During and after disasers, physical, financial, and social insecurity may erode the caring and coping strategies of individuals and households, rendering communities more vulnerable to HIV infection.
• Loss of livelihoods. -Disasters and emergencies lead to loss of livelihoods and further impoverishment, especially in poor societies. Women and girls become especially vulnerable, as they may find themselves coerced into engaging in sex as a survival strategy to gain access to food, shelter, and physical security. In some emergencies, increased powerlessness and insecurity make this group more vulnerable to rape and other sexual violence.
• Breakdown of social norms - Displacement often leads to the breakdown or weakening of traditional social norms and systems that control social behavior and activities, including sexual relationships. The breakdown of families and communities and exposure of the uprooted population to unfamiliar social and livelihood situations can increase vulnerability to HIV infection.
• Challenges to health care - Disaster situations can greatly overtax the existing health-care infrastructure. The result can be gaps, such as in the supply and distribution of condoms, which hamper HIV prevention. Efforts to treat STIs and other diseases are sometimes ineffective and sporadic in this setting. (STIs are relevant to this research not only because HIV is sexually transmitted but also because infection with other sexually transmitted diseases can increase a person’s risk of contracting HIV.)
The risk of transmitting HIV through transfusion of contaminated blood might also rise due to inadequate screening services at health centers.
• Disruption of HIV-control activities -During disasters, HIV- and AIDS-control activities like awareness campaigns tend to be disrupted or eclipsed by other priorities, like the provision of basic food, water, and shelter, and the treatment of wounds and more acute diseases and infections. Institutions like schools and shopping centers, where awareness campaigns tend to be conducted, are sometimes closed down in emergencies.
• General trauma -Trauma related to an emergency may sometimes lead to problems like alcoholism and high-risk sexual behavior.
• Relief efforts -Paradoxically, relief and rehabilitation efforts by aid providers may sometimes contribute to the risk of HIV and AIDS.3 In the case of the tsunami, for example, the structure and location of the new temporary shelters were major contributing factors.
(Referance: Oxfam Humanitarian Field Studies & Swasti Health
Resource Center of Bangalore-
Understanding the Effect of the Tsunami and Its Aftermath on Vulnerability to HIV in Coastal India )
Showing posts with label Effect of Natural Disasters on HIV Vulnerability. Show all posts
Showing posts with label Effect of Natural Disasters on HIV Vulnerability. Show all posts
Rationale for a Specific HIV/AIDS Intervention in Crisis
Over the last two decades, complex emergencies resulting from conflict and natural disasters have occurred with increasing frequency throughout the world.
At the end of 2001, over 70 different countries experienced an emergency situation, resulting in over 50 million affected persons worldwide. Sadly, the very conditions that define a complex emergency - conflict, social instability, poverty and powerlessness - are also the conditions that favour the rapid spread of HIV/AIDS and other sexually transmitted infections.
The long-term consequences of HIV/AIDS are often more devastating than the conflicts themselves: mortality from HIV/AIDS each year invariably exceeds mortality from conflicts. Most people are already living in precarious conditions and do not have sufficient access to basic health and social services. During a crisis, the effects of poverty, powerlessness and social instability are intensified, increasing people’s vulnerability to HIV/AIDS. As the emergency and the epidemic simultaneously progress, fragmentation of families and communities occurs, threatening stable relationships. The social norms regulating behaviour are often weakened. In such circumstances, women and children are at increased risk of violence, and can be forced into having sex to gain access to basic needs such as food, water or even security. Displacement may bring populations, each with different HIV/ AIDS prevalence levels, into contact. This is especially true in the case of populations migrating to urban areas to escape conflict or disaster in the rural areas. As a consequence, the health infrastructure may be greatly stressed; inadequate supplies may hamper HIV/AIDS prevention efforts.
During the acute phase of an emergency, this absence or inadequacy of services facilitates HIV/AIDS transmission through lack of universal precautions and unavailability of condoms. In war situations, there is evidence of increased risk of transmission of HIV/ AIDS through transfusion of contaminated blood. The presence of military forces, peacekeepers, or other armed groups is another factor contributing to increased transmission of HIV/AIDS. These groups need to be integrated in all HIV prevention activities. Recent humanitarian crises reveal a complex interaction between the HIV/AIDS epidemic, food insecurity and weakened governance. The interplay of these forces must be borne in mind when responding to emergencies.
There is an urgent need to incorporate the HIV/AIDS response into the overall emergency response. If not addressed, the impacts of HIV/AIDS will persist and expand beyond the crisis event itself, influencing the outcome of the response and shaping future prospects for rehabilitation and recovery. Increasingly, it is certain that, unless the HIV/AIDS response is part of the wider response, all efforts to address a major humanitarian crisis in high prevalence areas will be insufficient.
