JPRS-TEP-91-015
16 July 1991

There may be room for those most in need, if branches of
the facility can be created. For the time being, they can
only wait in hope.

ROMANIA

Update on Colentina Hospital AIDS Ward

91WE0365A Copenhagen BERLINGSKE AFTEN
in Danish 10 May 91 p 7

[Article by freelance journalist David Sears: “Colentina’s
Forgotten Wards”)

[Text] “Well, so you are a journalist? And what have you
then come to write about?”

Dr. Mariana Mardarescu’s tone is challenging. Journal-
ists from all corners of the world have been snooping
around the Colentina Hospital for twelve months now in
order to retell the story about the unhappy, young faces
behind bars in ancient steel cots in the wards for AIDS-
stricken children. She understands very well the task of
the journalists. She is aware of the fact that it furthers the
cleaningup process, that the closed door policy is being
suspended, at least for a while.

During the twelve months that have gone by since the
most brutal communist regime of Europe was over-
thrown in a bloody revolution, no journalist or photog-
tapher has been forbidden entry to the hospital, she says.
All have been well received. However, like many other
Romanian officials, Dr. Mardarescu has clearly been
hardened by the constantly inquisitive snooping around,
which seems to lead to a somehow negative press cov-
erage, a worldwide pity. She is alarmed, skeptical, direct.
She now wants to know the reason for it.

At the Colentina Hospital, Dr. Mardarescu is deputy
chief of the wards treating patients with virus diseases,
such as scarlet fever, German measles, meningitis,
chronic diarrhea and hepatitis. Her wards also treat
approximately eighty very young patients with AIDS.
Dr. Mardarescu, who is a pediatrician, is very much
aware that this small fraction of the hospital’s patients
has attracted global interest in the one-thousand-bed
hospital—just as AIDS among children has become a
symbol of the sad state of the entire nation.

Romanian officials are in agreement that the global
interest in the country’s AIDS tragedy among children is
largely due to the army of journalists who have lately
been tramping through the country’s notorious chil-
dren’s homes and hospitals. While the international
attention has often proved unpleasant and, in the
opinion of many, unjust, the public attention that has
been focusing on the extremely large number of AIDS
cases among children has resulted in the flow of an
enormous amount of equipment and humanitarian aid
into Romania, and much of it has been earmarked for
“the AIDS infants.”

EAST EUROPE 15

Hepatitis B

However, most of the aid focuses narrowly on AIDS
among children to the exclusion of other, often curable
diseases. The virus that is overtaking the AIDS virus
(HIV) in Romania is the most dangerous of several
hepatitis viruses, that is, hepatitis B (HBV), which may
cause infection in, and destruction of, the liver. The
World Health Organization regards Romania as one of
the world’s “hot spots” of the virus, which spreads via
the same channels of infection as HIV.

Generally, HBV is not regarded as constituting the same
mortality risk to the public health as HIV. More than
three hundred million people are infected with HBV,
especially in Africa, Southeast Asia and Central
America, although hepatitis B is not unknown in the
industrialized countries. Only one out of ten persons
infected with the virus are “chronic carriers of the
virus,” who constitute a health risk to others or them-
selves run a risk of cirrhosis of the liver, cancer of the
liver or failure of the liver; the other nine may lead
largely normal lives, in which the virus is repressed by
the body’s immune system or disappears from the body
entirely.

Although it is not in itself a mortal disease, two million
people globally die each year of the consequences of the
virus.

However, the very number of infected persons in a
country of twenty-three million inhabitants makes hep-
atitis the “major health problem in Romania,” according
to Dr. Vincent Babes of the State Virology Institute in
Bucharest. “It is the major cause of death, to a far greater
extent than AIDS.”

In cooperation with the French organizations Medecins
Sans Frontieres and Epicentre, Dr. Babes has under-
taken studies of the frequency of the incident of hepatitis
B throughout Romania. The results so far are aston-
ishing. Forty percent of all children have incurred HBV;
in the case of children living in children’s homes, the
figure is approximately fifty-five percent; fifty percent of
Romania’s children below the age of five are infected
with the hepatitis B virus.

Forty-seven percent of adults have HBV; one out of ten
adults is a chronic carrier of the virus, Nearly eight
percent of the country’s pregnant women are also
infected and are expected to transmit the virus at birth.
Dr. Babes goes on to say that sixty-eight percent of all
employees within the health sector in Romania are
infected with HBV and fifty-seven percent of the physi-
cians. Similar studies, undertaken by the World Health
Organization and the American Center for Disease Con-
trol, not only confirm Dr. Babes’ terrible figures but may
make them look optimistic. Results of more technically
advanced blood test procedures than those available to
Dr. Babes show that ninety percent of the children in
children’s homes may have HBV, says a spokesman for
the World Health Organization. A definitive report of



JPRS-TEP-91-015
16 July 1991

Besides increasing the budget for surveillance and
testing, the province has also tightened leadership over
the program, said the governor.

In December 1989 the province set up a leadership group
for the implementation of the AIDS control strategy in
Yunnan composed of officials from all concerned
departments as well as some medical experts. The group
includes a committee of experts who will consult on local
policies and conduct scientific research,

So far, eight prefectures and all the counties that
reported AIDS carriers have set up offices to study and
analyze the disease and work out policies to deal with the
various problems.

CHINA 9

Some districts such as Ruili County have also created
local regulations on AIDS control

And hospitals in districts with people who are HIV
positive have all started using disposable syringes in line
with the provincial stipulations.

With help from the World Health Organization (WHO),
the province recently completed drafting a midterm
(1990-1992) program on AIDS control.

WHO has designated Yunnan one of its collaborating
centers in China for AIDS control and invited some
foreign experts to help train the Chinese staff.



JPRS-TEP-91-015
16 July 1991

inform groups about ways of controlling the spread of
the HIV virus, which causes AIDS.

PARAQUAY

Officials Confirm 106 People Infected With AIDS

PY2205212091 Asuncion NOTICIAS in Spanish
21 May 91 p 30

[Excerpt] According to an official report, a total of 106
people are infected with AIDS. Of 26 patients who came
down with the disease, only two are alive; the rest died.
A laboratory network is currently being implemented.

Health authorities have admitted that 10 new cases were
discovered during the first four months of 1991. The
“rose pestilence” [peste rosa] is on the increase in the
face of an indifferent population. Despite the efforts in
the area of prevention, there have been few positive
results. [passage omitted]

ST. VINCENT & THE GRENADINES

Health Official Calls for Improved AIDS
Monitoring

FL1106145391 Bridgetown CANA in English
1430 GMT 11 Jun 91

[Text] Kingstown, St. Vincent, June 11, CANA—A Vin-
centian medical doctor is calling for a more useful

LATIN AMERICA 19

monitoring system for the spread in St. Vincent and the
Grenadines of the deadly HIV virus that causes.

Ann Eustace, who heads the local office of the Washing-
ton-based health agency AIDSCOM, says that because
there is no trained epidemiologist in the Health Ministry
here and record-keeping methods are haphazard, infor-
mation on the spread of the HIV virus and AIDS may
not be very accurate.

“What we need to have is prevalence rate, which is to say
you randomly sample different populations to find out
what is happpening with the infection rate,” she
explained.

Dr. Eustace said the use of AIDS cases is an imperfect
indicator and records kept on blood donors and ante-
natal mothers “don’t go far enough.” Health officials
here reported 67 persons had tested HIV positive up to
30 April, and there were four surviving AIDS victims.

Dr. Eustace said according to the available data, AIDS
awareness programmes seem to be having a positive
impact here. The local AIDS action committee, one of
several interest groups involved in the fight against the
disease, will begin its annual pre-carnival carnival AIDS
campaign on 24 June, Dr. Eustace said. Focussing on
safe sex, the programme will have as its theme—‘‘Don’t
Take Chances.”



IJPRS-TEP-91-015
16 July 1991 4 AIDS

WEST EUROPE
DENMARK

AIDS-Treatment Personnel Under Stress [Copenhagen BERLINGSKE TIDENDE, 25 Apr 91] 23
Study Shows Up to 350,000 With HIV /Nuuk GRONLANDSPOSTEN, 3 May 91)

Parliament Opposed to HIV Register {Copenhagen BERLINGSKE TIDENDE, 8 May 23
AIDS Spreading Rapidly in Greenland {Copenhagen BERLINGSKE TIDENDE, 11 May 91) 23
High ‘Burnout’ Rate for AIDS Care Nurses 23
Conference Airs Problems
[Trine Baadsgaard; Copenhagen BERLINGSKE TIDENDE, 24 May 91] ........ 23
Statistics Confirm Trend [Trine Baadsgaard; Copenhagen BERLINGSKE TIDENDE, 24
May 91] ...... 24

FINLAND

Slight Increase in New HIV Cases ...
‘New Information Campaign [Helsinki HELSINGIN SANOMAT, 8 Jun 91]
Earlier Medicine Use [Helsinki HELSINGIN SANOMAT, 20 Mar 91] ..

FRANCE

Researchers Release New AIDS Study [Jean-Yves Nau; Paris LE MONDE, 14 May 91]
ICELAND

National Medical Service Issues AIDS Report [Reykjavik MORGUNBLADID, I May 91]
IRELAND

AIDS-testing Program for Maternity Hospitals
[Katherine Donnelly; Dublin IRISH INDEPENDENT, 16 May 91]

ITALY
AIDS Risks in Transfusions Reported /Rome LA REPUBBLICA, 4 May 91] .....
SWITZERLAND

AIDS Countermeasures Success Discussed
[Jean-Marie Krill; Geneva JOURNAL DE GENEVE, 7 May 91]

. 27



16 EAST EUROPE

the World Health Organization and the Center for Dis-
ease Control is expected to be available in the spring.

True and Untrue Statistics

Dr. Mardarescu admits that she has not heard Dr. Babes’
figures before, and although she does not dispute them,
she feels disinclined to accept them as a matter of course.
Actually, she finds no use for the statistics. Under the
Ceaucescu regime, she says, AIDS was officially a “for-
bidden disease”; the country’s infant mortality figures
were, for many reasons, so high that births were not even
registered until the infants were three months old;
although factors in conjunction with malnutrition and
pneumonia were the major causes of death among eld-
erly Romanians, “heart failure” was, invariably,
recorded as the cause of death.

“There is true statistics, and there is untrue statistics,”
Dr. Mardarescu says admonishingly, “and that is the
reason why I question your statistics.” HBV “is defi-
nitely in the nature of an epidemic in the children’s
homes,” she admits, and, by and large, all of the young
AIDS patients of the Colentina Hospital are also infected
with the hepatitis virus. The hepatitis problem has been
further aggravated by the lack of vaccine; she points out
that although vaccine cannot help those who are already
infected, it could protect future generations. “Is it really
hepatitis that you want to know about?” Dr. Mardarescu
asks surprised—and aggressively. Even if hepatitis is a
disease that rages at all levels of the Romanian society
and is known as the major cause of death, Dr. Mard-
arescu appears unable to understand why it would be an
interesting topic at all. She puts up with trivial questions
for a few minutes and then suddenly asks whether the
journalist would like to see something “interesting.”

At the Colentina Hospital, the most conspicuous recipi-
ents of western aid are the most visible victims of
Ceaucescu’s psychosis. In the newly renovated children’s
ward for AIDS patients, the children’s cots are standing
close to one another in bright, high-ceilinged rooms,
which are newly painted in gaudy colors, and where
several radiators ensure that the temperature reaches
levels of around fourteen degrees Celsius. However, on
account of the large area and a severe Romanian winter,
with outside temperatures dropping as low as to minus
twenty degrees Celsius, the “tideal” room temperature is
only reached in the spring. Until then they have to make
do with an “adequate” room temperature. “Adequate”
is, of course, far better than what the children experi-
enced twelve months ago, or what the Romanian health
sector has been living with for years. Today nurses and
nursing assistants from the British aid organization
Health Aid, which grants aid to Romanian physicians
and other personnel within the health sector, may draw
on stocks of medications, equipment and other supplies
in their treatment of their young proteges. With well-
equipped playrooms and lots of toys, the AIDS children
at the Colentina Hospital, with the exception of a few
heart-rending exceptions, look energetic and happy. Like
normal children, in every respect.

JPRS-TEP-91-015
16 July 1991

“Look at their bellies,” Dr. Mardarescu remarks, while
pointing to the swollen, revealing symptoms of the
hepatitis B virus, which causes infection of the liver and
finally destroys it. It is her discreet way of pointing out
that the children are dying, each and everyone of them.

“Come,” she says abruptly, marching determinedly
through double doors, right across the central entrance
hall of the building, through still another set of doors and
into an entirely different world.

It is darker in the other wards for infectious diseases of
the Colentina Hospital. There are no newly painted
walls—no colors at all, only shades of cool grey in the
winter light from the high windows. During the night, the
pale light from a few naked low-watt light bulbs, sus-
pended from the ceiling of some of the rooms, ensures
the intrusion of complete darkness from the long hall-
ways. The temperature has also dropped considerably.
The slightly cool temperature of the AIDS wards has
been replaced by a cold which chills you to the bone, and
which, like a virus, does not let go of you. The best thing
to do is to learn to live with it.

Strangely enough, there are nearly as many adults as
children walking around the hallways, although these
wards are children’s wards. A woman, carrying a child,
greets Dr. Mardarescu with a big smile; an elderly
babushka, wrapped in layers of cotton and thin wool, is
carrying a swaddled little boy, and the eyes of both
brighten at the sight of the physician. She stops to talk to
another woman, who is wearing a threadbare hospital
bathrobe over layers of indescribable clothing; although
it is impossible to distinguish her from the patients, she
is, in fact, a nurse.

The daytime temperature in the hallways is eleven
degrees Celsius, says Mariana, the nurse. Radiators con-
nected to the central heating system of the building
actually prevent the rooms from freezing up, but seem
best suited for the slow drying of clothing. However, on
entering a few of the rooms, one encounters an unexpect-
edly fierce heat. Small portable electric heaters lie on the
floor, their red-hot coils exposed. “They take their por-
table heaters along with them from home, there is no
other heating here,” says Dr. Mardarescu with a sidelong
glance.

A girl of about twelve accompanies the physician on her
rounds, It is obvious that she admires the woman and is
anxiously looking forward to the daily routine. With a
bright smile to everybody, she walks around, from room
to room, like a popular girl strolling down the hallways of
her school. Catching the attention of a small boy while
the physician performs a quick examination, she is in her
right element.

“Chronic diarrhea, no change,” says Dr. Mardarescu.
“He is not getting any better.” Another weak three-
year-old child, swaddled from head to foot, is lying,
looking pitiful, in a small cradle without noticing that the
girl is gently stroking his head. An ugly rash covers his
stomach and thighs: measles. The boy screams in



2 SOVIET UNION

Ufa Scientists Develop Licorice-Based Anti-AIDS
rug

PM1306143791 Moscow IZVESTIYA in Russian

12 Jun 91 Union Edition p 2

[Report by A. Zinovyev: “Another AIDS Medicine?”]

{Text] Ufa—A promising remedy for prolonging the life
of AIDS patients has been developed by a group of Ufa
scientists. It is called niglizin.

During successful tests as a preparation for the treatment
of rheumatic arthritis, niglizin revealed qualities also
necessary in combating immune deficiency. This was no
surprise, but the exact expectation of the inventors of the
new compound.

