PLHIV in Humanitarian Context - Essay Example

?Introduction The complexities that are associated with specific health issues cause many to have difficulties with creating awareness that provides the correct responses to specific situations. A growing problem which continues to prevail is based on PLHIV (people living with HIV) and the ability to meet humanitarian needs for various groups of individuals. The problem is one which is based on gaps that are not available with the designs and initiatives that are associated with PLHIV. While there are some integration methods which are available for the proper care and assistance, it is also noted that there is a lack of development, strategies and planning with specific programs. The outcome is the need to stop HIV and to assist those which are a threat to the health of others continues to increase while PLHIV treatments are in need of reaching larger groups of individuals (Smith, 2010). The need to approach this issue is one which is based on responding to emergency situations as well as considering the growing numbers of individuals who are in need of treatment that have PLHIV. The needs to assist those who have PLHIV are continuing to increase not only from the responses which are required to emergency situations or the spread of the disease in specific regions because of the lack of resources. It is also noted that there are humanitarian needs associated with various regions. The concept of humanitarian responses is one which is associated with responding to vulnerable groups and ensuring that resilience can be built in situations because of the services provided. The humanitarianism which is provided first takes place in emergency situations in which an outbreak or other problem arises. There are also some specific concepts which are linked to assisting vulnerable groups because of culture, available resources and service provisions which combine with food, education and sanitation methods (Okal, Bergmann, 2007). Examining the humanitarian methods and designs, gaps that are associated with the needs in various communities and the way in which these can be reconsidered develops a stronger understanding of what is needed to assist those suffering from PLHIV. This research study will examine the current status of humanitarian efforts, how this is creating changes or gaps in providing assistance for PLHIV as well as how different designs can create stronger responses to those who are suffering from PLHIV. By examining these various associations with humanitarian responses, there will be the ability to identify the gaps in assisting those with PLHIV as well as understanding how designs can be changed to assist communities in need of humanitarian assistance. Methodology The methodology that will be used will consist of two main studies that will define the needs for those suffering from PLHIV and the humanitarian responses that are required. The first is a review of existing literature. This will examine various statistics from specific organizations which have designs and methods for assisting those who have PLHIV. This will also consist of other pertinent literature that is based on the current understanding of how to respond to outbreaks and what this means to those who are in specific settings. The research methodology will be combined with communication through questionnaires. This will be sent to offices in various regions around the globe. The objective of these questionnaires will be to look at the designs which are currently used to respond to PLHIV in various regions as well as what the strengths and weaknesses of the design are. By examining these various types of responses, conclusions can be drawn which relate to the gaps in designs which are used to respond to the needs of PLHIV in a humanitarian context. Special Needs of PLHIV in Humanitarian Contexts The first concept which is associated with PLHIV in human context is based on the vulnerabilities which are established in responding to specific needs. The risk for HIV is known to be a main factor in specific areas that lack infrastructure and assistance for health. It has been found that the detection of STI’s is one of the main strategies for control to stop and prevent HIV. However, this has also become a health challenge because of inadequate resources that are in a given area. The problem is one which is leading to over 19 million new infections that are reported every year with half that are reported between youth between the ages of 15 – 24. It has also been found that there are 33 million people living with HIV and AIDS around the globe with 6,800 people becoming infected with the disease every day. South Asia carries the largest percentage of the population with HIV, including 0.3% and with India carrying the largest population of people living with AIDS, at an average of 2.5 million. These specific areas are more prone to the disease and continue to be so because of a lack of resources, natural disasters which continue to occur, social breakdowns that don’t offer the correct infrastructure or education and health care challenges because of a lack of infrastructure. Rather than the problem being based on sexually transmitted diseases alone, it is now becoming vulnerable because of other components in society that are altering the disease (Swasti, 2009). The vulnerability that is associated with those living with HIV is furthered by the war, displacement and natural disaster. When this occurs, it stops the resources and available prevention