(Referance:
GUIDELINES for HIV/AIDS interventions in emergency settings
Inter-Agency Standing Committee Task Force on HIV/AIDS in Emergency Settings
www.humanitarianinfo.org/iasc)
At the end of 2001, over 70 different countries experienced an emergency situation, resulting in over 50 million affected persons worldwide. Sadly, the very conditions that define a complex emergency - conflict, social instability, poverty and powerlessness - are also the conditions that favour the rapid spread of HIV/AIDS and other sexually transmitted infections.
The long-term consequences of HIV/AIDS are often more devastating than the conflicts themselves: mortality from HIV/AIDS each year invariably exceeds mortality from conflicts. Most people are already living in precarious conditions and do not have sufficient access to basic health and social services. During a crisis, the effects of poverty, powerlessness and social instability are intensified, increasing people’s vulnerability to HIV/AIDS. As the emergency and the epidemic simultaneously progress, fragmentation of families and communities occurs, threatening stable relationships. The social norms regulating behaviour are often weakened. In such circumstances, women and children are at increased risk of violence, and can be forced into having sex to gain access to basic needs such as food, water or even security. Displacement may bring populations, each with different HIV/ AIDS prevalence levels, into contact. This is especially true in the case of populations migrating to urban areas to escape conflict or disaster in the rural areas. As a consequence, the health infrastructure may be greatly stressed; inadequate supplies may hamper HIV/AIDS prevention efforts.
During the acute phase of an emergency, this absence or inadequacy of services facilitates HIV/AIDS transmission through lack of universal precautions and unavailability of condoms. In war situations, there is evidence of increased risk of transmission of HIV/ AIDS through transfusion of contaminated blood. The presence of military forces, peacekeepers, or other armed groups is another factor contributing to increased transmission of HIV/AIDS. These groups need to be integrated in all HIV prevention activities. Recent humanitarian crises reveal a complex interaction between the HIV/AIDS epidemic, food insecurity and weakened governance. The interplay of these forces must be borne in mind when responding to emergencies.
There is an urgent need to incorporate the HIV/AIDS response into the overall emergency response. If not addressed, the impacts of HIV/AIDS will persist and expand beyond the crisis event itself, influencing the outcome of the response and shaping future prospects for rehabilitation and recovery. Increasingly, it is certain that, unless the HIV/AIDS response is part of the wider response, all efforts to address a major humanitarian crisis in high prevalence areas will be insufficient.
(Referance:
GUIDELINES for HIV/AIDS interventions in emergency settings
Inter-Agency Standing Committee Task Force on HIV/AIDS in Emergency Settings
www.humanitarianinfo.org/iasc)
Risk of Transmission in Emergency Contexts
Although arriving at definitive conclusions is based on the scant HIV prevalence data available in emergency settings, we do know that many of the conditions that facilitate the spread of HIV are common in these settings.
Such conditions include but are not limited to:
• Rape and sexual violence, including rape used as a weapon of war by fighting forces against civilians. This is most often exacerbated by impunity for crimes of sexual violence and exploitation
• Severe impoverishment that often leads women and girls with few alternatives but to exchange sex for survival
• Mass displacement which leads to break up of families and relocation into crowded refugee and internally displaced camps where security is rarely guaranteed
• Broken down school, health and communication systems usually used to programme against HIV transmission.
• Limited access to condoms and treatment for sexually transmitted infections.
(Referance:
GUIDELINES for HIV/AIDS interventions in emergency settings
Inter-Agency Standing Committee Task Force on HIV/AIDS in Emergency Settings
www.humanitarianinfo.org/iasc)
Such conditions include but are not limited to:
• Rape and sexual violence, including rape used as a weapon of war by fighting forces against civilians. This is most often exacerbated by impunity for crimes of sexual violence and exploitation
• Severe impoverishment that often leads women and girls with few alternatives but to exchange sex for survival
• Mass displacement which leads to break up of families and relocation into crowded refugee and internally displaced camps where security is rarely guaranteed
• Broken down school, health and communication systems usually used to programme against HIV transmission.
• Limited access to condoms and treatment for sexually transmitted infections.
(Referance:
GUIDELINES for HIV/AIDS interventions in emergency settings
Inter-Agency Standing Committee Task Force on HIV/AIDS in Emergency Settings
www.humanitarianinfo.org/iasc)
People already living with HIV/AIDS in emergencies
In general, people already infected with HIV are at greater risk of physically deteriorating during an emergency because:
• People living with HIV/AIDS are more prone to suffer from disease and death as a consequence of limited access to food, clean water, and good hygiene than are people with functioning immune systems.