The raw material for niglizin is licorice—one of the most
ancient medicinal plants. Tibetan medicine ranks the
sweet licorice root alongside the legendary ginseng, using
it as an expectorant, an emollient, and an antidote. An
extract of the root is also added to other medicines to
improve their effect. More than a dozen kinds of licorice
grow in our country. Those which present the most
interest for medicine are glycyrrhiza glabra, which is
widespread in the Asian part of the Union, and glycyr-
thiza uralenis, which is found in the Urals.

The composition and structure of the sweet substance of
the licorice root have been determined in our time and
glycyrrhizic acid has been isolated. It is well known that
it has a high and diverse biological anti-ulcerous and
anti-inflammatory effect. Some years ago a group of
Japanese scientists established yet another remarkable
property of glycyrrhiza. In scientific terms, it possesses a
pronounced effectiveness in inhibiting (restraining) the
virus in immune deficiency sufferers.

Work on the development of new medicinal prepara-
tions on the basis of the glycoside and its derivatives has
been conducted for more than 10 years at the USSR
Academy of Sciences Urals Department Bashkir Scien-
tific Center Chemistry Institute. This program is headed
by Academician Genrikh Tolstikov. New biologically
active substances have been obtained which are of value
to medicine. One of these synthetic preparations—
niglizin—was developed in conjunction with pharmacol-
ogists of the Bashkir Medical Institute.

SPRS-TEP-91-015
16 July 1991

Lidiya Baltina, senior scientific associate at the Chem-
istry Institute Laboratory of Fine Organic Synthesis says
that the preparations are not inferior to the AZT com-
pound developed in the United States, and in a number
of tests even surpass the latter. In addition, AZT is
produced from a raw material not found in the Union,
and this raw material requires multistage synthesis; it
takes seven months to produce the preparation. Hence
its high cost—$10,000 per patient for a year’s course of
treatment. Moreover, AZT is highly toxic, which limits
its clinical use, whereas niglizin is completely nontoxic,
as are, incidentally, all the derivatives of glycyrrhiza
acid. At the present time, at the proposal of the USSR
Academy of Medical Sciences, the new preparation is
undergoing clinical trials on patients in the Center for
Struggle Against AIDS (Moscow).

Professor Yuriy Murinov, leader of the Chemistry Insti-
tute Laboratory of Fine Organic Synthesis, states: “Our
preparation is registered as an invention; it has yielded
positive results in tests at the Kiev Oncological Center,
and has also been used successfully in the treatment of
stomach ulcers, bronchial asthma, and lung ailments.
Such is its wide spectrum of activity. Foreign pharma-
ceutical firms are keenly interested in it. For example,
the British firm ‘Oxford Virology.’ Our institute and the
‘Vektor’ Science and Production Association have con-
cluded a contract with this firm for the joint production
and sale of niglizin abroad. With the aid of this firm, the
preparation is being tested as an anti-AIDS remedy in a
London clinic. This same firm is assuming the costs of
registering and marketing the preparation abroad. [no
end quotes published]

Work on developing effective remedies is continuing. In
the very near future Bashkiria will have something to
offer pharmacy. Both for the internal and for the foreign
market,

Latvian AIDS Victim Dies

LD1706193491 Moscow All-Union Radio Mayak
Network in Russian 1800 GMT 17 Jun 91

[Text] The Latvian AIDS center reports that the first
inhabitant of the republic suffering from AIDS has died.
The victim of the disease of the century was a Riga to
Moscow route train guard. Previously two persons, a
man and wife, committed suicide on learning that they
had the terrible sickness. The head of the center said
another nine AIDS patients are registered in Latvia.


18 LATIN AMERICA

BARBADOS

Committee Chairman on Number of AIDS Cases,
AZT

FL2706170791 Bridgetown CANA in English
1604 GMT 27 Jun 91

[Text] Bridgetown, Barbados, June 27, CANA—A pro-
posal is before the Barbados Government to make the
drug AZT available through a national drug service to
persons with AIDS. The drug, under the scheme which
makes medicines available to nationals free or at
reduced fees, would cost the government between 5,500
and 9,200 dollars (one Bds dollar = 50 U.S. cents) per
person, said Professor Mickey Walrond, chairman of the
National Advisory Committee on AIDS. Walrond who
was speaking to newsmen as he launched a new series of
AIDS prevention messages for television and print
media, said AZT is now available to those Barbadians
who can afford it.

He said last year there were 60 cases of AIDS, a disease
which destroys the body’s immune system making it
vulnerable to even minor infections. The total number of
known AIDS cases to the end of 1990 was 192. Walrond
estimated the number of carriers of the Human Immuno
Defficiency Virus (HIV) which causes AIDS at between
300 and 500.

Walrond calculated that by 1995 the total number of
AIDS cases will be 580 with “200 alive at any one time.”
“They are infected already,” he said explaining that with
the incubation period of five and more years, the new
cases would then not be accounted for.

The University of the West Indies professor said Carib-
bean medical personnel had not made tests of the
controversial blood- based drug Kemron, heralded by
Kenyan doctors as a cure for AIDS.

“We're not satisfied that clinical trials in Kenya were
sufficiently conclusive,” he said adding that there was no
Caribbean trial partly because of a legal dispute between
Kenya and the manufacturers of Kemron.

AIDS treatment in the Caribbean has largely been con-
fined to the manifested illness of the patient, which in
most cases is pneumonia which doctors have found
responds well to a common anti-biotic, Walrond said.

“There is not as much of the cancers as seen in other
places,” he reported.

Walrond said AIDS research in the Caribbean has largely
been on “knowledge and behaviour.”

“It is largely into... the scope of the epidemic and
interventions and how people behave. I am not aware of
any formal clinical research although patients are being
treated,” he remarked. He said there was some research
in the Bahamas on one new experimental drug which is
“very toxic.”

SJPRS-TEP-91-015
16 July 1991

In 1990, the number of reported AIDS cases in the
English- speaking Caribbean including the Bahamas and
Bermuda coupled with Suriname, was 1,869, according
to the Caribbean Epidemiology Centre in Trinidad.

BRAZIL

Health Ministry Reports AIDS Figures

PY2806010991 Rio de Jaeiro Rede Globo Television
in Portuguese 2300 GMT 25 Jun 91

[Summary] A report issued by the Health Ministry on 25
June shows that, to March, almost 18,200 AIDS cases
have been detected all over the country.

JAMAICA

AIDS Cases Total 225; Attitudes Show Little
Change

FL0706014891 Bridgetown CANA in English
2014 GMT 6 Jun 91

{Text] Kingston, Jamaica, June 6, CANA—Jamaican
health authorities are concerned that, despite their con-
tinuing public warnings about the dangers of unsafe sex
and the increasing number of AIDS (Acquired Immune
Deficiency Syndrome) cases here, there is little indica-
tion that people have substantially changed their sexual
habits. The concern was expressed Wednesday by Dr.
Peter Figueroa, director of the National AIDS/Sexually
Transmitted Diseases (STD) Control Programme of the
Ministry of Health, at the launching of a community
drama project on AIDS and other STDs.

He said that 17 more Jamaicans, including young babies
and a 60-year-old man, had been infected with the
deadly AIDS virus during the months of March and
April. This brought the number of AIDS-infected per-
sons here to 225. There is no known cure for AIDS,
which destroys the body’s ability to fight off disease.

A statement from Dr. Figueroa’s office indicated that
there was a higher number of teenagers who maintained
that the disease had no relevance to their lives. A recent
survey revealed that many teenagers interviewed said
they felt it was “mainly licky licky (freeness-mentality)
people going to get AIDS”. They also felt that it was
people of the lower class, prostitutes, and people who
were always greedy for money who would become
infected. They expressed the view that “if you don’t
catch it already, you won’t catch it again”.

Dr. Figueroa pointed to the need for the population to
recognise the reality of the problem and how it could
affect them. He said the society needed to face and
address the problem as well as remove the stigma
attached to AIDS victims. The drama project involves
performances by students of the Jamaica School of
Drama in ten communities and aims to stimulate discus-
sion on AIDS problems and solutions. It also seeks to


JPRS-TEP-91-015
16 July 1991

BULGARIA
Health Ministry Announces Extent of AIDS
Problem

AUI806111391 Sofia DUMA in Bulgarian
14 Jun 91 pl

[DUMA PRESS report: 94 People Have AIDS in Bul-
garia”]

[Text] In the - beginning of June, there were 94 carriers of
the AIDS virus in Bulgaria. This number includes 7

people who have already died from the virus, specialists
from the Health Ministry announced.

According to information from the World Health Orga-
nization, AIDS tests are required when travelling or
staying for different lengths of time in Cyprus, Egypt,
Finland, India, Iraq, Libya, Kuwait, New Zealand, Paki-
stan, Poland, and the USSR, or under other circum-
stances,

AIDS tests on pregnant women in Bulgaria will only be
done on those wishing to give birth to their baby.

AIDS Foundation Endangered; AIDS Statistics
Cited

AU0307164591 Sofia BTA in English
1549 GMT 3 Jul 91

[“No AIDS National Foundation on Verge of Bank-
ruptcy”—BTA headline)

[Text] Sofia, July 3 (BTA}—The No AIDS National
Foundation, the first of its kind in Bulgaria, is in danger
of bankruptcy after a star-studded charity concert
proved a financial disaster.

The concert on July 1, staged at Bulgaria’s largest sta-
dium in Sofia, drew only 3,000 people while the founda-
tion expected no less than 50,000 to turn up. It cost
nearly 100,000 dollars to organise the concert, starring
Technotronic, Boney M and Sandra, while the box-office
takings, which were to be spent on the joint programme
with the Paris-based Louis Pasteur Institute, fell far short
of expectations.

According to Mr. Dimitur Dukov, president of the No
AIDS Foundation, the concert flopped because of the
driving rain, which had been pouring over Sofia for three
days. The other cause was the fact that Bulgarians are not
used to charity shows.

The AIDS problem in this country is assuming dan-
gerous proportions while the state and the general public
remain somewhat indifferent to it. According to official
statistics, Bulgaria has 96 registered HIV carriers, eleven
of whom have developed the full- blown symptoms of
the disease and seven have died. However, experts put
the number of HIV-infected people at 1,000 to 5,000 and
warn of a real danger of a snowballing AIDS epidemic.

EAST EUROPE 13

According to the No AIDS Foundation, Bulgarians have
an incredibly low sex culture. Health care is in a deplor-
able condition. Specialized laboratories rely on the foun-
dation to provide funds for purchasing AIDS tests. But
the No AIDS Foundation believes that the government
and most of the general public, preoccupied by political
and economic changes, ignore the gravity of the problem.

The Louis Pasteur Institute expressed its readiness to
help Bulgaria set up a local free test centre with guaran-
teed confidentiality of the results because the existing
centres do not observe it.

Faced with inevitable bankruptcy, the No AIDS Foun-
dation appeals for help, even if it is only an extended
friendly hand.

The foundation can be reached at the following address:
No AIDS Foundation

Tel/Fax 66 51 37

2 Bisur St., 15th floor

Sofia, Bulgaria.

CZECHOSLOVAKIA

Health Ministry Reports 25 AIDS Cases

AU0107134391 Prague CTK in English
1353 GMT 27 Jun 91

[Text] Prague June 27 (CTK)—Twenty-two cases of
AIDS in the Czech Republic were registered at the end of
May 1991, Jaroslav Kriz of the Czech Health Ministry
told a press conference today.

One of the 22 persons with AIDS was a female foreign
student no longer residing in Czechoslovakia. Nineteen
of the 21 Czechoslovak citizens were homosexual men,
one was a hemophiliac and it is not yet clear how the
remaining man came into contact with the AIDS virus,
Kriz said. Thirteen of those 21 have already died.

An additional 155 persons, including 64 foreigners, have
tested positive for the AIDS virus, but have not yet
developed the acquired immune deficiency syndrome,
commonly known as AIDS. Among the 91 HIV-positive
Czechoslovak citizens, 53 are homosexuals and 29
received blood or a blood derivative before blood began
to be tested for presence of the AIDS virus.

According to similar data, three persons with AIDS and
21 HIV- positive persons have been registered in Slova-
kia, which has a population approximately one-half that
of the Czech Republic.



IPRS-TEP-91-015
16 July 1991

A total of 129 people tested positive, twice the number in
the first quarter last year.

According to information supplied by the virus labora-
tories at Tygerberg and Groote Schuur hospitals to the
Department of Health, risk factors were unknown in the
case of 74 people. Ten were homosexual and 32 were
heterosexual.

By March this year a total of 853 people had tested
positive for the HIV virus in the Cape since testing
began.

Of these, 191 were white, 162 were coloured, 269 were
black and the race of 231 was unknown.

The Department of Health said that of the 129 who
tested positive this year, the race and sex of 47 were
unknown, but five were white males, one was a white
female, 20 were coloured males, 10 were coloured
females, 23 were black males and 23 were black females.
No Asians tested positive.

The AIDS testing is done anonymously and the cases can
be identified only by postal codes.

Of the 58 people who tested positive in the Cape in
March, 39 were from the Western Cape—22 of them
from Cape Town. East London had five cases, the Karoo
had two, the Kimberley area had two and the southern
Cape coast had three. Others were not identifiable by
postal code.

AIDS Infection ‘Soaring’ In Pietermaritzburg

MB1306083391 Umtata Capital Radio in English
0600 GMT 13 Jun 91

[Text] Infection with the AIDS virus is soaring in Piet-
ermaritzburg. The NATAL WITNESS reports the
number of people carrying the virus in the city in the first
5 months of this year doubled from the same period last
year.

The head of the HIV clinic at Edendale Hospital, Jim
Muller, says most of the 121 people who tested HIV-
positive had picked up the disease sexually. Three AIDS
victims have recently been diagnosed at Edendale; two
have since died.

In the city itself, one person has died and another 20
have the full-blown disease. All those who picked up the
HIV virus are expected to die.

Country Facing ‘Major’ AIDS Disaster

MB1406185091 Johannesburg SABC TV 1 Network
in English 1545 MT 14 Jun 91

{Text] South Africa faces a major AIDS disaster unless it
can bring the spread of tuberculosis [TB] under control.

The warning to this effect has been issued after a finding
{words indistinct] there is a definite link between AIDS
and TB. Scientists say that since the beginning of this

SUB-SAHARAN AFRICA 5

year, TB patients have shown a threefold increase in
AIDS infection. These facts came to light at a sympo-
sium of the Community Health Association of Southern
Africa Held at Kempton Park today. [Begin recording]

SABC reporter, Marinus Winjbeek: Speakers at the sym-
posium described a close relationship between TB and
AIDS. AIDS can trigger latent TB infections, and
increases incidents of active TB as much as ten times.

At a recent world conference on lung health, it was
estimated that TB cases worldwide could escalate to 80
toa 100 million by the year 2,000 due to the influence of
AIDS.

On the other hand, a TB infection will speed up the
development of AIDS, thereby shortening the life
expectancy of AIDS sufferers and increasing the death
rate three times.

In the USA, TB is again on the increase. This is directly
related to AIDS in that country.

A study at a local TB hospital revealed that in 1989/99,
1.8 percent of TB patients had AIDS as well. Provisional
figures indicate that since the beginning of this year, this
figure has risen threefold to 5.4 percent.

