Morocco makes headway against HIV but stigma remains

A member (L) of Morocco's Association for the Fight Against AIDs (known by its French acronym ALCS) talks with patients suffering from AIDS in the infectious diseases department at the Ibn Rochd Hospital in Casablanca on September 12, 2019. (File/AFP)
Updated 28 September 2019

Morocco makes headway against HIV but stigma remains

  • In Casablanca, a group therapy workshop offers HIV patients a rare opportunity to speak openly about their disease
  • Thanks to improved screening, access to treatment and monitoring, new HIV infections in Morocco declined by 42 percent between 2010 and 2016

CASABLANCA: In Morocco, the struggle against HIV has been so successful in recent years that campaigners worry about losing funding for combatting the virus, but for people living with the disease it remains a heavy stigma.

In Casablanca, a group therapy workshop offers HIV patients a rare opportunity to speak openly about their disease.

“Here I feel normal, I’m treated like a human being,” said Zineb, a 29-year-old mother. Organized by the Association for the Fight Against AIDS (ALCS), on a recent Thursday the workshop brought 12 HIV patients together with a psychologist and a therapist.

The ALCS also organizes follow-up therapeutic care in hospital, and prevention and screening campaigns, with funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria.

These programs were developed shortly after the first HIV case was detected in Morocco in 1986. This early start is partly why UNAIDS, the Joint United Nations Programme on HIV/AIDS, calls Morocco a “model country” for its HIV response.

Thanks to improved screening, access to treatment and monitoring, new HIV infections in Morocco declined by 42 percent between 2010 and 2016, compared to an average reduction of four percent across the rest of the Middle East and North Africa.

Morocco had 350 deaths from AIDS in 2018, from a population of about 35 million. But some groups remain vulnerable, with intravenous drug users, men who have sex with other men, and sex workers accounting for two thirds of Morocco’s 21,000 identified cases.

And the stigma attached to those infected remains high, even within the family. “My mother treated me like a murderer. For a long time I felt alone in the world,” said Youssef, a 28-year-old who has twice attempted suicide.

Like other HIV patients interviewed by AFP, he asked to be identified by a pseudonym. And all of them — save for a 40-year-old considered very lucky by the group — have either hidden their illness or been rejected by loved ones.

In this conservative Muslim society, where sex outside marriage and homosexuality are illegal, HIV patients seldom talk publicly about the virus.

“The subject is taboo, because the infection is linked to sex, itself a taboo subject in Morocco,” said Yakoub, a 25-year-old ALCS worker.

“The social rejection is such that some (HIV patients) lose everything: family, friends, work, home,” he said. Zineb, like many HIV patients, hides her medication to conceal her illness.

For 10 years, the former teen mother has told her family that she is being treated for diabetes. “My 17-year-old son knows nothing, I can’t bring myself to tell him, I’m too afraid,” she said with a sad smile.

“Once you’re sick, you’re no longer a person,” said Sakina, a mother who says she never speaks of her illness except with doctors, the ALCS staff and other HIV patients.

Like 70 percent of HIV positive women in Morocco, Sakina was infected by her husband. She cannot bring herself to tell her 15-year-old son that he is also infected.

She has always lied to him but she can “no longer sleep at night,” she told the group through tears. “My advice: above all, don’t tell him anything,” said a young man.

“For your sake, let him find out from someone else,” another group participant suggested. Then the psychologist interjected to say that private sessions are available to “reflect on these difficult questions.”

The shame of HIV is so entrenched, it even permeates the medical establishment. “For 30 years we’ve been talking about it, the virus is well known but the discrimination is still there,” said Dr. Kamal Marhoum El Filali, head of the infectious diseases department at Ibn Rochd Hospital in Casablanca, which hosts an ALCS branch.

“The stigmatization isn’t just from society but also from medical staff within the hospital environment.” Amina, another group therapy participant, experienced this first hand.

“When I went to the hospital to give birth, no one wanted to take care of me, no one wanted to touch me, I ended up in intensive care,” she recalled indignantly.

Others in the session though were grateful for the care they had received. “We are lucky to be under the care of the infectious diseases department: we are well cared for compared to others, considering the lack of funding and disrepair in Moroccan hospitals,” said another participant.

The emergency room at Ibn Rochd is sometimes overwhelmed with doctors each seeing up to 40 patients a day.

But the infectious diseases department is always spotlessly clean, providing personalized support as ALCS staff liaise with the medical teams.

But how much money Morocco will receive to continue its fight against HIV will be determined at a three-yearly conference for the Global Fund in October.

With funding declining globally and controversy surrounding the management of UNAIDS, ALCS president Mehdi Karkouri fears financial cuts.

“We are a victim of our own success: because our results are good, we risk losing funding,” he said.


Egyptian ministry of irrigation — torrent season begins

A general view of the High Dam in Aswan, Egypt February 19, 2020. (REUTERS
Updated 21 September 2020

Egyptian ministry of irrigation — torrent season begins

  • Preliminary indications of the flood showed that it is higher than average and that the incoming waters during August and September are so far higher than those of last year

CAIRO: Egypt’s flood season began in August and will continue for three months — and the torrent season is about to begin — Mohamed El-Sebaei, spokesman for the Ministry of Water Resources and Irrigation, has confirmed.

The Ministry of Water Resources and Irrigation continues to prepare for the torrent season and to deal with flooding, which has caused the levels of the Nile to rise significantly over the past few days.

El-Sebaei said the ministry is monitoring the quantities of water that reach Egypt and accumulate in front of the High Dam on a daily basis, pointing out that the Minister of Irrigation, Mohamed Abdel-Ati, has been in Aswan since yesterday to inspect the water facilities of the High Dam.

He said that the torrential season is about to start in the period between autumn and winter, and that the ministry is following up with all torrent, canal and drain networks to ensure that they are ready to receive any volume of water and to preserve private and public property.

The ministry is preparing to cope with the torrents and rains expected to occur during autumn and winter by preparing Lake Nasser, located behind the High Dam, which is one of the most important strategic points in containing the quantities of water coming from the Ethiopian plateau.

The Egyptian River Revenue Regulatory Committee, in its meeting headed by Abdel-Ati, reviewed the situation of the Nile flood, the procedures for monitoring, analyzing and evaluating its condition, and the quantities of water expected to arrive until the end of the current water year 2021-2022.

According to a statement by the Ministry of Irrigation, the rates of rain in the sources of the Nile is expected to start decreasing by the end of September.

Preliminary indications of the flood showed that it is higher than average and that the incoming waters during August and September are so far higher than those of last year. Is still too early to make a final judgment on the type and size of this year’s flood.

Eman El-Sayed, head of the planning sector and head of the forecast center at the Ministry of Irrigation, said the center works to calculate the rates of rain that fall on the upper Nile River countries until it reaches the country on a daily basis. She explained that the latest technology is used to take satellite images and download mathematical models to determine the amount of rain falling and when it will fall.

El-Sayed added that the ministry holds two meetings every week to discuss the developments of the flood season, which have been confirmed more than once to be very high — once during the meeting of the River Revenue Regulatory Committee and the other during the Leadership Committee meeting.

She pointed to the development of three scenarios to deal with a flood. If it comes at a power 10 percent stronger than expected, it will be water drainage as usual. If it comes 50 percent stronger than expected, the excess will be dealt with through drains and waterways and the Toshka spillway will open. If it is stronger than that, the country will declare a state of emergency, she said.