methods for the disease, making individuals more susceptible to the disease. In 2008, it was noted that 5.4% of PLHIV were also in a situation in which they were conflicted with another disaster, including displacement, war or natural disaster which caused them to leave their homes. Another 930,000 women and 150,000 children under the age of 15 years were known to be affected by emergencies, all which were already living with HIV. The number of individuals in total emergency settings that were under extreme conditions from natural disasters and war contributed to a total of 7.9% of all individuals. The excess suffering, higher death rates and the inability to offer help through various resources caused response plans and prevention of the infection to become difficult to respond to because of the situation (Zucca et al, 2008). Out of these statistics are the two most common vulnerabilities of war and natural disasters, specifically because this leads to a lack of resources and education. When these two problems arise, health care is not as accessible, prevention measures can’t be taken and basic needs, such as food and water, become a priority over prevention of PLHIV. When the war time environment or natural disasters occur, the individuals become more prone not only because of the lack of resources but also because each individual in the community may be affected and not realize their susceptibility to the problem. This is furthered because preventative measures, including education as well as tools such as condoms aren’t provided to those who are in the environment. It is known that the areas which lack infrastructure also have more PLHIV as well as individuals which are HIV negative and that are at high risk because of behaviors, lack of knowledge and unavailable resources that would assist with preventative measures (UNESCO, 2009). Along with the vulnerabilities in regular situations are also emergency situations which require humanitarian aid and which cause the resources and approaches to differ. In any type of situation which arises, there is the need to have specific tools and resources so individuals can be treated with the disease. The known needs that are required for emergencies include health prevention and care resources, treatment methods, prevention through education and social protection or support for PLHIV. The absence of each of these leads to more susceptibility of those in the community which are not affected with HIV and which are also in need of more assistance and resources to control the HIV symptoms and problems. The problem which arises is based on the need to change what is available to those who need assistance, both which is associated with the conflict and post – conflict environments and which changes the needs according to environment and situation. Currently, the needs associated with emergencies and vulnerabilities are one of the known areas which lack responses to those offering assistance to PLHIV (Jacob, Ouattara, 2009). The vulnerabilities which are associated with PLHIV, as well as the needs which arise, slightly differ from HIV negative individuals that are in a high risk environment. It has been found that the needs differ by the place in which one is in, the severity of the environment, types of resources which are available and challenges which come from both culture and education of a given region. While PLHIV are in need of health care and treatment, as well as prevention methods as a way of stopping the disease, those with HIV negative results are in need of other results. This is based on educational and prevention methods first, specifically to ensure that the disease doesn’t spread. It is also dependent on regulating and controlling PLHIV as most of the disease can continue to spread because of the emergency context which is unable to provide resources. The emergency situations then require assistance in response to PLHIV in terms of health care but also pressure more assistance for HIV negative individuals, specifically to stop their susceptibility to AIDS and the spread which occurs because of it (Samuels, 2009). How to Design a Humanitarian Response to Meet Needs of PLHIV The several types of vulnerabilities and needs for PLHIV and HIV negative individuals in emergency situations require different humanitarian responses which need to be met. I should be noted that there are two main types of responses which need to be looked into. The first is HIV specific problems, such as ART, (antiretroviral therapy) and mother to child transmission. The second is based on HIV sensitive cases, which is consistent with problems such as human right violations and how this links to PLHIV. Both of these require specific types of assistance with health care, preventative measures and empowerment of communities to stop the spread of the disease and to alter the outcomes which may occur from the given circumstance. The humanitarian response is one which requires awareness raising, community support, protection, health assistance, livelihood support, education and shelter, all which are some of the basic necessities for vulnerable regions that need assistance with HIV (IASC, 2009). The cases which are associated with the disease are now being designed to coordinate the different needs, specifically between agencies that can provide assistance to emergencies. The first noted problem that is a part of the design is based on the operational guidance that is in each region. When there is an HIV sensitive area that needs