Eric Glatthaar: The present situation is definitely cause
for quite serious concern, although there is a downward
trend in some areas. And in many other areas there is a
rising tendency of the disease, especially on our coastal
areas, and in the western Cape the disease has reached
epidemic proportions. [end recording]

Cooperation Bureau Allegedly Spread AIDS in
Townships

MB2806113391 Johannesburg NEW NATION

in English 28 Jun - 4 Jul 91 p 3

[Unattributed report: “CCB Sent AIDS-Infected
‘Askaris’ Into Townships”]

[Text] Members of the underground Civil Co-Operation
Bureau (CCB) used four AIDS-infected ‘askaris’ [former
ANC guerrilla] from the Vlakplaas police counter-
insurgency base to spread the deadly virus in Soweto and
East Rand township shebeens.

According to an affidavit by former security agent,
Ronald Desmond Bezuidenhout, the four ‘askari’s’—
former ANC [African National Congress] guerrillas
working for the police—regularly visited shebeens with
instructions to have sex with black women.

This was perceived as a perfect ploy to spread the disease
in the townships.

Bezuidenhout, a former policeman and member of the
counter-insurgency unit based at Vlakplaas, said in a
written affidavit that he personally took four AIDS-
infected ‘askaris’ to the townships on the orders of his
commanding officer.



28 WEST EUROPE

Among homosexuals, by contrast, prevention seems to
have become the normal practice, and most of them
engage in “‘safer sex.” The prevalence of the virus within
this group remains high, so it is important to consolidate
and maintain the progress already made and keep people
from getting discouraged.

Needle Sharing

The word has also gotten out to drug addicts. Needle
sharing is very infrequent (fewer than one user out of 10
in a six-month period) when clean hypodermic equip-
ment is available and easily accessible. Exceptions are
almost always the consequence of user urgency.

Distribution of syringes is authorized now in almost all
of Switzerland’s cantons, except for the demi-cantons of
Nidwald and Appenzell AI. Several programs for distri-
bution/exchange of hypodermic equipment have run
into problems, however. Dr. Dominique Hausser said
yesterday for example that he regrets Geneva’s syringe
distribution and social services bus-mobile program has
never gotten off the ground.

The question of sexual transmission of the AIDS virus
among drug users remains unanswered, since it has not
received as much attention as transmission via blood
contamination. Despite the fact that condoms are used
as widely by drug addicts as by the general population,
this group’s situation is rather unsatisfactory, consid-
ering its high rates of seropositivity (20 to 30 percent).

JPRS-TEP-91-015
16 July 1991

Parental Role

Researchers at the Institute of Social and Preventive
Medicine also analyzed the role played by parents,
doctors and schools in prevention. Although most par-
ents meet their responsibilities and offer realistic
counsel, the researchers say medical doctors could be
doing more, particularly with their younger patients. The
quality of preventive services offered by schools differs
greatly from region to region; it is generally more
advanced in French-speaking than German-speaking
parts of the country.

Overall, in any case, the Lausanne Institute finds that
parents, doctors, and schools are still hindered by lack of
adequate references and supports to guide their efforts.
The “Stop AIDS” campaigns, however, are generally
well received by the public. According to the report, the
subject continues to get good press coverage, although
the number of articles on AIDS is declining.

Recommendations

In conclusion, in order to prevent people from getting
complacent about AIDS, the Lausanne researchers
offered a series of recommendations for future cam-
paigns. Such campaigns should continue to targe-—and
focus on the concerns of—young people, they say. Use of
condoms should continue to be encouraged, so that it
becomes the social norm. They also suggest preparation
of an interim assessment at the end of the first five years
of preventive campaigns, in order to give the public a
sort of overview of the current situation (epidemiological
changes and advances in the scientific understanding of
AIDS).


SJPRS-TEP-91-015
16 July 1991

Earlier Medicine Use

91WE0392B Helsinki HELSINGIN SANOMAT
in Finnish 20 Mar 91 p 3

[Unattributed article: “AIDS Medication To Be Given
to HIV-Infected Persons Before Symptoms; Early Treat-
ment Prolongs Life”’]

[Text] The only AIDS medication now in use can, in the
future, be given to HIV-positive patients even before
they show severe symptoms. Government health services
have expanded the use of the drug after studies indicated
that patients treated with Retrovir live two to three times
longer than those without treatment.

The drug has also been shown to delay the progress of the
disease for HIV-infected patients who have not shown
any symptoms.

Studies have also revealed that the patients have
retained their immunity better when treatment has
begun in the early stages. Further, serious side effects are
rarer among these patients.

Those patients with few or no symptoms who have had
their T-4 cell count fall below a certain level or decrease
rapidly can henceforth also be treated.

Supervising physician Juhanin Lahdevirta estimates that
the treatment will annually cost an average of 15,000
markkas per patient. In Finland, the patient receives
medicine free of cost.

Prof. Pauli Leinikka of the State Health Institute’s AIDS
Laboratory feels that expanding the use of the drug as
well as the promising research results will cause people to
more readily have themselves tested for HIV infection.

The State Health Institute currently tests about 50,000
persons a year, a figure that has held steady in recent
years. In addition to these, the blood donor service
conducts approximately 300,000 tests per year.

The total number of HIV cases in Finland is 373.
Seventy-four have actually developed AIDS—that is,
loss of immunity. Of these, 46 have died.

FRANCE

Researchers Release New AIDS Study

91WE0358A Paris LE MONDE in French
14 May 91 p 12

[Article by Jean-Yves Nau: “French Discovery Leads to
Better Understanding of AIDS Physiopathology”)

[Text] Speaking before the Academy of Sciences on
Monday, 13 May, a team of French biologists from the
Pasteur Institute in Paris, headed by Professor Luc
Montagnier, made public the results of original research

WEST EUROPE 25

into the physiopathology of AIDS.’ The data open up
new possibilities of treatment in the handling of persons
stricken with the disease.

The work of the team headed by Montagnier provides a
solution to one of the most difficult problems that AIDS
poses for biologists. If the virus identified at the Pasteur
Institute in Paris in 1983 does indeed play a role in the
conduciveness of the disease, the viral infection does not
by itself enable one to understand it. In particular,
scientists have yet to gain a full understanding of how
one progresses from this infection to a clinical manifes-
tation of the disease and why the “silent” period sepa-
rating these two stages is so long, sometimes 10 years or
more!

For several years now, Montagnier and his aides have
favored the hypothesis that AIDS could be the result of
infection by the HIV virus and other organisms, mainly
Mycoplasmas. In the Pasteur Institute’s ANNALES, first
of all (LE MONDE, 20-21 May 1990), and then before
the Academy of Sciences (LE MONDE, 14 November
1990), the team presented a series of experimental argu-
ments backing this hypothesis. The work presented
today fits into the same framework.

“Death by Programmed Suicide”

The research starts from an observation: Lymphocytes
(white corpuscles playing a central role in the organism’s
system of immunity) taken from seropositive persons
and grown in vitro die much faster than those from
uninfected persons. This loss of cell viability exists at all
stages of the infection (asymptomatic phases, ARC,
AIDS) and does not seem to exist in any other infectious
human pathology. Only after trying for years to under-
stand the reasons for such a phenomenon did the Pasteur
Institute team discover that one type of lymphocytes
from seropositive persons was engaged in a deadly
process known in biology as “apoptosis.” “Apoptosis,”
Montagnier explains, “is one of the two forms of cell
death. There is sudden death of the membrane by lysis
and there is apoptosis, which can be described as a kind
of death by programmed suicide, a phenomenon internal
to the cell and leading to the sectioning of the cellular
ADN into multiple fragments.”

The French researchers also observe numerous pre-
apoptosis cells in their culture. How is such a phenom-
enon to be interpreted? According to the hypothesis
developed in the article presented before the Academy of
Sciences, the viral infection reportedly unleash the pro-
cess preparing the cells for death by apoptosis. This
phenomenon would presumably be triggered by subse-
quent encounters of the cell with different antigen from
infectious agents (Mycoplasmas, Toxoplasmas, and so
on). Such a scenario would thus explain the long incu-
bation period following the primary viral infection
during which one observes a slow decrease in the number
of certain lymphocytes.

This advance in the physiopathological understanding of
the disease opens up new therapeutic prospects. It is



2 SUB-SAHARAN AFRICA

about 9,000 seropositive individuals. This led the min-
ister to acknowledge that, since therapeutic action is
currently unable to check the pandemic disease, the
international community must mobilize around “pre-
vention, to reduce the transmission and dissemination of
the virus.”

The epidemiological profile of AIDS in Gabon, which
was presented by Dr. Hamono, shows that the illness is a
recent development—the virus responsible for it was
only identified seven years ago. Consequently, it can be
deduced from studies done on cluster surveys of the
population, especially among high-risk groups such as
sexually transmitted disease carriers, tuberculosis
patients, and prostitutes, that the disease is still
spreading steadily. This is known because studies con-
ducted among 15- to 44-year-olds revealed a prevalence
rate of 2.2 percent in Libreville alone.

This raises the question of how programs for the second-
year PMT activities, which require a sum of 500 million
CFA [African Financial Community] francs, will be
revised. Generally speaking, based on the talks of
Gabon’s traditional partners, the already existing
arrangement will be maintained and shored up as needed
to meet priorities. Gabon has allocated a package of 98
million CFA francs for this year. As you might suspect,
this sum would not be sufficient to get the program off
the ground. The 11 governments and institutions repre-
sented in the meeting made commitments to cover the
rest. This PMT program revision will serve as a frame-
work for all anti-AIDS efforts and as the foundation for
the financial commitments of all the partners.

IVORY COAST

Health Minister Advises Increased Use of
Condoms

AB0805111891 Abidjan FRATERNITE MATIN
in French 4-5 May 91 p 2

[Passages within slantlines printed in boldface]

[Excerpts] /““U.S.-made high quality condoms tested in
the factory and laboratory...”/ that is the way “Pru-
dence” was presented. This condom seems to have won
the Ivorian health minister’s favors who, by setting it
against the background of remarks made in his office
yesterday on the development of AIDS in Ivory Coast,
gave the impression that he was recommending its use to
Ivorians. In reality, the minister of health was inviting
his compatriots to increasingly acquire the reflex for
protected sexual relations. In this regard, the use of
condoms is the best method of prevention. [passage
omitted]

A new state of mind should govern AIDS prevention.
The health minister has signed a two-year renewable
protocol agreement with Population Service Interna-
tional (PSI), an American nongovernmental organiza-
tion whose objective is “to increase the physical and

IJPRS-TEP-91-015
16 July 1991

economic accessibility of condoms in Ivory Coast,” in
other words, generalize their use, and this for a very good
reason,

Speaking in solemn terms Minister Alain Ekra said that
/“our country is currently sixth in Africa concerning
WHO-registered AIDS cases,”/ an epidemiological situ-
ation which reveals that Ivory Coast has 6,836 cumu-
lated cases, including 3,189 seropositive cases.

The largest number (80 percent) of adult cases range
from between 20 and 49 years, with maximum cases
found among men aged from between 30 and 39, and
among women from between 20 and 29. It has been
observed that the /epidemic/ (which is seriously wors-
ening in our country) /is spreading from the high risk
groups to the general public/. [passage omitted]

KENYA

Semiannual AIDS Statistics Updates Planned

91WE0396 Nairobi KENYA TIMES in English
30 May 91 p3

[Article by Michael Otieno]

[Text] The number of AIDS victims in Kenya currently
stands at 17,260 cases. Of these 700 are children under
the age of five, the Director of Medical Services, Pro-
fessor Joseph Oliech, said yesterday.Prof. Oliech pledged
to release a report with an update on the number of
victims of the dreaded scourge after every six
months.The DMS said this when he briefed the press on
the status of the disease in the country at his Afya House
office.The Coast Province, the director said, had the
highest number of AIDS cases in the country with 45.7
percent of the national burden. In terms of figures, the
province has a total of 7,895 cases out of which 5,024 are
male and 2,871 female. Prof. Oliech raised concern over
the high number of children victims and posed: “What
are we going to do with these kids?” adding “the burden
on the Government to take care of these children is
enormous.” Prof. Oliech said that Nyanza Province has
3,848 (22.3 percent) AIDS cases, Nairobi alone has
2,542 (14.7 percent) while Western had 1,054 (6.1 per-
cent). The figures, the DMS said, were alarming and
called upon Kenyans to change their sexual habits for the
better since sexual intercourse remained the major
avenue of transmission of the human immunodeficient
virus (HIV) which causes AIDS.“ Last year during the
international AIDS Day celebrations which were
observed at Kibera, Nairobi, the Minister for Health,
Mr. Mwai Kibaki revealed that the number of AIDS
cases in the country stood at 12,000. ’From last year’s
figures you people (journalists) can clearly see that we
have at least 5,000 cases every year, who demonstrate the
clinical signs of AIDS (have fully blown condition), said
Prof. Oliech. He called on all concerned to heed the
advice from the health professionals in the fight against
AIDS. He cautioned patients not to receive blood which
has not been screened for the virus. “We have the best


SJPRS-TEP-91-015
16 July 1991

ANGOLA

Luanda Reports 23 Cases of AIDS, Including 10
Deaths

MB0506083891 Luanda ANGOP in Portuguese
1915 GMT 4 Jun 91

[Text] Luanda, 4 June (ANGOP)—A total of 23 cases of
AIDS, including 10 deaths, were registered at Josina
Machel Hospital in Luanda from January to May this
year. ANGOP learned this today from Dr. Francisco
Mendez during a visit to the hospital by Nikola von
Hassel, coordinator of the Medical. Mission Institute
{preceding words in English]. Dr. Francisco Mendez also
revealed that the hospital lacks resources to deal with the
disease. On the occasion, Dr. Hassel was briefed on the
patients’ health conditions and their needs. The Medical
Mission Institute is a German nongovernmental charity
organization which assists the sick, particularly those
suffering from AIDS.

BOTSWANA

Kgalagadi District—35 People HIV Positive
MB2706175291 Gaborone Radio Botswana Network
in English 1610 GMT 27 Jun 91

[Text] The medical practitioner in Tshabong, Dr. Sam
Adu, says the spread of AIDS in the Kgalagadi District is
becoming serious. Speaking to BOPA, Dr. Adu said there
were about 35 people infected with the AIDS virus in the
Kgalagadi District, most of them women. He said Tsha-
bong alone had 25 cases. Dr. Adu said the most affected
age group ranges from 19 to 35 years.

He said the spread of AIDS can be controlled by edu-
cating people about the disease, and encouraging people
to stick ot one partner, and to use condoms.

CAMEROON

By 1990: 243 AIDS Cases, 173 Fatalities

91WE0354A Yaounde CAMEROON TRIBUNE
in English 25 Mar 91 p 5

{Article by Bernard Fualefac]

{Excerpts] The killer disease, the Acquired Immune
Deficiency Syndrome (AIDS) has plunged mankind into
a dilemma and extreme fear especially as there is no cure
yet. Last Tuesday, 19 March, all the media personnel in
the North West province who are the mouth piece of the
population participated very actively at the one-day
seminar for AIDS prevention organised by the health
department in the province. [passage omitted]

Some Statistics

In delivering a paper on AIDS epidemiology, statistics,
evaluation and distribution in the province and at

SUB-SAHARAN AFRICA 1

national level the seminar coordinator, Dr, Tembon,
noted that since the disease was first diagnosed in
America (in 1981), scientists, doctors, researchers and
the World Health Organisation (WHO) have been
working round the clock to find a drug which can cure
the ailment.