• Caretakers may be killed or injured during an emergency leaving behind children already made vulnerable by infection with HIV/AIDS or loss of parents to AIDS.
• Health care systems break down (attacks on health centres, inability to provide supplies, flight of health care staff ), and populations have limited access to health facilities because roads are blocked or mined, and financial resources are even more limited than usual.
(Referance:
GUIDELINES for HIV/AIDS interventions in emergency settings
Inter-Agency Standing Committee Task Force on HIV/AIDS in Emergency Settings
www.humanitarianinfo.org/iasc)
• People living with HIV/AIDS are more prone to suffer from disease and death as a consequence of limited access to food, clean water, and good hygiene than are people with functioning immune systems.
• Caretakers may be killed or injured during an emergency leaving behind children already made vulnerable by infection with HIV/AIDS or loss of parents to AIDS.
• Health care systems break down (attacks on health centres, inability to provide supplies, flight of health care staff ), and populations have limited access to health facilities because roads are blocked or mined, and financial resources are even more limited than usual.
(Referance:
GUIDELINES for HIV/AIDS interventions in emergency settings
Inter-Agency Standing Committee Task Force on HIV/AIDS in Emergency Settings
www.humanitarianinfo.org/iasc)
Emergency preparedness and response
Emergency preparedness focuses on addressing the causes of the emergency with a view to avoiding its recurrence or mitigating its impact and strengthening resilience, especially on vulnerable households and communities, and building up local capacity to address the crisis (including pre-positioning of relief items to shorten the time of the response). These efforts are often linked to early warning systems, especially in natural disaster prone areas. Disaster preparedness includes the continuous collection and analysis of relevant information and activities in order to prepare for and reduce the effects of disasters such as:
• predicting hazards by identifying and mapping key threats;
• assessing the geographical distribution of areas vulnerable to seasonal threats; defining which groups and communities are more at risk;
• assessing strengths and coping mechanisms of vulnerable groups and their capacity to respond to a threat; and
• identifying gaps in government preparedness plans and advocating with policymakers to ensure that plans are developed that aim to reduce the disaster’s impact on vulnerable populations.
Emergency preparedness plans are developed in order to minimize the adverse effects of a disaster, and to ensure that the organization and delivery of the emergency response is timely, appropriate and sufficient. Such preparedness plans should be part of a long-term development strategy and not introduced as a last-minute response to the unfolding emergency. In the case of
HIV/AIDS, such preparedness means that all relief workers would have received a basic training, before the emergency, in HIV/ AIDS, as well as sexual violence, gender issues, and non-discrimination towards HIV/AIDS patients and their caregivers. It also implies that adequate and appropriate supplies specific to HIV are pre-positioned. These are crosscutting issues which are relevant to all sectors.
A disaster preparedness plan should put in place certain elements in order to bring about a successful response:
• a solid needs assessments that will allow relief agencies to jointly determine who does what and where, under the umbrella of a comprehensive humanitarian action plan;
• staff properly trained and emergency response tools available on time;
• common tools for natural disasters and complex emergencies;
• funding mechanisms that ensure money is readily available, and
• information management network available to key decision-makers.
• predicting hazards by identifying and mapping key threats;
• assessing the geographical distribution of areas vulnerable to seasonal threats; defining which groups and communities are more at risk;
• assessing strengths and coping mechanisms of vulnerable groups and their capacity to respond to a threat; and
• identifying gaps in government preparedness plans and advocating with policymakers to ensure that plans are developed that aim to reduce the disaster’s impact on vulnerable populations.
Emergency preparedness plans are developed in order to minimize the adverse effects of a disaster, and to ensure that the organization and delivery of the emergency response is timely, appropriate and sufficient. Such preparedness plans should be part of a long-term development strategy and not introduced as a last-minute response to the unfolding emergency. In the case of
HIV/AIDS, such preparedness means that all relief workers would have received a basic training, before the emergency, in HIV/ AIDS, as well as sexual violence, gender issues, and non-discrimination towards HIV/AIDS patients and their caregivers. It also implies that adequate and appropriate supplies specific to HIV are pre-positioned. These are crosscutting issues which are relevant to all sectors.
A disaster preparedness plan should put in place certain elements in order to bring about a successful response:
• a solid needs assessments that will allow relief agencies to jointly determine who does what and where, under the umbrella of a comprehensive humanitarian action plan;
• staff properly trained and emergency response tools available on time;
• common tools for natural disasters and complex emergencies;
• funding mechanisms that ensure money is readily available, and
• information management network available to key decision-makers.
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