The vulnerability of the millions who are still displaced by the floods in Bihar has only re-emphasized the need for HIV, and Sexual Health services for this displaced population. As the flood affected populace will take months to return to their original lands and many are migrating to cities like Mumbai and Delhi, HIV and sexual health services need to be made available to them.
The nature of the humanitarian emergency determines the degree of exacerbation for the existing HIV epidemic, in a particular disaster affected area. Accordingly, there is no doubt that today in Bihar’s flood there is a far greater danger of increasing the vulnerability of the flood-affected people and their service providers, than it was in the Tsunami-affected coastal belt of South India. The difference between Tsunami and flood is that while the coastal ‘belt’ is severely damaged by the Tsunami, in flood a large broad area is submerged and may remain so for a long time as has happened recently in Bihar. Consequently in Tsunami, aid agencies are able to reach the affected populace much faster than in flood, mostly within a day, as only a ‘belt’ is affected. However, in the Bihar flood the infrastructure of whole districts are submerged and disrupted. Accordingly, it is much more difficult to reach the marooned populace in a flood. As a result, even after weeks some stranded people remain cut-off from rescue and services in flooded situations.
Floods are increasing in incidence and intensity due to the increasing effects of climate change. The Bihar flood is a classic example of an extreme event with disastrous consequences due to climate change. A changing climate is expected to increase the risk of disasters and thereby the demand for aid measures.
Therefore, keeping in tune with the fact that programme interventions on background development factors of HIV vulnerabilities require holistic strategies and multidisciplinary partnership, the following points must be considered:
• The transmission of HIV from person to person through sexual contact or other means may be climate independent. Nevertheless, there is need for sufficient research studies to substantiate the interrelation between climate change and Sexually Transmitted Infections (STI).
• The larger issue of disaster impact mitigation and HIV needs to be a part of the national response framework to HIV at the policy level.
• Almost no one would challenge the fact that climate changes. However, the impact of climate change will not necessarily be floods always. It could be of different in nature as well as in magnitude. Therefore, there is a need to explore strategic dimensions both at micro and macro level to design intervention on HIV, based on the variable of climate. It could be as a early “warning and early response” approach or as a “long term” approach targeted to prevent HIV- integrated within the prevention of human induced climate change.
Finally, it is the outcomes of changes in climate, the vagaries of its impact on the environment and our surroundings, which determine the nature of the stage on which people work, rest and live. That's why, understanding some of these apparently countless, but root causes, is fundamental to designing any type of response in humanitarian emergencies.
Referance: Discussion on HIV and Humanitarian Emergencies - Experiences
Solution Exchange, AIDS community-
1. E. Mohamed Rafique, UNAIDS India Office, New Delhi
2. Jagdish, Telugu Network of People Living with HIV (TNP+), Vijayawada
3. Upahar Pramanik, UNAIDS India Office, New Delhi
4. Kalika Mohapatra, United Nations Development Programme (UNDP), Bhubaneswar
5. Lalit Mohan Mishra, YOJANA , Puri (Response 1; Response 2)
6. Ravishwar Sinha, Independent Consultant, New Delhi
7. Rudra Prasanna Rath, Orissa State Disaster Management Authority, Dhabalagiri, Jajpur District, Orissa
8. Sudha Kalangi, Society for Welfare of HIV infected People (SHIP), Positive Network, Guntur, Andhra Pradesh
9. Avnish Jolly, Consultant, Chandigarh
10. Brijesh Dubey, Rajasthan Network For People Living With HIV, Jaipur
11. Kiran Jayasa, Consultant, Hyderabad)