He observed that the matter is now a political, social,
economic and medical problem.

At the national level, between 1983 and 1990 some 243
cases of AIDS were diagnosed. Dr. Tembon said of this
figure 173 are already dead and 23 are below the age of
18 years. He went on further to disclose that of the 143
who are AIDS carriers 133 are women. Other statistics
out of the global figure of 243, six contacted the ailment
through blood transfusion, 63 were heterosexual, 13
prostitutes and 20 imported cases.

In the North West province, Dr. Tembon pointed out
that as of March 1991 the number of HIV carriers stands
at 148. Of this figure 94 came from the urban centres and
54 from the rural areas, He said the distribution by sex
revealed that 88 males were HIV carriers as against only
41 for females. Other analysis further showed that 72
HIV victims are married, 44 single and others who are
either widows, or widowers constituted 13. The provin-
cial preventive medicine boss, however, did not disclose
the figures for AIDS patients in the province. [passage
omitted]

GABON

About 9,000 Found HIV-Positive Since 1986

91WE0376A Libreville L'UNION in French
3 Apr 91 p3

[Article by Annick-Brigitte Bouma: “Capital Available
To Step Up Fight Against AIDS”; L’UNION introduc-
tion is “AIDS—Second Meeting of Moneylenders”

[Text] The Meridien Re-Ndama was recently the site of
discussions among those concerned with marshaling the
resources to finance the second phase of the medium-
term program (PMT) to combat AIDS. The meeting was
an important one, judging by the number of representa-
tives who attended. Included at the meeting were the
Gabonese state, which was joined by the Ministries of
Health, the Budget, and National Defense, by traditional
partners—among them WHO, UNDP [UN Deveopment
Program], the EC, UNFPA [UN Fund for Population
Activities], and the CIRMF [expansion not given]—and
by the Western-country delegations [sentence as pub-
lished]. Participants reaffirmed their support for the
National Anti-AIDS program.

In his opening speech, the health minister Eugene
Kakou-Mayaza reminded participants of his ministry’s
concern about the spread of the disease. The seropositive
rate on the 117 cases reported since 1986 is 2 percent, or



14 EAST EUROPE

POLAND

AIDS Patients, HIV Carriers in Detention

91WE0357A Warsaw POLITYKA in Polish No 19,
11] May 91 p7

[Article by Grazyna Kadro and Tomasz Trabuc: “First
Hand: AIDS in Prison”]

[Text] The wave of articles about AIDS in Polish prisons
and the monstrous pictures they evoke have created
renewed interest in this subject.

The first difficulty that journalists encounter in gath-
ering information is in determining the exact number of
AIDS patients and HIV carriers in Polish prisons.
Tadeusz Kolarczyk, who heads the Department of
Health of the CZZK [Central Administration of Penal
Institutions], would seem to be the most reliable source
of information on the subject. He places the figure at 105
patients and carriers, including 46 sentenced and 59
temporarily detained (data from the end of February,
1991). At on-the-job training for prison employees set up
in Popowo in March, 1991, however, the figure was set at
180, which is nearly twice the given figure.

Of course, neither figure is exact, because the CZZK
does not think that all the people entering prison need to
be tested. Physicians are of the same opinion. The high
costs of the tests are an obstacle—this despite the fact
that the Ministry of Health and Social Welfare covers
them—and the procedure is a complicated one. There-
fore, testing is done only on drug addicts, those known to
be homosexuals, and those people who themselves wish
to be tested, in view of a possible lighter sentence if they
are diagnosed with the disease or found to be carriers.

The latest health department statistics show that there
are 1,480 carriers of the HIV virus and 50 people with
AIDS out of the 4 million Poles that have been tested.
Thirty of them have already died. The latest victim of
this terrible disease was a young bisexual from Warsaw,
but experts on the matter say that the statistics on
carriers reflect only about one percent of the true situa-
tion, because there may even be 100,000.

It is also alarming to look at these prisoners against the
backdrop of these statistics, which would seem indicate
that about one HIV carrier in ten winds up behind bars.
They can count on far greater care and understanding,
because in the prisons the epidemic of fear and intoler-
ance has already passed. Not a single Prison Service
employee has refused to work out of fear of AIDS.

The first detection of an HIV carrier in prison was in
1988. This convicted drug addict was admitted to a
special section at the penal institution in Sluzewiec. In
1989 two convicted drug addicts were referred for detox-
ification. After the tests were repeated, they were found
to have been infected. New people began to come in
during the next few months.

SJPRS-TEP-91-015
16 July 1991

In March and April, 1990, hospital departments were set
up in penal institutions for clinical cases in Gdansk,
Poznan, and Warsaw. Sections for HIV carriers were
created in some institutions. All that is lacking is a place
to temporarily detain those HIV carriers who have been
arrested.

We need to add a new category to the list of self-inflicted
injuries peculiar to confinement, shooting up with con-
taminated blood. At last reports, a cubic centimeter cost
between 300,000 and 400,000 zlotys. Prisoners imagined
that confirmation of HIV infection or illness would be
their ticket to freedom. They were counting on para-
lyzing fear on the part of the prison staff, who would be
eager to rid themselves quickly of those stricken by the
“plague,” but nothing of the sort happened. No carrier’s
sentence was interrupted, and, as Tadeusz Kolarczyk
emphasizes, irresponsible articles on the subject only
caused unnecessary hope among those afflicted.

Drug addicts represent the largest group of prisoners who
are carriers of the HIV virus. Two special sections have
been set aside for them. They are separated nearly
entirely from the rest of the prison. They are like islands
for the “condemned.” They do not see other prisoners,
only those who bring them food.

In Sluzewiec it is freer than in Lodz, though. This part of
the penal institution operates as an open department.
The cells are open, and the prisoners can move about
freely. There is a dark room, a carpentry workshop, and
a small greenhouse, where the prisoners raise vegetables.
This is especially valuable, because although they are
entitled to special dietary privileges, these are limited to
an additional glass of milk and an egg. Working in the
greenhouse also gives them something to do. There is
100-percent unemployment among the HIV carriers.
They used to put the ink chamber inserts into ballpoint
pens. Once jobs became scarce, they were the first to feel
the effects. There are cells to be painted and simple
upkeep jobs to be done, but not often. Boredom prevails
in the confinement sections.

The drama of the AIDS patients and HIV carriers
continues as well, perhaps even mainly, once the pris-
oners leave. They usually do not have anywhere to go.
They have been rejected by their families and friends.
They do not have jobs. Any return to the drug culture
means losing what they gained inside, the chance to
make a break with drugs, but there are few institutions
eager to help them. They are sentenced to a slow death,
without friends, a job, long-range prospects, or hope.

The Drug Independence Clinic on Dzielna Street in
Warsaw is trying somehow to fill this gap in institutional
shortcomings, but it is all too little. Nobody helps with
housing, a job, long-term help, or what is most needed.
Only a handful of people can live at the Ministry of
Health’s Readaptation Center in Konstantin. Fr. Arka-
diusz Nowak, who heads the facility, would be glad to
accept everyone, but he only has room for ten people.


4 SUB-SAHARAN AFRICA

indicates that about 500,000 Nigerians may be carrying
the virus at the present time“.

The vice president said the feedback reaching him since
his last appeal in 1989 for concerted efforts at educating
Nigerians on the AIDS epidemic, indicated that there
was a high-level complacency and a disturbing level of
non-chalance among Nigerians to the AIDS epidemic.
What is most disturbing about this dreaded disease is the
fact that the people afflicted by the HIV virus carry
AIDS without being aware of it for years and yet remain
healthy and capable of spreading the virus to others,“ he
said.

He urged all tiers of government to take urgent steps to
save our children from dying or watching us die of
AIDS“. To this end, Aikhomu directed states ministries
of health, education and information, and local govern-
ments to allocate sufficient funds in their annual budgets
to prevent and control AIDS.

Health Commissioner: Ten AIDS Cases
Discovered in Jos

91WE0383A Lagos THE GUARDIAN in English
2 May 91 p3

{Article by Benedict Hart]

[Text] No fewer than 10 carriers of the dreaded Acquired
Immune Deficiency Syndrome (AIDS) virus are stalking
the streets of Jos, according to the Health Commissioner,
Dr. Nensort Gomwalk.

The cases were discovered from the results of blood
sample surveys undertaken by health officials.

Suggesting that it is a growing threat, Dr Gomwalk said
that although only 10 of the 8,921 blood samples
screened for the HIV virus proved positive, there was
cause for concern because none of the samples tested
about three years ago when the AIDS control program
started proved positive.

“With time, there has definitely been an increase in the
number of confirmed cases,” he said.

Reviewing the activities of his ministry during the first
quarter of this year, Dr. Gomwalk acknowledged that
guineaworm was still a problem in Awe, Lafia, Nasa-
rawa, Kessi and Shendam, but insisted that the number
of cases has dropped from 11,000 three years ago to
9,694 in 1988/89 and 4,041 in 1989/last year.

This, according to him, was due to the government’s
health education campaigns and active intervention
strategies.

The commissioner announced that multiple drug
therapy centers would be set up in Mangu, Bassa,
Akwanga and Lafia to produce treatment for 9,630
registered leprosy patients. Workers in the four councils
are to be trained in drug administration.

IJPRS-TEP-91-015
16 July 1991

Dr. Gomwalk noted that malaria was still a major
killer-disease among children under five years.

Last year, 18 deaths were recorded of 1,601 malaria
cases, and 19 deaths occurred the previous year when
8,364 cases were reported.

Over 700 Affected by HIV, 94 Said To Develop
AIDS

AB1006091991 Lagos Radio Nigeria Network
in English 2100 GMT 6 Jun 91

[Text] Seven hundred and eight Nigerians have so far
been infected by the Human Immune Deficiency Virus,
HIV. Out of this, 94 have developed the disease,
Acquired Immune Deficiency Syndrome, AIDS. The
minister of health, Professor Olikoye Ransome-Kuti,
announced this today in Lagos while inaugurating the
mass media committee on AIDS. Prof. Ransome-Kuti
said over 123,000 blood samples have been screened in
the country. The minister said that so far, no drugs had
been found to cure AIDS and no vaccine developed to
prevent infection by the virus. He said that the weapons
against the deadly disease were information and educa-
tion which should be designed to effect the behavioral
changes in the society. Prof. Ransome-Kuti said that
research has shown that when people were given accurate
and culturally appropriate information in the language
they understand, it could lead to behavioral changes. He
therefore advised members of the committee to be
sufficiently informed and knowledgeable about the
problem to be able to educate the people.

Official Says ‘About 154,000’ Infected by AIDS
‘rus

AB3006182091 Dakar PANA in English 1544 GMT
30 Jun 91

[Text] Lagos, 30 June (NAN/PANA)—The national co-
ordinator of the Acquired Immune Deficiency Syn-
drome (AIDS) programme in Nigeria, Mrs. Biola Tilley-
Gyado, has said that available data shows that about
154,000 adults in the country are infected with the HIV
virus responsible for AIDS.

Speaking at the inauguration of the Soroptimist Interna-
tional in Lagos at the weekend, Tilley-Gyado also said
that about 5,000 children born to HIV-infected parents
were also infected with the virus. She told the club, made
up of professional women from all walks of life, that a
return to traditional attitudes toward sex could help
contain the spread of the virus.

SOUTH AFRICA

Number of HIV-Positive Children in Cape Rising
91WE0375 Cape Town THE ARGUS in English
2 May 91 pl

[Text] Thirteen children tested positive for the HIV
virus in the Cape in the first three months of the year.


20 NEAR EAST & SOUTH ASIA

REGIONAL AFFAIRS

Efforts To Combat AIDS Differ in Algeria,
Morocco

91WE0369A Paris LE MONDE in French
23 May 91 p 16

[Article by special correspondent Jean-Yves Nau:
“North Africa Tried by AIDS”; first paragraph is LE
MONDE introduction]

[Text] North African countries are no longer untouched
by the epidemic, and their prevention drives may bring
them into conflict with Islamist circles.

“Contrary to what is widely believed, North Africa is no
longer at the beginning stages of the AIDS epidemic. It is
clear that the number of cases in Morocco, Tunisia, and
Algeria is going to rise spectacularly.” For Professor
Abdallah Benslimane, director of the Moroccan Pasteur
Institute and president of the African AIDS Society,
there is no longer the slightest doubt. The AIDS epi-
demic, which appeared in North Africa later than it did
in central Africa, Europe, or the United States, has been
adramatic reality for North African countries for the last
several years. A first symposium has just been devoted to
it in Algiers’.

Because no reliable figures exist for Libya and Maurita-
nia, only the epidemiological data of Morocco, Tunisia,
and Algeria count. Each of those countries officially
reports between 70 and 80 declared cases and between
100 and 200 infected persons. All indications are, how-
ever, that these data—at least as far as the seropositive
figures are concerned—are underestimated since they
are taken essentially from virus tests run on only a
portion of the donated blood.

The virus is believed to have appeared in North Africa in
the mid-eighties, apparently brought over chiefly from
European countries (especially France). In practice, the
return of North African workers or young French-born
Arabs to their countries of origin already constitutes a
undeniable risk of spreading the virus. In Algeria, the
first two cases of AIDS were diagnosed in 1986 in
individuals who had been hospitalized and transfused in
France.

Overall epidemiological data are about the same within
North Africa. Yet differences among countries exist.
According to Professor Benslimane in Morocco, most
cases are sexually transmitted, while in Algeria blood-
contamination still seems to be the predominant route.
Although Moroccan health officials are reassured about
the serological status of their hemophiliacs (since no
coagulating factors were imported, no hemophiliacs are
infected), they are worried about the persistence of the
“sexual tourism—homo and hetero” of Marrakesh and
Agadir.

SPRS-TEP-91-015
16 July 1991

Algeria seems less concerned about this modern form of
prostitution. On the other hand, one of its main prob-
lems is detecting infected blood donors. “Only half a
dozen of the 130 Algerian blood donation centers had
blood-monitoring capabilities at the beginning of 1990.
So we can wonder by what coefficient the official serop-
ositivity figures should be multiplied,” muses Mustapha
Khiati from Algeria. “Specialists believe that, for every
person who is recognized as seropositive, the actual
number is 100.”

Until now, the market for immunological kits limited to
only about 250,000 the number of HIV-detection tests
that could be run annually throughout Algeria. However,
Algerian authorities have taken the necessary measures
to ensure that all blood transfusions in the country are
safe from the risk of infection by the AIDS virus. But
that is only a piecemeal measure, which cannot in itself
constitute a real AIDS prevention policy. As it happens,
progress in prevention is beginning to be made.

Disagreements on Condoms

Here too, situations are far from similar. In Morocco,
specialized associative sectors working in close collabo-
ration with the national anti-AIDS program have devel-
oped. “In this country, we talk about the risks associated
with sexual transmission of the disease,” explains Pro-
fessor Benslimane, “and we are not afraid to advertise
condoms on the radio.”

