Fighting against silence: refugees living with HIV in northern Ecuador

Telling the Human Story, 27 January 2011

© UNHCR/V.Rodas
Lucilda, a young mother of two, recently discovered that her husband had infected her with HIV. He recently died and the Colombian refugee finds herself alone in an area where people living with HIV or AIDS are stigmatized.

LAGO AGRIO, Ecuador, January 27 (UNHCR) Ten years ago, a teenager called Lucilda* fled her home in Colombia because she feared her mother's rage after going to a party without permission. She should have stayed and faced the music.

Instead, the 25-year-old ended up marrying a violent, unfaithful man and fleeing to northern Ecuador's Sucumbios province with him and his family to escape conflict in southern Colombia's Putumayo department. Today, Lucilda is struggling to raise two children, her husband is dead and she is living with HIV.

"He was very ill, but he didn't want to go to see a doctor. I took him and they told us what was going on. They also said that I was infected," she said: "He knew that he had AIDS, but he never told me," she added bitterly.

Tragic as her story is, Lucilda is just one of a small, but growing, number of people living with HIV in Sucumbios and its capital, Lago Agrio, where some 20 per cent of the population of 60,000 are Colombian refugees. At least 30 people here had HIV or AIDS as of the end of last year, or double the number for 2009.

"This figure is certainly just the tip of the iceberg with regard to the number of people who are infected with HIV," said Paul Speigel, head of UNHCR's Geneva-based Public Health and HIV Section.

But tackling the problem is difficult in a conservative, male-dominated society, where those living with HIV or suffering from AIDS, especially women, face stigmatization. UNHCR and its partners are trying to counter this mindset and to spread awareness about the disease and the importance of safe sex.

A special UNHCR programme to improve disease prevention, implemented by community health workers, has helped to educate refugees and host communities in isolated areas of the jungle surrounding Lago Agrio. They also give lessons on sexual health, family planning and general health services.

Meanwhile, at least Lucilda's children were not infected and she receives free medical treatment in Ecuador. But the young woman has been made to feel like a pariah by the relatives of her husband, who died four months ago. "They are scared of me," she said. "They don't even want to touch me. They say that I will spread the disease with my sweat."

They are the only people, aside from medical staff in Lago Agrio, who know the truth about her health. "I'm afraid that if other people know, I won't be able to work anymore," said Lucilda, who cleans clothes for oil industry workers to earn enough to pay for spartan accommodation and to feed her children. "The owner of the room where I live offered me sex to pay the rent," she claimed.

All those years after running away from her mother's wrath, Lucilda is alone, ill and scared of the future. She never imagined anything like this as a wilful teenager. When she ran away from home without any documentation, she existed by taking poorly paid jobs, including working as a barmaid.

But in one town in Putumayo she met and fell in love with a local man. They were soon wed and two children followed in rapid succession. Then she found out that he was fooling around with other girls.

"I didn't want him to touch me, but he took a knife and forced me," she recalled. "I felt as if I had been raped." Lucilda, with little other choice, stuck by her husband when they fled to Ecuador. She later found out she was HIV positive.

"Here life is also hard. You don't know people, everything is different. When doctors told me I also had the disease I thought about jumping under a car," she told UNHCR.

Xavier Creach, head of the UNHCR sub-office in Lago Agrio, said the case raised concern about societal attitudes. "The stigma associated to sexually transmitted diseases, such as HIV, escalates the risks because of society's silence," he noted.

* name changed for protection reasons

By Sonia Aguilar in Lago Agrio, Ecuador

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After more than forty years of internal armed conflict, Colombia has one of the largest populations of internally displaced persons (IDPs) in the world. Well over two million people have been forced to flee their homes; many of them have left remote rural areas to take refuge in the relative safety of the cities.

Displaced families often end up living in slum areas on the outskirts of the big cities, where they lack even the most basic services. Just outside Bogota, tens of thousands of displaced people live in the shantytowns of Altos de Cazuca and Altos de Florida, with little access to health, education or decent housing. Security is a problem too, with irregular armed groups and gangs controlling the shantytowns, often targeting young people.

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