Putu Duff: A World of Challenge

Posted by Lydia Sorflaten

Through her growing years, Putu Duff called Indonesia and Truro/Shortts Lake her home. Her studies and work has taken her to Alberta, Africa, India, Mexico and now Vancouver. Our Rotary Club helped her with travel expenses to Mexico City where she shared her research findings on AIDS treatment in Uganda with the International Community.

In August of 2008, roughly 22,000 leaders, policy makers, academics and activists descended into Mexico City to participate in the XVII International AIDS conference. The goal of this conference was to assess progress, challenges and future priorities in the global fight against the AIDS epidemic. Improving access to AIDS treatment was identified as one of the key steps to curbing the epidemic. I was provided the opportunity to act as a Canadian delegate and present a paper based on my Masters research which addresses barriers to accessing AIDS treatment in Uganda. Financial assistance provided by the Truro Rotary Club made my participation in this monumental conference possible.

As a Global Health student at the University of Alberta, I undertook a study in Kabarole District, Western Uganda, a region where approximately one in ten people are infected with the HIV. This study aimed to find out why 25% HIV positive mothers in the district were not taking the free AIDS treatment, Highly Active Antiretroviral Therapy (HAART). Although HAART is not a cure, it can increase the length and quality of one's life. This is especially important for mothers, prolonging their lives and ensuring that their children are cared for and have a family to grow up in.

Poverty was the most formidable barrier to accessing HAART. The majority of participants could not afford to the transportation costs to the clinic for their check-ups and to pick up their drugs. As the majority of women were subsistence farmers, they did not have access to cash to transportation and lived in rural areas distant from the clinics.

Financial constraints also cause problems in the hospitals. Lack of resources and human resources have resulted in congestion of the HIV/AIDS clinic, overworked and frustrated health care workers, and long waiting times (up to 9 hours). Many women cited paying for transport to the hospital and waiting the entire day only to return home empty-handed. Under these circumstances of poverty, health takes a backseat to mere survival.

After poverty, stigma represented a barrier to treatment. Due to the stigma associated with HIV/AIDS, many of the women we interviewed kept their HIV status a secret from their partners. These women feared that disclosure of their HIV status could lead to blame, violence, abandonment, divorce, and loss of financial support.

Failure to disclose that one is HIV positive undermines prevention efforts, making practicing safe sex a challenge. Safe sex is imperative to prevent resistance to the drug and re-infection of the patient and further HIV transmission.

HIV/AIDS stigma also deters men from testing. Unlike many women, who are offered testing during pregnancy, men do not have this opportunity. HIV/AIDS stigma deters men from voluntarily testing. Men's ignorance of their own HIV status, which is a common problem, exacerbates the problem of partner HIV status disclosure by women.

I would like to thank the Rotary Club for the opportunity to share these research findings with the International community. Hopefully these findings will be used to improve access to HAART and survival of AIDS patients globally.

Putu Duff