Things have not yet gotten that far in the other North
African countries. In Algeria in particular, preventive
messages are a long way from emphasizing the impor-
tance of using condoms. On the contrary, the discussion
is limited to general, popularized information on how
the virus is transmitted. Compared to the preventive
drives of certain black African countries or the industri-
alized nations, condoms are mentioned only anecdotally.
Yet the programs undertaken in North Africa do not
deserve to be caricatured, insofar as health professionals
are striving, above all, to find a common ground with
existing forces.

The prevailing logic is to reach a compromise with the
religious authorities. “AIDS prevention is a social
problem more than a political issue,” says Professor
Benslimane, for example. “Everyone must contribute to
the fight, with the clerics taking part in their own way.
We will undoubtedly disagree on the priority that should
be given to condom use and to chastity or faithfulness.
However, it is important that the religious authorities
talk about the need to prevent this disease. The rest is
our job.”

The language is less take-charge in Algeria. There Pro-
fessor Bouguermouh of Algiers Pasteur Institute advo-
cates open collaboration. The professor is the coordi-
nator of the national anti-AIDS program, which has a
representative from the ministry of religion. “We think
that useful information can be disseminated through
Islamic cultural centers,” he says. “What’s more, we
have found some extremely attentive partners there.”


JPRS-TEP-91-015
16 JULY 1991

| Foreign ‘oreign
Broadcast
Information
Service

ANNIVERSARY
1941 - 1991

PRS Report—

Epidemiology

AIDS

a a DTIC QUALITY INEPECTED §

REPRODUCED BY |

U.S. DEPARTMENT OF COMMERCE

NATIONAL TECHNICAL INFORMATION SERVICE
SPRINGFIELD, VA. 22161



JPRS-TEP-91-015
16 July 1991

A total of 724 new cases of fully developed AIDS were
reported in Zimbabwe during the first three months of
this year, bringing the official total to 7,718. However,
the Zimbawean minister of health, Dr. Timothy Stamps,
says the actual number of cases is far higher, because
many cases are not reported. Dr. Stamps says some
calculations show that at least 500,000 Zimbaweans
have the HIV virus which usually leads to the develop-
ment of AIDS.

Over 700 Cases of AIDS in 1991 First Quarter

91WE0395 Harare THE HERALD in English
29 Apr 91 pp 1,7

[Text] At least 724 AIDS cases had been reported
throughout the country during the first three months of
this year, with the majority of them in the 20 to 39 age
group, according to a spokeswoman for the AIDS Coun-
selling Trust (ACT).

The spokeswoman said in an interview yesterday that
these figures were frightening and showed that people
had not changed their sexual behaviour despite repeated
warnings about the dangers of promiscuity.

She said whole families would be decimated by the
disease, for which no cure has been found, saying the
spectre of industry and commerce losing productive
labour was worrying medical experts.

President Mugabe has already warned that the AIDS
scourge was now a major public health menace, which he
said could only be curbed through self-discipline and
demanding commitment from everybody.

During the 12-month period ended December 1990,
5,992 cases of human immuno-deficiency virus (HIV)
had been recorded in Zimbabwe.

However, medical experts believe there is a general
under-reporting, and that the cases could be much higher
than the official figures reflect.

According to the ACT spokeswoman, a total of 139
children between birth and four years had been diag-
nosed HIV-positive during the first quarter of this year.
Of this figure, 79 were male. She said these children
probably got infected in the mothers’ wombs.

Four cases had been diagnosed in the five to 14-year age
group, 214 in the 20 to 29-year age group, 207 in the 30
to 39-year age group, 68 in the 40 to 49-year age group,
29 in the 50 to 59-year age group, seven in the 60-plus
age group and 42 were unspecified.

The spokeswoman said AIDS cases by province during
the first quarter of this year showed that in Manicaland,
54 had been reported, Mashonaland Central 124, Mas-
honaland East 51, Mashonaland West 53, Masvingo 34,
Matabeleland North 135, Matabeleland South 59, Mid-
lands 63, Bulawayo 108, Chitungwiza 1, Harare 39 and
three were unspecified.

She said AIDS cases in Chitungwiza could be much
higher, considering the size of the population.

SUB-SAHARAN AFRICA 7

The high number of girls infected in the 14 to 19-year age
group showed that girls were starting sexual relations at
an early stage, and also reflected the influence of the
so-called sugar daddies.

She said the most frightening picture was the prevalence
of the disease among the 20 to 39-year age group, which
was the most economically active and had reached child
bearing age.

Some of the people in this age group might have been
infected at birth, as there was a period after infection
during which no anti-bodies to the AIDS disease were
produced.

As tests detect these anti-bodies, rather than the HIV
virus itself, there was no way of confirming infection
immediately.

She said because HIV often remained undetected for as
long as six or eight years after infection, most people
would not even know that they had the virus.

The spokeswoman said her organisation was concerned
by the under-reporting of HIV cases by some medical
practitioners. This made it difficult for the Ministry of
Health and other related organisations to plan control
measures,

She said ACT was also concerned that some people,
particularly religious sects such as the Vapostori,
shunned modern medicine, and resorted to traditional
healers who had no professional knowledge about the
AIDS disease.

The spokeswoman said with under-reporting, industry
and commerce might under-estimate the prevalence and
seriousness of the disease.

She said, however, that there was need for the private
and public sectors to launch massive education cam-
paigns, and spread as much information as possible
about the dangers of promiscuity and the magnitude of
the AIDS scourge.

The spokesman said because of the rural-urban migra-
tion, and the resultant lowering of moral values, parental
guidance in some homes was lacking.

The poverty in rural areas was also forcing girls into
prostitution.

The social and financial costs of looking after orphaned
children, whose parents would have died of AIDS, would
be beyond means of many families.

She said, for example, counsellors in Mutare recently
visited 60 orphans, and about 30 widows and widowers,
whose loved ones had succumbed to the disease.

Meanwhile, a South African-based group, the African
Research and Educational Puppetry Programme,intends
to tour Zimbabwe from 23 July to 31 August, to educate
people about AIDS.

Their production, “Puppets against AIDS,” utilised two-
metre-high puppets, local languages and open-air dem-
onstrations.



6 SUB-SAHARAN AFRICA

“I was ordered by a certain major Eugene de Kock to
take the four AIDS infected ‘askaris,’ who were also
based at Vlakplaas, to the townships in order for them to
build relationships with black women and thus spread
the virus,” his affidavit said.

Bezuidenhout told NEW NATION that he was still on
the run and lived in fear of being killed by his former
colleagues for revealing information relating to CCB
activities.

Insurance Official Says AIDS Doubling Every 12
Months

MBO0107134291 Johannesburg SAPA in English
1314 GMT 1 Jul 91

[Text] Johannesburg July 1 SAPA—The number of
people suffering from AIDS is currently doubling every
10 to 12 months says Southern Life [insurance company]
Chairman Mr. Neal Chapman.

Writing in the group’s annual report Mr. Chapman
states: “However incomplete our current data might be,
it is a fact that the number of people infected is currently
doubling every 10 to 12 months and projections for the
mortality rate by the end of the century are alarming.”

He went to state that it was inevitable that life offices will
have to increase premiums in the foreseeable future,
especially for younger people, in order to cater for
payments due to policyholders who become infected
after taking a life policy out.

“While it is difficult to increase rates in a competitive
market environment, failure to do so timeously will
compound the problem and lead to mortality losses
which will have to be borne by policyholders and, in the
case of propietary companies, by shareholders too.”

Mr. Chapman writes: “As the plague spreads and begins
to impact on labour forces, national health costs and
dependents, employers across the full spectrum of busi-
ness will face major problems.

“I cannot urge strongly enough the importance of edu-
cating employees and their families on the causes of
AIDS and how to take proective measures,”

SWAZILAND

March-April AIDS Death Toll 22
MB0606143691 Mbabane THE SWAZI OBSERVER

in English 6 Jun 91 p 1
{Report by Lungile Nduli: “22 Die of AIDS”]

[Text] Twenty-two people are reported to have died of
AIDS between March and April this year.

Delivering a Lecture on AIDS at a four-day workshop for
government hospital nurses on Primary Health Care

JPRS-TEP-91-015
16 July 1991

held at Thokoza Church Centre in Mbabane, Mrs. Nom-
pumelelo Gama of the Public Health Unit said 27 people
were found to be HIV positive and 17 died in March.

She said in April 22 cases were reported with five deaths
which gives a total number 22 of those dead.

She pointed out that it is possible that more people could
have died of AIDS because not all patients are treated at
the government hospitals in the country.

Mrs, Gama said the figure might look small but looking
at the size of the population in the country of | million
people, this is frightening.

UGANDA

President Museveni Addresses AIDS Conference

EA1706112991 Kampala Radio Uganda Network
in English 0700 GMT 17 Jun 91

[Excerpt] President Yoweri Museveni has told the sev-
enth international conference on AIDS in Florence,
Italy, that the spread of this disease, especially in devel-
oping countries, has been intensified by adverse eco-
nomic, social, and cultural factors. In a speech delivered
at the opening of the six-day conference, President
Museveni called for immediate steps to be taken to
redress the imbalance in the economic relations between
north and south. He said that if this is not done, many
more people will die in great numbers in the developing
countries.

He said that Africa’s problems, including AIDS, have
been worsened by the fact of the falling prices of com-
modities dictated by the unfavorable economic condi-
tions. Mr. Museveni said that when AIDS came on the
scene in east and central Africa it landed on fertile
ground compared to Europe and North America where
the economic situation is not adverse.

President Museveni called for a return to traditional
practices of restricting marital sex as one way to stamp
out the spread of AIDS, and at the same time expressed
his conviction that condoms cannot be the main means
of stemming the AIDS tide. Mr. Museveni told the
conference that Uganda adopted a multisector strategy
to control and fight AIDS. [passage omitted]

ZIMBABWE

Health Officials Alarmed at Increase in AIDS
Cases

MB1105144691 Johannesburg Radio RSA in English
1100 GMT 11 May 91

{Text] Zimbabwean health officials are alarmed at the
rate of increase in the number of AIDS cases, and HIV
infection in the country, despite the public awareness
campaign of the past year.


JPRS-TEP-91-015
16 July 1991

“Transfusions were carried out with blood infected by
the virus,” it was said. But yesterday, the alarm launched
by the Italian Polytransfusion Association has developed
into a serious accusation against the Health Ministry,
which is guilty, the association said, of having authorized
or tolerated the sale of contaminated blood. And the
criticism does not even spare the pharmaceutical com-
panies which are reported to have directly sold plasma
coming from countries that are less careful than ours.
Here, controls required by law are among the most
exacting in Europe. The number of cases so far reported
is said to be 1,200, all documented by the Higher Health
Institute.

The association’s president, Angelo Magrini, said, “Even
knowing that blood derivatives sold did not conform to
regulations, the Ministry nevertheless kept them on the
market, Regarding the pharmaceutical companies, even
though they knew that the blood collected in Italy is very
strictly controlled (it is subjected to an additional test:
Hepatitis C), they continue to import from other coun-
tries such as Austria, Switzerland, Germany and the
United States blood that comes from ‘mercenary’
donors, that is, those who do not donate blood volun-
tarily as is the case in Italy.”

The association spokesman did not add other details for
the time being. And in order to find out if and why it is
possible that such a risky importation occurred, it is
necessary to wait for the investigation of health author-
ities or at least the press conference organized for 9 May.
At that time the Italian Polytransfusion Association will
present, according to Dr. Magrini’s statement, detailed
documentation containing evidence concerning the
responsibility of organizations in charge.

While awaiting an investigation of the alarming charge,
President Margrini simply supplied facts: “According to
data collected by the Higher Health Institute, more than
1,200 persons were infected by the AIDS virus because
of transfusion therapies.”

But behind the figures there is the fear that our country,
too, could suffer what happened in France in 1985 when
the National Transfusion Center administered coagulent
concentrates contaminated by the virus to about 5,000
French hemophiliacs. The seriousness was increased by
the fact that this was not due to an error but to incredible
carelessness.

SWITZERLAND

AIDS Countermeasures Success Discussed

91WE0374A Geneva JOURNAL DE GENEVE
in French 7 May 91 p 16

[Article by Jean-Marie Krill: “AIDS: Prevention Is
Working”—first paragraph is JOURNAL DE GENEVE
introduction]

WEST EUROPE 27

[Text] The AIDS prevention campaigns carried out in
Switzerland since 1986 are working. The Swiss are not
only well informed, but they have modified their behav-
ior—especially the young people. For example, use of
condoms has greatly increased, and more and more drug
users have given up sharing needles. These are the results
of a study published yesterday in Bern covering the
1989-1990 period. The study was carried out by the
Institute of Social and Preventive Medicine at the Uni-
versity of Lausanne.

Bern—Though Switzerland still has the highest inci-
dence of AIDS in Europe, it has also done pioneering
work in prevention of the disease, with its national “Stop
AIDS” campaigns organized by the Federal Public
Health Office. Since 1986, as a means of gauging their
impact, the task of evaluating these campaigns has been
entrusted to the University of Lausanne’s Institute of
Social and Preventive Medicine. The evaluations are
based primarily on surveys carried out on various pop-
ulation groups: youths, beginning workers, drug addicts,
homosexuals, migrant workers.

Published yesterday, this third report (covering 1989
and 1990) shows an improvement in disease-preventive
behavior among all groups surveyed. But the young
generation has been most responsive to the AIDS pre-
vention message, which advocates sexual fidelity or the
use of condoms.

Fewer Partners

Whereas in 1989 some 53 percent of young people aged
17-20 claimed to have had sexual relations with three or
four partners, by 1990 that percentage had fallen to 40.
The use of condoms for casual sexual encounters has
greatly increased, from 19 percent in January 1987 to 73
percent in October 1990.

By comparison, mature adults (31 to 45 years of age) use
condoms less frequently. Even so, condom use within
this age group significantly increased between 1989 and
1990. Overall, condom sales in Switzerland rose
sharply—by close to 80 percent between 1986 and
1989—before reaching a plateau in 1990.

Better Informed

The principal vectors of transmission for the disease are
now understood by the populace as a whole. There are a
few gaps, however, for example among migrant workers,
who still have a number of false ideas on the subject.
Utilization of condoms is less common among this group
than among permanent residents in the same age group.

The authors of the report also said it was unfortunate
that some sexual behavior patterns have been insuffi-
ciently investigated to date. Apart from sexual tourism
(most of whose practitioners apparently take preventive
measures), little is known about prostitution in Switzer-
land.



26 WEST EUROPE

possible to prevent cell death by apoptosis by using
different growth factors (mixtures of cytokines or T. Cell
Growth Factor) naturally secreted by the T. lympho-
cytes. It would therefore appear that these biological
agents could (in association with antibiotics or antiviral
molecules) be used in seropositive patients to prevent the
death of cells indispensable to proper functioning of the
immune system and thus prevent the evolution into
full-blown AIDS.

Footnotes

1, “Discovery of a Process Leading to Death of the Cell
by Apoptosis in the Lymphocytes of Patients Infected by
the HIV Virus.” The article, presented before the
Academy of Sciences, is signed by M.L. Gougeon, R.
Olivier, S. Garcia, D. Guetard, T. Dragic, C. Dauguet,
and L. Montagnier.

