AIDS cases 'exploding' in Vietnam
HANOI — U.S. Ambassador Randall Tobias, head of President Bush's $15 billion global AIDS initiative, saw firsthand this weekend the multitude of challenges facing Vietnam, where one in every 75 households has been touched by the disease.
Bush recently added Vietnam as the only Asian nation among 15 countries eligible for his Emergency Plan for AIDS Relief. One-fourth of the 4.8 million new HIV infections reported in 2003 are in Asia.
Tobias chose Vietnam because HIV is spreading faster here than in India and China. It's driven by the country's young population, by high infection rates among injecting drug abusers and by a sex trade that caters to up to 15% of men each year. The only risk for most women to become infected is their husband's sex or drug abuse. Nearly 25% of women who seek HIV testing cite their partner's behavior as why they visit a clinic.
"Vietnam is a country where the disease is largely confined among sex workers and drug users but is on the verge of exploding into the general population," Tobias told a USA TODAY reporter accompanying him on a two-day official visit before continuing on to the 15th International AIDS Conference in Bangkok.
Sunday at the conference, Tim Brown of the East-West Center reported that Vietnam's pattern is repeated throughout Asia.
Unlike many countries, however, Vietnam has made a commitment to fight the epidemic, Tobias said. Although government officials are welcoming the additional $10 million in U.S. AIDS funding, forging a partnership with one of the world's last communist regimes will mean:
• Providing AIDS treatment in a country where fewer than 300 of roughly 200,000 people with HIV now get treatment. On a visit to Vietnam's biggest hospital, Bach Mai, which has 1,400 beds, Tobias stopped in wards with two AIDS patients per bed.
Like most of Asia, Vietnam lacks trained doctors, with only one for 11,250 AIDS patients, Kevin Frost of the American Foundation for AIDS Research reported at the Bangkok conference.
• Setting up prevention, care and treatment programs in walled rehabilitation camps where tens of thousands of drug addicts and sex workers, half of whom are HIV-positive, are warehoused for five years or more. Tobias said the United States will not finance one method for combating HIV transmission among drug addicts — needle-exchange programs, which swap clean syringes for dirty ones.
In Bangkok Sunday, Brown criticized that limitation and the administration's failure to strongly promote the use of condoms.
"In some ways, it's good that Vietnam was chosen" for the president's initiative, Brown said, "if the U.S. allows them to do what they need to do — needle exchange and heavy condom promotion, particularly among sex workers and their clients."
• Enlisting the several faith-based groups now working quietly in Vietnam to become more active in the country. Vietnam lacks religious freedom, and the government fears religious groups will gain power and thereby threaten the status quo.
"We hope we can encourage the government to allow (religious groups) to expand their activities going forward," Tobias said after meeting with representatives of eight religious groups, including Buddhists, evangelical Christians from World Vision International, and Daughters of Charity of St. Vincent de Paul, who run an AIDS hospice for abandoned and dying adults and children with AIDS.
Sister Nguyen Kim Thoa, of the Daughters of Charity, told Tobias that government officials she did not identify called her archbishop and asked that their Mai Hoa Center expand its activities to take care of even more dying patients.
"What I read into this is that it's a pressing need, and I suspect it's difficult to find people to do the work," Tobias said. "I think that's extremely encouraging."
By Steve Sternberg - USA Today - July 11, 2004.
Vietnam's new cultural permissiveness may worsen the country's growing AIDS woes
While working on a documentary for PBS in Vietnam last year, I was amazed to find many teenagers still in their high-school uniforms at a Saigon nightclub, kissing each other on the dance floor and drinking alcohol with glee.
One of them, a 15-year-old girl named Hoa, said that her parents thought she was studying at a friend's house. "Vietnam has an open-door policy," she joked as she padded her worn leather knapsack and sipped her rum and coke. "And young people are all liberated now."
I thought of Hoa again recently when I read that President Bush declared he would commit money to a program for delivering medications to people with HIV and AIDS in Vietnam. The first country in Asia eligible for the White House's $15 billion program to fight AIDS worldwide, Vietnam will receive money for the next five years, up to $10 million in the first year alone.
The medications from the United States are welcome news in a country where 210,000 people are known to be HIV-positive and many more remain untested. But Vietnam is a long way from effectively fighting the disease, with or without foreign aid.
Since the end of the Cold War, Vietnam has experienced a new revolution: a sexual one. Though images of Saigon bar girls marked the Vietnam War, the truth is that Vietnamese society remained for the most part private and traditional.
That is, until now.
Vietnam's population has grown from 32 million to 84 million since the war ended in 1975. Seventy percent of Vietnamese are now under 30.
This new generation is coming of age in a post-Cold War era that is rapidly divorcing itself from the past, be it the more recent communist ideology or a longtime conservative Confucian ethos.
When Hoa said "liberated," she was making a play on words. The term once carried a certain ideology: Saigon was "liberated" by Hanoi in 1975. Now, one is liberated in Vietnam when she or he is sexually open.
Duong Thu Huong, the author of the internationally acclaimed "Paradise of the Blind," a novel critical of the errors of Vietnamese communism, once observed that, "Vietnamese youths are no longer idealistic. Today they are revolting as if to avenge the prior generations for their deceptions."
This new revolution comes with its own vocabulary. Di quay: To go wild, to get drunk, to stir up trouble. Song voi: To live fast, to hurry life and spend it away. Van hoa toc do: Culture that moves along at a very high speed.
Young people's behavior has scandalized the old. The trend last year, for instance, was for young women to wear bikini tops to bars. The year before, young men would race motorcycles late at night along tree-lined boulevards in Hanoi and Saigon while their friends bet and cheered them on.
Vietnamese newspapers are full of lewd stories that shock -- and no doubt titillate -- many of their readers.
A group of communist officials were caught drinking from a beer-filled bathtub in which a naked prostitute sat. Last month, 15 school girls were caught having sex with two foreigners in a widely circulated homemade pornography video, filmed by one of the girls herself.
In a country full of restless youths who find traditional constraints useless and who may practice unsafe sex, AIDS is a scourge. Adding fuel to the fire is the lack of sex education in schools, where teachers still find it difficult to talk openly about sex. All the while, prostitution has reached an all-time high, along with drug use, including heroin and the sharing of needles.
Vietnam has one of the highest rates of teenage pregnancy in the world. About 1 million abortions are performed each year in the country, 30 percent to unmarried females, according to the Vietnam Investment Review. Between 25 to 30 percent of pregnancies in Vietnam occur among women under the age of 18.
Duong Thu Huong, the novelist, is right. The young of Vietnam are in revolt. But their revolution lacks any coherent direction. While youth movements in Vietnam in previous generations changed the political direction of the country -- in the August Revolution in 1945, youths responded to Ho Chi Minh's call and joined the fight against French colonialism -- this generation does little more than posture a la James Dean in "Rebel Without A Cause."
In contemporary Vietnam, sex becomes a stance against the past and a directionless future. Alas, in the age of AIDS, it is also a dangerous position.
Unless a caring leadership in Vietnam can seriously address the social malaise in much of the country, especially among the young, foreign aid alone will not staunch the AIDS tide.
By Andrew Lam - The Athens News - July 12, 2004.
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