On Tuesday December 8th Panama celebrated Mother’s Day. Panamanians take this day so seriously that it is a national holiday, and offices are closed. Many people take this day off of work to spend time with their mothers and families. On Friday December 11th, the HIV/AIDS clinic I volunteer at decided to celebrate the mothers that come to the clinic. A volunteer from the Peace Corps brought in gifts for them. She gave them things like soap, wallets, and cleaning supplies – all gifts that these women can use in their daily life. All of these women are indigenous women. To celebrate these mothers Dr. Anne Okwuka, the doctor who runs the clinic, organized a lunch at the clinic where these mothers could enjoy a free meal and share their stories. Dr. Okwuka began by reminding all of those who were there that being diagnosed with HIV/AIDS is not a death sentence. As long as people take care of themselves by regularly taking their medicine and maintaining healthy diets, they can live long lives. Surviving with HIV/AIDS is one thing, but living and coming to grips with it is another. Some of these women have been recently diagnosed and some of them have been living with HIV/AIDS for over ten years. Everyone stood up and shared their experience with the group. I will share some of their experiences here so you can understand how this disease spreads, how it is viewed culturally, and why it is such a big problem here.
The first woman who spoke had one of her daughters with her. She began by saying that she has two daughters, ages 10 and 15. Both of her daughters are HIV positive. They were not born infected. In the indigenous community there is a hidden culture of family members sexually abusing children. In this case an uncle, who was infected, sexually abused the children. No one talks about this abuse, but everyone knows about it. This woman did not volunteer the information on how her daughters became infected. She had to be pushed to say what had actually happened. Even as she told her story it was said in a quiet, hurried voice. As soon as she was finished she sat down quickly. I know she felt shame and guilt for what had happened even though it was not her fault.
The second woman who stood up to talk had been recently diagnosed. As she stood up she began to cry. Dr. Okwuka stood to comfort her, and gently urged her to speak. It soon became clear why this woman was crying – her entire family had abandoned her. Her parents kicked her out of the house. Her brothers no longer financially supported her. She had no job, and no chance at getting one. The rest of her extended family kept their distance. Why? Because HIV/AIDS is not very well understood or accepted by the community. All most people in the community believe is that it is easy to get and if you get it you will die. This is true if you ignore your symptoms, don’t take your medicine, and fail to take care of yourself. A lack of education and knowledge leads to fear. Because this woman’s family did not have a clear understanding of what was happening, they acted based on pre-conceived notions and popular opinion. They shunned her. Unfortunately this is not an isolated incident. Stories like hers spread fast within the community. No one wants to be shunned by their family. Many people decide to ignore their symptoms when they first notice them. If they do decide to go see a doctor, and even if their tests comes back positive, many people will decide to do nothing rather than be cast out by their family.
A third woman stood up to share her story. She began by sharing how she had been diagnosed. She was married and faithful to her husband. She had been living in David (in the north of the country) and needed to travel to Colón (several hours to the south) to visit her mother and to look for work. She returned to David several months later. Two years later she went to the doctor and discovered that she was HIV positive. She had been infected by her husband. There needs to be some clarification about sex and sexual relations in the indigenous community. While marriage and monogamy are present, a culture of open sexual relationships is common. During parties it is common for people to have multiple partners in one night. While there is nothing wrong with this, when this is coupled with a culture of ignoring or being unaware of sexually transmitted diseases, then they can spread rapidly. So even if people have one sexual partner, much like this third woman, it is still entirely possible for them to become infected. A lack of comprehensive sex education and safe sex practices also allows for the spread to continue.
These three stories are only a few of the thousands that are out there. Dr. Okwuka and the clinic she runs works within this community to help the people. She finds ways to bring people together, like this Mother’s Day celebration, to show the community that there is life after being diagnosed and that there is support for them. But Dr. Okwuka knows that more needs to be done. A culture of hiding and maintaining is not a solution. She envisions a culture of openness and prevention. Once the taboo is conquered and people begin to talk about and attain more knowledge, then we can move forward and work towards eliminating HIV/AIDS for good. It starts by celebrating what we can. So even if it’s not Mother’s Day where you live, I would like to wish you a happy Mother’s Day.