ICELAND

National Medical Service Issues AIDS Report

91WE0340A Reykjavik MORGUNBLADID in Icelandic
1 May 91 p 2

[Unattributed report: “61 Diagnosed with HIV Infec-
tion”—first paragraph is MORGUNBLADID introduc-
tion}

[Text] Sixty-one individuals have been diagnosed the
HIV-virus as of March 31, 1991, of which ten have died,
according to information from the National Physician’s
Office. Six individuals are judged to have AIDS. Since
then two more individuals have been diagnosed with
HIV-infections, but none with AIDS. A total of 16
people in Iceland have been diagnosed as having AIDS,
the final stage of the disease, and ten of them have died.
The so-called rate of the disease is according to this 6.3
per 100,000 inhabitants. Most HIV-infected individuals
are between 20 and 29 years of age, or 29 in all. Three of
these have developed AIDS in the final stage, and two of
them have died. Fifty-two men and nine women have
been infected with HIV.

IRELAND

AIDS-testing Program for Maternity Hospitals

91WE0399 Dublin IRISH INDEPENDENT in English
16 May 91 p 13

[Article by Katherine Donnelly]

[Excerpt] The Department of Health is to introduce
sample testing for the AIDS-related HIV virus at some
maternity hospitals in the first move away from solely
voluntary testing.

The new programme, targetted at ante-natal patients, is
expected to start at one or two maternity hospitals in the
coming months.

JPRS-TEP-91-015
16 July 1991

UP to now, official statistics have been based on volun-
tary tests and so far regarded as giving an incomplete
picture.

The new testing plan is aimed at giving the Department
a broader and more accurate view of the level of infec-
tion, particularly outside known risk groups and in the
heterosexual community.

The tests will be done on samples of blood already being
taken in ante-natal clinics but it will be on an anonymous
basis with no record of the identity of donors.

National AIDS Co-ordinator Dr. James Walsh told the
IRISH INDEPENDENT that ethical and legal problems
arose on this issue, but he stressed the anonymous nature
of the testing.

Obviously the Department will know the samples are
from sexually active heterosexual women, but there will
be the disadvantage of not knowing the donor’s status in
terms of risk categories.

According to statistics drawn up by Professor Irene
Hillery of UCD, 44,607 people have already been tested
for HIV here, with 1,044 samples showing positive.

Most at risk are male intravenous drug abusers, with
almost 14 percent of the 3,168 tested showing positive,
while women drug addicts recorded a rate of 10.6
percent among the 1,323 tested. Drug abusers account
for more than half the known HIV cases.

After drug abusers, children at risk, of whom 671 have
been tested, and haemophiliacs (1,010) are the next
highest categories at 11 percent, while the incidence
among homosexuals/bisexuals is 6.6 percent of 2,338.

Testing among prisoners resulted in a 3.3 percent dis-
covery rate.

[Passage omitted]
ITALY

AIDS Risks in Transfusions Reported

91WE0346A Rome LA REPUBBLICA in Italian
4 May 91 p 25

[Unattributed article: ‘“‘Transfusions Carry AIDS
Risk” —first paragraph is LA REPUBBLICA’s introduc-
tion]

[Text] Polytransfusion Association criticizes Health
Ministry. Italy imports shipments of blood from nations
where controls are inadequate. The number of cases
ascertained so far are reported to be 1,200. In France,
more than 5,000 persons were infected. Worldwide,
360,000 have been infected.

Rome—The threat of AIDS is subtly being spread even
through normal transfusions. And following cases noted
in France, similar episodes were reported in Italy.


JPRS-TEP-91-015
16 July 1991

blood screening facilities in Africa and nobody should
accept blood which has not been screened,” said Prof.
Oliech. He also cautioned health workers to handle
donated blood carefully to avoid contamination. Prof.
Oliech said blood transfusion was among the major
avenues for the transmission of the AIDS virus. He
revealed that Nyanza had a total of 1,859 cases of
donated blood infected with the HIV. The figures of
infected donated blood are as follows: Coast—1,215,
Nairobi—1,381, Western—990, Rift Valley—389, Cen-
tral—233, Eastern—219, North Eastern —22 and the
total figure stood at 6,308. In terms of age groups, the
group between 20 and 29 years had the highest number
of cases of infected blood at 2,530 (40.1 percent) fol-
lowed by 30 to 49 years with 1,880 (29.8 percent).
Another group marked unknown had 1,219 (19.3 per-
cent) cases on infected blood. Mombasa District is
leading the pack with the highest number of cases of
infected donated blood with 1,124 followed by South
Nyanza—669 cases, Kakamega—594, Kisumu—490,
Kisii—484 and Busia—274, From the figures, Mombasa
District, has a total of 92.5 cases of blood with HIV while
South Nyanza has 36.0 percent of the provincial burden.
The number of AIDS patients in other districts are as
follows: Central—632 cases, Eastern—663 cases, Rift
Valley—594, North Eastern—22 cases.Meanwhile, at
another function while receiving a donation of books
from the Ciba Geigy Renya Limited, the DMs hailed the
private sector to the Government in its efforts to provide
medical care.

MALAWI

Mozambican Refugees Flee to Malawi; AIDS
Threat Increasing

MB0706152491 Johannesburg SABC TV I Network
in English 2040 GMT 6 Jun 91

[From the “Agenda” program]

[Text] Refugees are fleeing from war-torn and drought-
plagued Mozambique in ever-increasing numbers. Many
of them head for Malawi but the burden of supporting
them, even with international aid, is becoming simply
too great. [Begin recording]

Unidentified Reporter: In the last five years Nsanje
District in southern Malawi has been turned into a
massive refugee camp. The tightly packed huts are home
to nearly 300,000 Mozambicans. They outnumber the
local population. They are still arriving at a rate of 40a
day at this camp alone. It’s the unnoticed exodus. They
come with little. Most of their possessions destroyed in a
war none of them understand.

There were few women in this batch. They’re often
abducted by the rebels. Manuel Joaquim walked for nine
days. He’s no longer interested in who is to blame. Like
others he says both sides kill and maim in the fight for
territory.

SUB-SAHARAN AFRICA 3

It takes 14 truck deliveries every day of the year to feed
the influx of refugees across the country. But the strains
are beginning to tell. At some distribution centers the
rations have been cut. Aid workers say most refugees are
now receiving only two-thirds of what they need.

Fr. Connor Kennedy: The refugees are a major burden on
the resources of this country. At their level of education,
health, land use, forestry, timber, water resources; all
these are problems. Malawi can only continue to give
this service with the assistance of the international
community.

Dr. Tom Klassman: And local people may soon need
handouts too. The pressure on land in these parts means
they no longer produce enough food to feed themselves.

Nsanje district hospital was designed to take 150
patients. There are 400 there now, most of them refu-
gees. There is only one nurse on this shift and only time
enough to deal with the worst cases. Half the children in
the ward are suffering malnutrition.

But there is a more sinister threat. Fifty percent of the
patients in the hospital, including 10-year-old Medya
Banda, have AIDS-related diseases.

Klassman: The way it is increasing we think that in a few
years time the figure will have risen to maybe 70 or 80
percent.

Unidentified Reporter: With problems like that in store
many believe Malawi can no longer afford its open-door
policy on refugees. [End recording]

NIGERIA

First National AIDS Conference Announces
Government Approves Salary Structure for
Doctors

AB2603150091 Dakar PANA in English 1006 GMT
26 Mar 91

{Quotation marks as received]

[Text] Ota (Nigeria), 26 March (NAN/PANA)—The
Nigeria Government has approved new salary structure
and conditions of service for all categories of medical
doctors in the country, the vice president, Adm.
Augustus Aikhomu, has announced. Speaking at the
opening of the first national conference on AIDS, on
Monday in Ota, Ogun State, west of Lagos, Aikhomu
said the government would provide necessary funds to
accomodate the new salary package.

He said the measure was part of the government’s
package of incentives aimed at stopping the brain drain
syndrome in the medical sector. On AIDS, Aikhomu said
medical experts should improve on enlightenment pro-
gramme and argued that though experts tell us that the
incidence in Nigeria is low at the moment, a projection
of the sero-positivity rate to the general population


JPRS-TEP-91-015
16 July 1991

delirium, kicking off his cotton cover. There are no
ointments nor any other medications to relieve some of
the discomfort, she says—not in this ward.

Actually, the truckloads of relief equipment, arriving at
the hospital during the last few years, have gone to the
children on the other side of the entrance hall, and only
to them. The non-AIDS children of the Cortina Hospital
have not got anything. There are few new blankets,
portable heaters or electric bulbs for sharing, and even
fewer medications or pieces of medical equipment. The
children’s toys consist of empty bottles or syringes; there
are no videos with children’s songs, nor a playroom full
of sparkling plastic toys for their entertainment.

Dr. Mardarescu’s barely concealed indignation reflects
partly her wounded professional pride, partly jealousy.
“There is paint, there is warm clothing, there are radia-
tors for the AIDS children, but, for all the others, there is
nothing, because they are “normal. Normal“ stands
for children with diseases that are curable, children who
are not necessarily dying. She is also very concerned
about her own personnel, most of whom have been
working at the hospital for years, earning extremely low
wages. Many are bitter about the relative abundance—
and apparent arrogance of the British nurses working in
the AIDS wards.

Survival Shelter

However, Dr. Mardarescu’s tour of the wards reveals a
source of optimism in the darker wards of the Colentina
Hospital. In an environment where the nurse is impos-
sible to distinguish from the patient, the recovery process
assumes different proportions. Patients leave their beds
to gather under the naked electric bulbs; they gossip,
drop in en masse to visit the disabled, assist in feeding

EAST EUROPE 7

and washing each other’s children. A healthy mother is
staying in the ward to look after her child; a family, all
members of which are infected, share a room; a young
orphaned girl consoles a lonely child that is crying.

Consider the so-called normal ward a survival shelter,
built under circumstances of common suffering by
people who are tied to one another by common priva-
tions. Without any of the material advantages, patients
and personnel manage on what little they have; they
share their burdens; the provisional society is clean and
orderly—and despite the misery, one feels that human
kindness thrives in the wards. And that is the only thing
lacking in the AIDS wards.

YUGOSLAVIA

Over 200 AIDS Cases Registered, 118 Dead

LD0207175491 Belgrade TANJUG in English
1434 GMT 2 Jul 91

[Text] Belgrade, July 2 (TANJUG)—According to the
figures provided by the Federal Public Health Institute,
211 people in Yugoslavia have so far developed AIDS
symptoms, and 118 have died.

In the first six months of this year, 37 new AIDS cases
were registered in Yugoslavia, as against 30 in the
corresponding period of last year.

The largest number of AIDS patients has been registered
in Serbia—140, followed by Croatia with 34, Slovenia
with 14, Bosnia- Hercegovina with nine, Macedonia with
three and Montenegro with one.

Among the officially registered AIDS patients in Yugo-
slavia, ten are foreign nationals.



IJPRS-TEP-91-015
16 July 1991

DENMARK

AIDS-Treatment Personnel Under Stress

91WE0361B Copenhagen BERLINGSKE TIDENDE
in Danish 25 Apr 91 p 3

[Text] The pressure of the job and the mental stress have
resulted in the staff at the AIDS centers in this country
leaving their jobs in great numbers.

During 1990, 42 of 109 nurses at the AIDS departments
at the Rigshospital, Hvidovre Hospital, and Marselis-
borg Hospital in Aarhus chose to resign, writes the
professional journal SYGEPLEJERSKEN that is pub-
lished by the Danish Council of Nurses.

“A number of them left because of the great pressure of
the job and, at the same time, it is mentally stressful,”
Viola Foder, ward nurse of the Infectious-Medical
Department at Hvidovre Hospital, tells the paper.

Psychologist Ragnar Gunnarsson, who provides psycho-
logical help to the care personnel, HIV-infected, AIDS-
infected and their dependents at the Marselisborg Hos-
pital, feels that the personnel frequently become too
involved with the patients and therefore risk becoming
burnt out.

Study Shows Up to 350,000 With HIV

91WE0370E Nuuk GRONLANDSPOSTEN in Danish
3 May 91 p6

[Unattributed article: “Hidden HIV”]

[Text] Copenhagen—Upwards of 350,000 Danes—
250,000 men and 100,000 women—could be infected
with HIV without knowing it is the conclusion of a study
done by two researchers—Mads Melbye and Robert
Biggar of the State Serum Institute.

The study, supported by the State Health Science
Research Council, shows that the risk of getting AIDS
has not made Danes change their sexual behavior.

“It is not our intention to frighten people to death but it
is important for us to have a common sense approach to
the risk,” said Mads Melbye.

Parliament Opposed to HIV Register

91WE0370D Copenhagen BERLINGSKE TIDENDE
in Danish 8 May 91 p 5

[Unattributed article: “No HIV Register”]

[Text] Yesterday a wide majority in the Folketing swept
aside the Progress Party’s motion to register all HIV-
positives and persons with AIDS. The attitude among
the parties in the Folketing continues to be that Den-
mark’s AIDS effort should be on a voluntary basis, with
anonymity and public information.

WEST EUROPE 23

AIDS Spreading Rapidly in Greenland

91WE0370C Copenhagen BERLINGSKE TIDENDE
in Danish 11 May 91 p 3

[Article from Ritzaus Bureau wire service: “AIDS
Spreading Rapidly in Greenland”)

{Text] Nuuk—HIV infection is spreading rapidly in
Greenland. And it is just as common to become infected
with HIV through heterosexual as it is through homo-
sexual intercourse. Dr. Mads Melbye, the head of the
State Serum Laboratory, has assessed the spread of AIDS
in Greenland. At a medical conference in Nuuk this
week, he sounded the alarm even if in terms of per-
centage no more HIV-positives have been reported in
Greenland than in Denmark. Mads Melbye’s AIDS
alarm is based on the fact that the spread of the disease
took 10 years in Denmark whereas the spread of HIV in
Greenland occurred in only three years.

High ‘Burnout’ Rate for AIDS Care Nurses

Conference Airs Problems

91WE0406A Copenhagen BERLINGSKE TIDENDE
in Danish 24 May 91 p 6

[Article by Trine Baadsgaard: “Flight From AIDS
Jobs”—first paragraph is BERLINGSKE TIDENDE
introduction]

[Text] Nurses in hospital AIDS wards are leaving their
jobs because they are burnt out from psychological
stress. Now Scandinavian nurses are holding a confer-
ence to share experiences.

An inter-Scandinavian AIDS conference will be held this
weekend in Hvidovre; 130 nurses from all over Scandi-
navia will participate. The conference has been arranged
because work stress and psychological strain have caused
nearly 50 percent of the nurses who care for AIDS
patients to quit their jobs. Thus 42 of the 109 nurses
employed in 1990 quit their jobs in the AIDS wards of
the Rigshospital, Hvidovre Hospital, and Marselisborg
Hospital in Arhus.

“To care for AIDS patients is unbelieveably psycholog-
ically stressful. We know that we can tend and alleviate,
but there is no treatment. We know that they will die in
the end,” said Jan Rostad, one of the organizers of the
conference.

There is no risk of infection to make caring for AIDS
patients problematic. The nurses are instructed to
observe a minimum of safety rules in order to avoid
infection and not a single nurse has been infected in
Denmark,

The nurses feel that the two greatest problems are that
they do not have time to talk to each other about the
problems involved in caring for terminally-ill patients.
The second is that AIDS patients are very young, as a
tule, and have difficulty accepting that they must die.



