuality the law wants to prevent, in prison where they will be surrounded by men only? What sort of control do you have there? The only answer I got was a shrug of the shoulders.

Is any pressure being exerted on institutions, parliamentarians, or the president to stop putting homosexuals in prison?

Aaraj: No. They just say that their hands are tied and that that's just the way the law works.

It's no different with the so-called drug addicts; they get treated in the same way as the homosexuals.

Aaraj: Yes, of course. They are criminalised in the same way and if they are not completely excluded from society, they are certainly marginalised.

Most of the world's AIDS sufferers are heterosexuals. How can you reach Arab husbands?

Aaraj: There is a so-called "outreach programme" through which we try to raise awareness by handing out brochures and condoms. There is also a support group for people living with AIDS. We are trying to make them an increasingly visible part of society, to fight against all types of discrimination and to fight for their right to have free medication.

It must be difficult to go public.

Aaraj: Of course, especially for those who are married. In many cases they are just thrown out of the house and onto the streets.

Why? Has it something to do with religion? Conservatism? Ignorance?

Aaraj: In these cases it is not about religion. The wives realise that their husbands have cheated on them and have maybe even infected them. They are hurt, angry, and show their husbands the door. To a certain extent, this is understandable.

Beirut is the stronghold of prostitution in the Middle East. Most of the girls come from Romania, Russia, the Ukraine, or Poland. There are thousands of them here, living and working in the Christian Eastern part of the city.

Aaraj: Yes, but we generally have good contact with them. There are also girls from Syria and, of course, from Lebanon. Beirut is a centre of the sex tourism industry, especially for people coming from the Gulf States.

How does society react to your work?

Aaraj: It must be said that we are respected by society. However, as soon as the problem of marginalised people gets too close, the sympathy and support quickly evaporates. At a press conference, we asked journalists to use different, more humane terminology in future. In Arabic, for example, the word for prostitute is loaded with negative connotations. But the media did not want to play ball. Their reaction was: "why should we make things better than they really are."

How do the Christians react to you distributing condoms? After all, they are very strict believers.

Aaraj: The Christian leaders have no problem loving all of society's "condemned". But they just cannot accept the fact that we are distributing condoms. They accuse us of running an advertising campaign for a western lifestyle: sex as a product to be bought and sold.

Is there no chance for dialogue?

Aaraj: We're trying. I once asked a priest what he would do if a young person came into the confession box and confessed to having had sexual relations. He replied that he would pray for him. "You see," I replied, "we all do whatever we can. You pray; we distribute condoms." I think he understood what I was trying to get at. But if I had told him about young men that meet in cinemas and disappear into the toilets together, I don't think he would have understood that  or wanted to understand. Giving condoms to these sinners! And free of charge too!

Is it a case of people refusing to face reality?

Aaraj: Yes. Neither the religious leaders, nor the politicians and older generation want to face reality. There is a problem between youth and society, which doesn't want to hear that everything has changed.

You have just been speaking about the Christian side. Are things different with the Muslims?

Aaraj: Of course Muslim clerics cannot share our views. In some Muslim communities, the penalty for homosexuality is death by stoning. But it must be said that, for the most part, they are tolerant. They just turn a blind eye: "we don't accept it, but what can we do? It exists."

Are there any Muslim organisations that take action on AIDS?

Aaraj: Yes, there are some. We work with them on certain campaigns and activities. Most of them are working in health prevention, not in care for the infected. We are, for example, working with the Hezbollah's "Health Society".

Is it possible to provide sex education under religious auspices?

Aaraj: During the discussions about the new curricula for public schools, we suggested that sex education should be included as a new subject. This was jointly prevented by the Muslims and the Christians. We explained to them that sex education is not a call for people to have sex and that it is important for children to know not only about their own body and soul, but also about those of the opposite sex. It is better for schools, churches, and mosques take responsibility for sex education than for it to happen on the streets. But no-one is interested in arguments like that.

Lebanon is now considered to be a liberal country in the Arab world. What is the situation regarding the problem of AIDS in other countries?

Aaraj: Officially, the number of infected people is very low. It is not possible to say what the situation is in reality; no-one knows. There is quite simply no data.

This would imply that there is generally little interest in AIDS.

Aaraj: In some countries, people don't want to face reality. But nevertheless, things are happening. Recently, there was a meeting of health ministers in the Gulf States (GCC) at which it was agreed to start an AIDS prevention campaign. It's slow, but things are happening. However, in these countries, the AIDS problem is certainly not as big as it is in Iran or Libya.

What is the origin of the high rates of infection in these countries?

Aaraj: A lot of people take drugs. In Libya, for example, there has been a massive increase in the number of people infected with AIDS.

What is being done in these countries, which are generally considered to be dictatorships?

Aaraj: I would say that everything is very reasonable. They are first of all trying to reduce the rate of infection. In Iran, where just over 1 million people are known to take drugs, there is a widespread needle distribution programme.

Is this being done in Lebanon too?

Aaraj: No, that is forbidden.

Approximately 500,000 people in the Arab world are infected with AIDS; that's almost as many as in Europe.

Aaraj: This high figure is primarily down to Somalia and Sudan. For two years now, the infection rate in both countries has been high. In Sudan there is one AIDS patient to every 1,000 inhabitants; in Somalia there are 1.2 to every 1,000 inhabitants. For other countries, like Egypt, there are no statistics at all.

How many people have AIDS in Lebanon?

Aaraj: Officially, 765. Unofficial estimates say there are between 2,000 and 3,000. But unfortunately, we don't know for sure. We could be facing an explosion in numbers. Since the government agreed two years ago to assume the total cost of treatment and medication for people suffering from AIDS, the number of cases that have been officially registered has risen every year.

Interview conducted by Alfred Hackensberger

© 2005

Translated from the German by Aingeal Flanagan

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