help with health and control, there is often a lack of resources and available tools. While this is sometimes linked to the mobility that is within the region because of a natural disaster or war, there are also difficulties with designs because of the expectations with the operation. Many times, there isn’t the ability to create an understanding of the situation or the needs, specifically when the HIV specific situations arise. The short time frame for response, problems with capacity and the lack of resources as well as difficulties within the country then create the same problems that are associated with the vulnerability in the region. From these noted problems is also an understanding that interlinking organizations and preparing the operational potential before going into a given situation can help with the control, health assistance and prevention of HIV in any given region (Simon, 2008). Another concept which arises with PLHIV as well as those susceptible to AIDS is based on the sensitive cases that are looked into when going into certain regions. This is based on divisions with demographics, including women, children and those who are aged. The design which is initiated is one which has to note the different types of care needed for those that are vulnerable to HIV and which are in situations where extra care and assistance is needed. Most often, PLHIV are prone not only to the basic difficulties with the disease, but this leads to complications from the other health issues which may begin to arise. This issue is combined with sensitive problems that are related to culture and the territory which one is in. It is found that HIV disclosure is often not given, especially among groups of women and children, specifically because of the surrounding stigma of the problem and the unacceptable application which relates to the culture. This is combined with problems that are associated with inequalities, gender dynamics and other difficulties which may not allow PLHIV to receive the correct support. The design not only needs to initiate opportunities for susceptible groups which can’t receive as much access to the different needs. There is also the need to create a given response by working within the vulnerable groups through various perspectives and designs, such as specialized health care programs that can give access to and control the more sensitive cases relating to HIV (Deribe et al, 2010). Case Studies An example that shows the levels of vulnerability in responding to emergency situations as well as what changes and designs are needed comes from the response to the Sri Lanka tsunami. Before the tsunami, it was noted that less than 1% of those living in the region had HIV, which was an average of 3,000 to 5,000 individuals. It was also noted that health care facilities and protection areas were available for those that were interested in the facilities. However, the tsunami raised the vulnerabilities, specifically with those who were now more susceptible to receiving HIV. Displacement, loss of lives, changes in social norms and trauma were some of the results that raised the vulnerability. This was combined with several health facilities that were unable to assist with further prevention and alternative for PLHIV and HIV negative individuals who were more susceptible to the disease. The main problems which arose included many women and girls who were forced into the sex trade industry because of loss of their livelihoods and families. Others who were displaced didn’t have access to the same health care, which led to a lack of protection and understanding about the vulnerability which increased after the emergency (Proudlock, Ruwanpara, 2008). Another case study which shows the same alterations is the Central African Republic. The emergency is based on war time situations which continue to arise. As this occurs there is a lack of resources which are available to those within the region. There are also difficulties with more vulnerabilities, specifically with rape, sex workers and unprotected sex that takes place in many of the camps and among those that are in the combat areas. The problem is one which consists of the tension in the situation, specifically which leads to lack of resources and assistance at the right times. Those in the region also have a lack of money and access to health services, making the vulnerability levels increase. To try to overcome this situation, the UNAIDS project has stepped in to change the affected families and impoverishment within the region. The complexity which has arisen is based on the war time problems that are occurring. When a war or conflict begins to arise, it becomes difficult to send in resources or to continue with the work. The crisis is then followed by another humanitarian crisis in the region that sets the projects back and increases those who are vulnerable within the region. When rebel groups, government guards and other combat groups heighten, the project becomes in danger until a peace agreement is signed. This stops the resources from being available and causes most in the region to stop using the services because of the threats which are surrounding the region. In the last outbreak, it caused 1 million people to be affected, 300,000 to flee their home and very few that were able to receive assistance because of the disruption in lifestyle (Spraos, Kom, 2008). Lessons Learned, Strengths and Weaknesses When looking at the specific situations as well as the review of literature, it can be seen