JPRS-TEP-91-015
16 July 1991 3 AIDS
EAST EUROPE

BULGARIA

Health Ministry Announces Extent of AIDS Problem [Sofia DUMA, 14 Jun 91]
AIDS Foundation Endangered; AIDS Statistics Cited Sofia BTA, 3 Jul 91] ..

CZECHOSLOVAKIA

Health Ministry Reports 25 AIDS Cases /Prague CTK, 27 Jun 91]
POLAND

13
13

AIDS Patients, HIV Carriers in Detention
{Grazyna Kadro, Tomasz Trabuc; Warsaw POLITYKA, 11 May 91] ...

ROMANIA

Update on Colentina Hospital AIDS Ward
[David Sears; Copenhagen BERLINGSKE AFTEN, 10 May 91] ....

YUGOSLAVIA
Over 200 AIDS Cases Registered, 118 Dead (Belgrade TANJUG, 2 Jul 91] ....
LATIN AMERICA
BARBADOS

Committee Chairman on Number of AIDS Cases, AZT [Bridgetown CANA, 27 Jun 91]
BRAZIL

Health Ministry Reports AIDS Figures /Rio de Jaeiro Rede Globo Television, 25 Jun OT].
JAMAICA

AIDS Cases Total 225; Attitudes Show Little Change [Bridgetown CANA, 6 Jun 91)
PARAQUAY

Officials Confirm 106 People Infected With AIDS [Asuncion NOTICIAS, 21 May 91] ....
ST. VINCENT & THE GRENADINES

Health Official Calls for Improved AIDS Monitoring [Bridgetown CANA, 11 Jun 91)

NEAR EAST & SOUTH ASIA

REGIONAL AFFAIRS

Efforts To Combat AIDS Differ in Algeria, Morocco
[Jean-Yves Nau; Paris LE MONDE, 23 May 91]

ALGERIA

Seventy-seven AIDS Cases Reported to Date /Algiers EL MOUDJAHID, 20 May 91]
SOVIET UNION

. 21

Ufa Scientists Develop Licorice-Based Anti-AIDS Drug
IA. Zinovyev; Moscow IZVESTIYA, 12 Jun 91]
Latvian AIDS Victim Dies [Moscow All-Union R



10 EAST ASIA

REGIONAL AFFAIRS

Study Finds AIDS Under-Reported in South
Pacific

BK1906103091 Hong Kong AFP in English 0936 GMT
19 Jun 91

[Text] Apia, June 18 (AFP}—Cases of Acquired Immune
Deficiency Syndrome (AIDS) in the South Pacific may
be as much as 50 times greater than the official figures, a
new AIDS bulletin says.

The newly-published Pacific AIDS Alert Bulletin pub-
lished by the World Health Organisation and the South
Pacific Commission (SPC) said that since the first
regional case in 1985 the number of cases of full-blown
AIDS had increased to 67, with 229 infected with the
HIV virus in eight island countries.

However in an editorial, the bulletin said it estimated
that the actual number of cases may be 50 times the
official figure.

It said the important lesson the Pacific countries should
learn from other countries was not to wait until they
were directly affected.

SPC Secretary General Atanraoi Baiteke said people
should not be ashamed to discuss the sexual aspects of
AIDS. “This, I feel, is one of those rare situations when
we can justifiably lay aside our traditional constraints
and speak openly on such matters,” he wrote.

The SPC was offering up to 5,000 U.S. dollars to any
nongovernment organisation that wanted to do some-
thing about AIDS in the Pacific, the bulletin said, adding
that the most successful AIDS programmes in many
countries were being funded by nongovernmental organ-
isations.

BURMA

AIDS Statistics Show Northern Towns Most
Infected

BK1506094191 Rangoon Radio Burma in Burmese
1330 GMT 14 Jun 91

[Excerpts] A seminar on finding the causes of the spread
of AIDS at townships in the border region and finding
preventive measures was held at the meeting room of the
Planning and Statistics Department, Ministry of Health,
in Theinbyu Road at 0845 this morning.

Major General Khin Nyunt, secretary-1 of the State Law
and Order Restoration Council, and chairman of the
National Health Committee attended and delivered an
address. [passage omitted]

Maj. Gen. Khin Nyunt first welcomed guests attending
the seminar and said that today AIDS is little known in
Myanmar [Burma] as a potentially dangerous disease.
He said the disease is widespread in the United States

SJPRS-TEP-91-015
16 July 1991

and Africa and is considered to be a very dangerous
disease. He also quoted that responsible countries and
the World Health Organization are giving priority to
implementing various preventive and educational activ-
ities. Although AIDS is not widespread in Myanmar, the
situation could become worse if responsible persons
neglect it and it could even effect the national cause in
the future. He said AIDS originated in the United States
and Africa and has now spread to the Asian countries.
Especially in neighboring Thailand, the AIDS rate is high
and there are about 80,000 people [figure as heard] who
have been found HIV positive, which is considered the
first detected sign of AIDS. [pasage omitted]

The results obtained from the research groups that
carried out activities in cities in Myanmar shows that in
Yangon [Rangoon], 68,008 persons were examined and
1,035 persons were found HIV positive (1.5 percent); in
Mandalay 2,307 persons were examined and 69 persons
were found to be infected (2.9 percent); in Moulmein 53
out of 789 persons examined were infected (6.7 percent);
in Mergui 37 persons out of 647 persons examined were
found with the virus (5.7 percent); in Kawthaung 1,066
persons were examined and 6! persons were infected
(5.7 percent); in Tachilek 70 persons out of 675 persons
examined tested positive (10.3 percent); in Keng Tung
49 persons out of 440 persons examined were infected
(11.1 percent); in Myitkyina where 220 persons were
examined, 146 persons were found to be infected (66.3
percent); in Bhamo 201 persons out of 209 persons
examined tested positive (96.1 percent).

According to statistics, there are more HIV positive
people in Tachilek, Keng Tung, Mtyitkyina, and Bhamo.
Myitkyina and Bhamo have the highest rate. There is a
difference in the discovery of AIDS in the border region,
Myitkyina, and Bhamo. The rate of people contracting
AIDS is higher in Myitkyina and Bhamo because of
infection through hypodermic needles used by drug
addicts. In the border towns of Keng Tung and Tachilek,
the HIV virus was found mostly in women. [passage
omitted]

INDONESIA

Twenty-eight Recorded AIDS Cases

91WE0372C Jakarta KOMPAS in Indonesian
6 May 91 pp I, 14

[Text] Bandung (KOMPAS)—Indonesia has 28 recorded
AIDS cases, consisting of 26 men and two women. Of
these, 14 have tested positive for AIDS, and 14 are
seropositive for HIV (human immunodeficiency virus).
Twenty-three are Indonesian citizens, and the rest are
aliens. Most of the AIDS cases in Indonesia are related to
the sexual behavior of the victims. Therefore, the spread
of AIDS in Indonesia must be stopped as early as
possible.


12 EAST ASIA

State Health and Medical Services Department Director
Dr. Abdul Aziz Mahmud said the inmates were found to
be suffering from AIDS while serving their rehabilitation
period at the pusat serenti [rehabilitation center] in
Kampung Raja, Besut.

“They are now being treated for AIDS at the centre.
Most of them are hard-core addicts who shared needles
with other addicts to administer drugs in their bodies.”

He added that the rest of the victims were being treated
at the Kuala Terengganu General Hospital here. [passage
omitted)

THAILAND

Bangkok Health Official on IV Drug Use, AIDS

91WE0337C Bangkok DAO SIAM in Thai
21 Mar 91 p 15

[Excerpts] [passage omitted] Dr. Suphak Wanichaseni,
the director of the Drug Addiction Control and Rehabil-
itation Division, Department of Health, Bangkok, dis-
cussed the results of the blood tests. [passage omitted]

She said that a Ministry of Public Health report on AIDS
stated that in the first years, those with full-blown cases
of AIDS were homosexuals and people who had received
a blood transfusion or who had been operated on abroad.
Later on, prostitutes and drug addicts began contracting
this disease. But only a small number of drug addicts
have contracted the disease, because they have been able
to change their behavior. That is, they have been able to
keep from spreading or contracting AIDS by not sharing
needles. Today, more and more men who use the ser-
vices of prostitutes are contracting AIDS. The number of
these people with AIDS has increased rapidly during the
past two years. “The time has come for men to help stop
or reduce the spread of this disease in order to protect
themselves and their families. They can do this by not
using the services of a prostitute or by reducing the
number of times that they visit a prostitute. To protect
themselves, they should use a condom every time,” said
Dr. Suphak in conclusion.

JPRS-TEP-91-015
16 July 1991

Lampang AIDS Risk Groups, Trends
91WE0337A Bangkok NAEO NA in Thai 3 Apr 91 p 3

{Excerpts] On 2 April, Dr. Nopphadon Sombun, a public
health official in Lampang Province, revealed that sta-
tistics to the end of March show that the number of
people with AIDS in Lampang Province has increased to
1,135, an increase of 73 people since February. Of these
one has died.

Dr. Nopphadon said that of the people with AIDS, 536
are prostitutes, 472 are men who used the services of
prostitutes, 87 are intravenous drug users, five are homo-
sexuals, 28 are prisoners, 29 are housewives, one is an
infant who contracted the disease from his mother, and
22 are people who contracted the disease from an
unknown source. [passage omitted]

This shows that the number of people with full-blown
cases of AIDS will certainly increase. However, provin-
cial public health officials are making a great effort to
solve this problem.

VIETNAM

AIDS Department Set Up To Prevent Spread of
Disease

BK1906142691 Hanoi VNA in English 1353 GMT
19 Jun 91

[Text] Hanoi VNA June 19—Although so far only one
woman has tested positive with HIV virus, great efforts
are being deployed to prevent AIDS in the country
especially in Ho Chi Minh City.

With assistance from the World Health Organisation
and the Paris Pasteur Institute, the tropical diseases
centre in the city has set up an AIDS department
including an AIDS laboratory and a consultancy room.
The lab has since December 1990 conducted blood tests
on 800 people of high-risk groups. A test takes an average
of three hours.

According to Mrs. Truong Xuan Lien, head of the AIDS
department, there should be more funds to publicize
preventive measures about the disease as well as to
modernize equipment for AIDS detection.



JPRS-TEP-91-015
16 July 1991 2 AIDS

SWAZILAND

March-April AIDS Death Toll 22
[Lungile Nduli; Mbabane THE SWAZI OBSERVER, 6 Jun 91] ......

UGANDA

President Museveni Addresses AIDS Conference [Kampala Radio Uganda Network, 17 Jun 91]. 6
ZIMBABWE

Health Officials Alarmed at Increase in AIDS Cases /Johannesburg Radio RSA, 11 May 91]
Over 700 Cases of AIDS in 1991 First Quarter {Harare THE HERALD, 29 Apr 91]

aD

CHINA

AIDS Surveillance in Yunnan Province of China (1986-1990)
Zhao Shangde; Beijing [ZHONGHUA LIUXINGBINGXUE ZAZHI [CHINESE JOURNAL OF
EPIDEMIOLOGY] Apr 91] ......

More Funds Promised for AIDS Control [Beijing

Sichuan Reports First AIDS Case [Chengdu SICHUAN

Sichuan Discovers First AIDS Virus Carrier
[Zhu Huilun; Beijing ZHONGGUO QINGNIAN BAO, 16 May 91] ...

AIDS Case Updates [Zhu Baoxia; Beijing CHINA DAILY, 17 May 91]

EAST ASIA
REGIONAL AFFAIRS

1A , 5 Apr 91]
RIBAO, 12 May 91]

00 «CD GO

Study Finds AIDS Under-Reported in South Pacific /Hong Kong AFP, 19 Jun 91]

BURMA

AIDS Statistics Show Northern Towns Most Infected /Rangoon Radio Burma, 14 Jun 91]... 10
INDONESIA

Twenty-eight Recorded AIDS Cases Jakarta KOMPAS, 6 May 91]
SOUTH KOREA

Two Boys Receive AIDS Through Blood Transfusion /Seoul YONHAP, 22 Jun 91]
Three More AIDS Cases Identified in June [Seoul YONHAP, 2 Jul 91] ....

MALAYSIA

Most of 200 AIDS Victims in Terengganu Drug Addicts
[Kuala Lumpur NEW STRAITS TIMES, 6 Jun 91] ..

THAILAND

il

Bangkok Health Official on IV Drug Use, AIDS [Bangkok DAO SIAM, 21 Mar 91]
Lampang AIDS Risk Groups, Trends {Bangkok NAEO NA, 3 Apr 91] ...

VIETNAM

AIDS Department Set Up To Prevent Spread of Disease [Hanoi VNA, 19 Jun 91] .....



JPRS-TEP-91-015
16 July 1991

Will this collaboration extend to the official promotion
by Algerian Islamic authorities of condom use? Such an
outcome is highly uncertain, since there is reason to fear
a divorce between religious professionals and health
specialists if the epidemic continues to spread. Yet so far
both sides refuse to dramatize the situation.

“The right to life must take precedence over freedom,”
explains Professor Khiati. “To be effective, the use of
condoms assumes that they be widely available and
nominally priced, if not free of charge. That is a financial
burden that is difficult to bear. Moreover, encouraging
the use of condoms creates a false sense of security,
causing an increase in sexual relations, and thus in the
number of partners. Each and every person must know
that only marital fidelity can prevent catastrophe. The
rest, that is, the systematic inspection of drawn blood, is
up to state authorities.”?

Be that as it may, courageous initiatives are cropping up
from time to time in North Africa. One such is that of
Mr. Djoudi Djemoui, the director of the Rouiba health
district of Algeria. Mr. Djemoui has just produced a play
in which—with the help of paraphrase—homosexuality
and multiple sex partners are finally publicly brought up,

for preventive purposes. It is also worth stressing that the
different initiatives undertaken in Morocco and Algeria,
unlike those in Tunisia, have so far effectively avoided
any wrong turns leading to the segregation AIDS patients
or persons infected with the virus.

NEAR EAST & SOUTH ASIA a

Footnotes

1, A Euro-North African symposium on AIDS organized
between 18 and 20 May 1991, in the Algiers Cultural
Hall by FOREM [expansion not given] and the French
nongovernment association Inter-Med Assistance.

2. “What Kind of Health for Algerians?” by Professor
Mustapha Khiati, Editions Maghreb Relations, 10, Blvd.
Said-Hamdine, Algiers.

ALGERIA

Seventy-seven AIDS Cases Reported to Date

91P40317A Algiers EL MOUDJAHID in French
20 May 91 p 20

[Text] Since the discovery of the first cases in 1985, 77
AIDS cases, including 16 women, have been recorded in
Algeria, as well as 265 HIV-positive cases. This informa-
tion was announced on Sunday by Algerian specialists
during the Euro-Maghreb seminar on AIDS, which has
been in session at the Cultural Center in Algiers since
Saturday.

The number of AIDS cases recorded in Algeria, which
was seven in 1988, with 47 HIV-positive cases, rose to 41
(and 50 HIV-positive) in 1990, and to 77 (plus 265
HIV-positive) in 1991.



Epidemiology
AIDS

JPRS-TEP-91-015 CONTENTS 16 July 1991

[This EPIDEMIOLOGY report contains only material on AIDS. Other epidemiology topics are covered in a later
issue.]

SUB-SAHARAN AFRICA
ANGOLA
Luanda Reports 23 Cases of AIDS, Including 10 Deaths /Luanda ANGOP, 4 Jun 91]
BOTSWANA
Kgalagadi District—35 People HIV Positive {Gaborone Radio Botswana Network, 27 Jun OT] vase 1
CAMEROON

By 1990: 243 AIDS Cases, 173 Fatalities
[Bernard Fualefac; Yaounde CAMEROON TRIBUNE, 25 Mar 91]

GABON

About 9,000 Found HIV-Positive Since 1986
[Annick-Brigitte Bouma; Libreville L’UNION, 3 Apr 91] ....

IVORY COAST

Health Minister Advises Increased Use of Condoms
[Abidjan FRATERNITE MATIN, 4-5 May 91]

KENYA

Semiannual AIDS Statistics Updates Planned
[Michael Otieno; Nairobi KENYA TIMES, 30 May 91]

MALAWI

Mozambican Refugees Flee to Malawi; AIDS Threat Increasing
(Mohannesburg SABC TV 1 Network, 6 Jun 91]

NIGERIA

First National AIDS Conference Announces Government Approves Salary Structure for Doctors
[Dakar PANA, 26 Mar 91] ....

Health Commissioner: Ten AIDS Cases Discovered in Jos
[Benedict Hart; Lagos THE GUARDIAN, 2 May 91] ...

Over 700 Affected by HIV, 94 Said To Develop AIDS
[Lagos Radio Nigeria Network, 6 Jun 91] ..

Official Says ‘About 154,000” Infected by AIDS Virus /Daka

SOUTH AFRICA

Number of HIV-Positive Children in Cape Rising [Cape Town THE ARGUS, 2 May 91]
AIDS Infection ‘Soaring’ In Pietermaritzburg (Umtata Capital Radio, 13 Jun 91] .....
Country Facing ‘Major’ AIDS Disaster [Johannesburg SABC TV 1 Network, 14 Jun 91)
Cooperation Bureau Allegedly Spread AIDS in Townships

[Johannesburg NEW NATION, 28 Jun - 4 Jul 91]...
Insurance Official Says AIDS Doubling Every 12 Months [Johannesburg SAPA, 1 Jul 91]



Wiis 2
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24 WEST EUROPE

“At the same time, AIDS patients are a very demanding
group of patients. They are very conscious of their illness
and their lives and make demands on us and their
treatment. That is what is exciting about working with
AIDS patients,” said Claus Philipsen, a nurse at Hivovre
Hospital and coorganizer of the conference.

In the coming weekend, the 130 Scandinavian nurses
will exchange experiences, ideas, and frustrations about
nursing AIDS patients. The organizers hope that the
various contributions will give participants a possibility
to anticipate the risk of burnout and thereby avoid it.
The Conference will be held at the Scandic Hotel in
Hvidovre and is supported by funds from the Nordic
Ministers’ Council.

Statistics Confirm Trend

91WE0406B Copenhagen BERLINGSKE TIDENDE
in Danish 10 Jun 91 p 1

[Article by Henning Ziebe: “Many Nurses Giving Up
Nursing AIDS Patients”—first paragraph is BER-
LINGSKE TIDENDE introduction}

[Text] Allowance is not made for the extra time needed
to take good care of the very ill and dying.

Nurses who work in the AIDS wards are exposed to so
much psychological and physical stress that they quit
their jobs much more often than their colleagues in
‘ordinary’ wards do.

Statistics show that the turnover of nurses is basically
more frequent in the AIDS and cancer wards than in
other wards. This is apparently due to the fact that more
staff is not allocated to these areas, even though very ill
patients demand much more time than patients in other
wards.

Professor Peter Skinhoj, M.D., of the Righospital epide-
miology department confirms that the turnover of nurses
is rapid.

“It happens that very ill AIDS patients have a much
greater need to have their hand held than patients who
are hospitalized with a broken leg, but no allowance is
made for this.

“One shouldn’t believe that nurses shrink from taking
care of very ill and dying patients. They do not, and we
also have a lot of applications for new positions, but the
amount of strain involved in comparison to the number
of staff members is so high that they are both physically
and psychologically overtaxed. They simply give up
because the task is too great.”

Elin Pilgaard, a nurse at the Rigshospital, told MOR-
GENPOSTEN that the problems are great also because
of the demand patients make on the overburdened
personnel.

SJPRS-TEP-91-015
16 July 1991

“AIDS patients are very young and most of them are
very conscious of their illness and the demands they can
make concerning their treatment.

“Patients confront us all the time with the fact that we
are not doing well enough. That we do not have enough
time for them. They don’t put up with things that older
people, for example, do.” Elin Pilgaard added.

FINLAND

Slight Increase in New HIV Cases

New Information Campaign

91WE0392A Helsinki HELSINGIN SANOMAT
in Finnish 8 Jun 91 p 11

[Unattributed article: “Many New HIV-Positive Cases
Still Being Discovered”]

[Text] The incidence of new HIV infections is up slightly
from last year. Testing during the first five months has
revealed 27 HIV-positive samples, whereas the number
for last year during that time was 21. Last year saw
Finland’s HIV infection numbers go into a steep climb,
with 91 new cases in all.

Supervising physician Olli Haikala from the Health and
Social Services Ministry feels that the statistics for the
first part of the year are not yet a reliable enough
indicator for predicting the total number of cases that
will be identified during the current year. He does say,
however, that apparently Finns have already forgotten
the fear of AIDS they had toward the end of the 1980’s
and, because of this, have also forgotten their caution in
random sexual relations.

Eighty-two HIV-infected persons in Finland have devel-
oped AIDS. Of these, 53 have died. The total number of
HIV-positive cases in Finland is now 398.

Half of the infections have occurred abroad, and about
one-fifth of the infected persons are foreigners.

According to Haikala, only a couple of the political
refugees who have come to Finland have tested HIV-
positive. The refugees have been very good about partic-
ipating in the testing programs.

The Health and Social Services Ministry is preparing a
new poster campaign to be launched this summer. The
posters will be put in trains and other places.

Young people travelling on Inter-Rail will be given a kit
containing, in addition to a travel guide, a reminder
about sexually transmitted diseases and a condom.


8 CHINA

AIDS Surveillance in Yunnan Province of China
(1986-1990)

54004806B Beijing ZHONGHUA LIUXINGBINGXUE
ZAZHI [CHINESE JOURNAL OF EPIDEMIOLOGY]
in Chinese Vol 12 No 2, Apr 91 pp 72-74

{Article by Zhao Shangde [6392 1424 1795], Cheng Hehe
[4453 0149 5440, et al.; Yunnan Provincial Hygiene and
Epidemic Prevention Station]

[Abstract] Since 1986 a surveillance has been carried out
on HIV/AIDS in Yunnan Province. Up to 1990 a total of
13,417 people has been surveyed and 373 HIV-positive
cases were found in five areas, of which two AIDS cases
were reported to GPA WHO. The persons with HIV
were attributed to intravenous drug users (IVDUs) and
their wives, most of them came from IVDUs from
Dehong Dai Race and Jingpo Race Autonomous Region
located in the border between China and Burma. No
positive case has been found in prostitutes, STD patients
and blood donors.

More Funds Promised for AIDS Control

54004807A Beijing CHINA DAILY in English
5 Apr 91 p3

{Text] An HIV positive case has been detected in
Sichuan, an interior province of China, for the first time.
The HIV carrier is a man who returned home in early
April from a labour export program. His case was
confirmed by tests at the China AIDS Inspection Center
of the Chinese Academy of Preventive Medical Sciences,
the China News Service reported. Up to date, a total of
494 HIV-positive cases, including five AIDS patients,
have been reported in China. Eighty-three are foreigners,
the rest are mainlanders, with most found in Yunnan,
the border province.

Sichuan Reports First AIDS Case

91P30146F Chengdu SICHUAN RIBAO in Chinese
12 May 91 p1

{Summary] On 11 May the Sichuan Provincial Public
Health Department reported its first AIDS case. The
infected person is a middle-aged man who returned from
overseas at the beginning of April. Chinese law stipulates
that persons who are overseas for more than one year
must be examined by the epidemic prevention station
after their return to China. China has reported 493 cases
of AIDS, 429 of which were reported in Yunnan Prov-
ince.

Sichuan Discovers First AIDS Virus Carrier

HK1306085191 Beijing ZHONGGUO QINGNIAN BAO
in Chinese 16 May 91 p 2

[Report by Zhu Huilun (2612 2585 0243): “First Case of
AIDS Virus Carrier Found in Sichuan”]

JPRS-TEP-91-015
16 July 1991

{Text] The Sichuan Provincial Government Public
Health Department reported on 11 May that not long
ago, the first case of an AIDS virus carrier was found in
Sichuan.

The virus carrier is a middle-aged man. He returned to
China from Africa in early April this year after being a
laborer according to an overseas labor service contract.
After the first AIDS case was found in Beijing in June
1985, 493 AIDS virus carriers have been discovered in
12 provinces and municipalities of our country. Among
them, 429 cases were found in Yunnan Province.

AIDS Case Updates

54004807B Beijing CHINA DAILY in English
17 May 91 p3

[Article by Zhu Baoxia: “More Funds Promised for
AIDS Control”]

[Text] Leading officials in Yunnan, a frontier province
in Southwest China which has reported over 87 percent
of China’s total number of HIV-positive cases, have
promised to increase funding for a program aimed at
controlling the spread of AIDS.

The money will be spent to further expand surveillance
and publicity among high-risk groups including drug
addicts and their family members, prostitutes and
patients with venereal diseases. Funds will also be used
for scientific research which hopes to find a cure for the
disease using traditional Chinese medicines, said He
Zhiqiang, governor of Yunnan, in an interview with
CHINA DAILY.

He did not give the specific figure for the increase, but he
said that over 900,000 yuan ($180,000) was spent last
year for importing necessary instruments and tests and
also for launching extensive surveillance and publicity.

So far this year, no new HIV positive cases have been
detected in the province, he said.

He said that since 1986 when the province started AIDS
surveillance among high-risk groups, 17,012 people have
been tested.

A total of 397 Yunnan residents have been found to have
contracted the HIV virus, a virus that can lead to the
fatal disease of AIDS. Most of those who have been
affected are male intravenous drug addicts who were
infected through the communal use of contaminated
syringes.

Only two women in Yunnan are known to have con-
tracted the HIV virus through sexual transmission.

Of the 397 HIV carriers in Yunnan, 67.5 percent are of
the Dai minority nationality, while 17.59 percent are of
the Jingpo nationality and 13.57 percent are of the Han
nationality.

Over 86.43 percent of the HIV carriers are farmers.

And more than 80 percent of Yunnan’s HIV carriers are
between the ages of 20 and 39.


JPRS-TEP-91-015
16 July 1991

Dr. Rachmat Sumantri, a disease specialist at the
UNPAD [Pajajaran University] Medical Faculty, dis-
closed this on Saturday [4 May] in Bandung at a one-day
seminar on “What You Need To Know About AIDS.”
He said that the effort to prevent the spread of AIDS in
Indonesia consists of dissemination of good information
on how the disease is transmitted and develops and how
it can be prevented.

He added that AIDS has a current death rate of 100
percent within five years after diagnosis and that no truly
effective medicine or vaccine has been discovered. A
WHO report says that an estimated 20 million people are
HIV carriers who have no symptoms of the disease. They
are the ones who spread AIDS.

An AIDS explosion in Asia will be difficult to stop,
according to Dr. Rachmat. One reason is the drastic
change taking place in sexual values and norms as a
result of progress in tourism in the Asian region. As an
example, he pointed out that one ASEAN country which
had discovered only 55 AIDS cases in 1989 has found
more than 5,000 cases this year.

Iceberg Phenomenon

He said the spectrum of disorders caused by the AIDS
virus is like the iceberg phenomenon. The number of
patients testing positive for AIDS is relatively small, but
if combined with the high-risk group made up of HIV
carriers, the total becomes very great. To prevent the
transmission and spread of AIDS in Indonesia, the
public needs to understand clearly that AIDS can be
transmitted in ways other than sexual relations: blood
transfusions, use of contaminated hypodermic needles,
and transmission from mothers who are AIDS carriers to
their babies, whether before or after birth.

Another speaker in the seminar, Dr. Wibisono Suwarno,
head of the West Java Health Laboratory, said the
incidence of HIV in Indonesia is still low. Examination
of high-risk groups, namely prostitutes and homosexuals,
has found only 18 seropositive HIV carriers. As of
December 1990, nine AIDS victims had died in Indo-
nesia.

The low incidence of AIDS in Indonesia must not cause
us to relax our vigilance, since advances in international
communications and transportation facilitate the trans-
mission of HIV infection. Indonesia represents a channel
for the spread of AIDS in the Asian-Pacific region. AIDS
is spread primarily by homosexuals and secondarily
through blood transfusions.

The Department of Health’s efforts toward prevention of
AIDS in Indonesia are still limited to monitoring and
HIV serological surveys in high-risk areas like Bali.
Organized, single-area AIDS monitoring, called “senti-
nel surveillance,” will be conducted in Bali because of its
status as a tourist gateway. Obstacles to this effort are
admitted to be very great, since the AIDS problem is
closely related to sexual behavior.

EAST ASIA oT

SOUTH KOREA

Two Boys Receive AIDS Through Blood
Transfusion

SK2206024091 Seoul YONHAP in English 0121 GMT
22 Jun 91

[Text] Seoul, June 22 (YONHAP)—Two South Korean
boys who were given transfusions of AIDS [Acquired
Immunodeficiency Syndrome]-infected blood in 1989
have tested HIV positive, the Health and Social Affairs
istry said Saturday.

It is the second time the AIDS virus has been transmitted
by a blood transfusion in Korea since 1989. A 46-
year-old housewife has also tested HIV positive.

The blood the two boys, aged nine and 17, received
during operations was donated to the Korea National
Red Cross in October 1989 by a 30-year-old presumed
homosexual, the ministry said. His blood was tested and
found negative because AIDS antibodies had not yet
formed.

When he donated blood for a second time this April he
tested positive and the National Institute of Health
confirmed that he was a carrier of the AIDS virus and
traced his blood donation to the two boys.

The number of HIV positive Koreans is now 148.

Three More AIDS Cases Identified in June

SK0207064591 Seoul YONHAP in English 0604 GMT
2Jul 91

[Text] Seoul, July 2 (YONHAP)—Three people were
identified as HIV [human immunodeficiency virus] pos-
itive in June, meaning they have the virus that causes
AIDS [acquired immunodeficiency syndrome], the
Health and Social Affairs Ministry said Tuesday.

Two got the AIDS virus from transfusions with infected
blood and the third was infected abroad through unsafe
sex, it said.

The figure brought the total number of AIDS-infected
people in South Korea to 149, of whom 12 have died,
one has emigrated and 136 are under government con-
trol.

MALAYSIA

Most of 200 AIDS Victims in Terengganu Drug
Addicts

BK0706155491 Kuala Lumpur NEW STRAITS TIMES
in English 6 Jun 91 p 7

[Excerpt] Kuala Terengganu, Wed.—Most of the 200
AIDS victims identified in the state are dadah [drug]
addicts, out of which 40 are inmates undergoing reform
programmes at a dadah rehabilitation centre.