that there are certain gaps and unavoidable circumstances based on intervention and assistance with PLHIV. The areas which are affected are mostly having difficulty not only because of the disease and spread of the infection, but also because of the surrounding environment. Natural disasters, war fare and other threats continue to arise in countries which continue to be affected. This is combined with problems which pertain to the number of resources which are available and the relationship which this creates with others. Most who have become involved with the circumstances of various regions have stated that education is the primary need to begin to change circumstances; however, preventative care also needs to be matched with other health care capacities and alternatives. The weaknesses then combine not only the external environment but also are based on the lack of organizational supervision and options which are being made available. While there are some alternatives which continue to be available, as well as various programs which continue to work together to create some relief to regions, the resources and opportunities need to be heightened to assist individuals in vulnerable situations. Bringing the Division of Labor to Life The weaknesses of the external environment as well as the organizational responses to assist PLHIV and HIV negative individuals is one which is required to change according to organizational development first. The division of labor to life is one which ensures that there are some changes which can begin to work more efficiently and effectively with those in society. The main approach is to find the most vulnerable groups, such as women and children, who are at risk for AIDS and HIV. This can be combined with several forces, or labor groups, that are able to intervene. By combining resources and programs, it makes it easier for continuous support and prevention programs to be available to specific target groups, even when the external environment is surrounded with difficulties. The division of labor to life is one which is inclusive of government interventions, organizations which can move into the environment from external locations and the ability to set up internal areas that can provide continuous support without interruption from the external environment. However, to do this, approval rates would need to change, cost effective solutions would need to be implemented and an understanding of behavioral risks, specifically for war time situations and because of lifestyle changes, would need to be considered. By attacking the most vulnerable populations and doing so with several organizational areas of assistance, there would be more opportunities to assist individuals that are having difficulties within the region (Sarkar, Menser, McGreevey, 2009). Conclusions and Future Studies The complexity with PLHIV and HIV negative that are at risk is based on the several gaps with being able to offer complete assistance. Vulnerable groups, including regions that do not have access to resources, war time regions and areas which are recovering from a natural disaster, are also known to have higher susceptibility to HIV. This is combined with complexities based on what needs to be offered to groups, which is inclusive of health and treatment programs as well as preventative measures. These often times do not become available to groups which are highly susceptible and to sensitive groups, such as women and children, specifically because of cultural interference. The complexities which are associated with this then creates difficulties in being able to assist and change the conditions that are a part of PLHIV in vulnerable positions, which leads directly to unsafe practices and harmful results with those infected with HIV. To understand how to change the conditions of various areas with humanitarian responses, specifically with emergency situations, is also the need to re-examine the approaches used. Currently, there is an understanding that the weakest points for providing help is based on the organizational structure that is used as well as the ability for many to access resources within a given region. The conditions have led several to the ideology of changing the organizational structure for different alternatives. However, this is also leading to gaps with being able to work with several organizations and to change the associations with how to respond with situations that are affected by the external environment. Future studies can provide insight on the vulnerable situations, specifically in offering resources to the region while developing a different format for organizing and changing the association with offering humanitarian options in highly vulnerable situations. References Deribe, Kedebe, KifleWoldemichael, Bernard Njau, Bereket Yakob, Sibhatu, Biadgillign. (2010). “Gender Differences Regarding Barriers and Motivators of HIV Status Disclosure Among HIV Positive Service Users.” Journal of Social Aspects of HIV / AIDS 7 (1). IASC. (2009). “Guidelines for Addressing HIV in Humanitarian Settings.” IASC. Jacob, James, Yafflo Ouattara. (2010). “HIV Education in Emergency, Conflict, and Post – Conflict Contexts.” Prospects 39 (4). Okal, J, Thobias Bergmann. (2007). “HIV In Emergencies: Case Study: Northern Kenya.” Overseas Development Institute 11 (7). Proudlock, Karen, Eshani Ruwanpura. (2008). “HIV and AIDS in Emergencies: A Sri Lanka Case Study.” Overseas Development Institute. 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