“The Person Has No Tolerance for Illness”…A glimpse of the reality of HIV+ refugees & asylum seekers in Egypt
“The United Nations High Commissioner for Refugees (UNHCR) protects people forced to flee conflict and persecution as well as those denied a nationality. We provide life-saving assistance during emergencies, protect basic human rights, and help find long-term solutions so they can find a safe place to settle.”
This is the international definition and the primary goal of the UNHCR in the world.
The High Commissioner for Human Rights is the primary human rights official in the United Nations. The United Nations High Commissioner for Human Rights is accountable to the Secretary-General, and is also responsible for the activities and management of the Office of the High Commissioner for Human Rights.
The role of (Unhcr) & its partner groups
We cannot ignore the major role played by the United Nations High Commissioner for Refugee Rights around the world and all the services it provides, the most important of which are health services, a large part of which is to help and assist refugees and asylum seekers living with HIV, children, women, men and people among the most vulnerable groups including members of queer communities, trans people, sex workers, people who inject drugs, and people who have been exposed to assault.
People living with HIV in Egypt face many different obstacles, which begin with their discovery of being infected and opening a medical file with the UNHCR, and the subsequent medical follow-ups, treatment disbursements, and psychological support sessions. All of these procedures are carried out by UNHCR and other friendly organizations such as Caritas, CARE, Refuge Egypt, Save the Children, and Doctors Without Borders.
Naturally, many problems often occur due to the large numbers of beneficiaries, and due to poor training of service providers and how to deal with refugees, especially individuals from closed communities such as the queer community.
“The awareness is absolutely not enough, the person has no tolerance for illness.”
These words were stated to us by one of the Sudanese refugees in Alexandria, who conducted an interview with us and refrained from giving his real name for fear that his relatives would find out the truth about his infection and living with HIV, and the stigma of the disease that attacks the bodies of those living with HIV more fiercely than the virus itself. After a forced displacement journey due to wars, and displacement from their home country to another host country.
He had discovered his infection when he was tested at Caritas, and a medical file was opened to record all the data on his health condition and its developments. An Egyptian companion was also sent for protection until he completed all the paperwork to follow up on the necessary tests to find out the extent of the virus’ development and the performance of his immune system.
The problem occurred with him when he was referred to psychological support automatically without asking for his opinion or consent.
The responsible doctor was trying to cast doubt on the validity of his orientation and the sincerity of his feelings and how this led to the infection with the virus, which fueled and built his feeling of discontent and his fear of continuing to come and follow up again, because he knows the preconceptions and the way he will be treated because of his health condition.
“Those who attend psychological support sessions try to conform to the requirements of the treating physician, whatever they may be”
He also stated that all refugees who attend psychological support sessions try to conform to the requirements of the treating physician, whatever they may be, because they know that refugees with psychological files face deliberate delays in their procedures for rehousing or renewing their card, and therefore they must pretend most of the time and not give the therapist any answer that might result in their files being delayed, which negatively affescts their entire situation in Egypt, which constitutes an excessive burden, not only in bearing the negative complications of living with HIV, the difficulty of psychological recovery from the idea of displacement, rehousing and integration, but also pretending and completely separating from their feelings towards everything that happens around them, including medical and psychological violations and abuse, and deliberate neglect.
He also expressed the lack of awareness provided to refugees living with HIV, their unwillingness to begin treatment due to their intense feeling of stigma at the idea of being infected with the virus, and their inability to obtain the available services of psychological support, because it may cause a significant delay in their files, as was explained before. This closed circle is a threat to the lives of refugees living with HIV from the LGBT community, and leads to the death of many individuals living with HIV on a regular basis, as if we had returned in time to the 1980s, where panic and stigma were inseparable from HIV.
On one occasion, when he was regularly monitoring his health condition, he was treated unprofessionally by one of the doctors providing the services more than once because they knew about his sexual orientation, which forced him to file an official complaint due to his poor tone of treatment and failure to provide sufficient information about his health condition. It is worth saying that no action or investigation was taken into the incident, but rather he was merely patted on the shoulder and received condolences in a hypothetical, non-material way in an email.
When we were able to obtain permission to conduct an interview with one of the Nigerian refugees living with HIV, he reported being given some expired condoms - with the service providers knowing that he was living with HIV - from Saints Church in Zamalek, which caused him anger and doubt of how the workers there are commitment to health protocols and providing services to people living with HIV.
This incident calls into question the absence of care on the part of some people working with people living with HIV, and its violation of all health charters and codes stipulated in United Nations documents regarding the provision of medical services specifically to refugees living with HIV.
Another Sudanese refugee stated that the health services available to refugees are delayed and that he waited for more than six months to receive the service, which was a necessary surgery, and in the end he had to borrow the money to perform the necessary surgery, which is normally done through Save the Children and hospitals contracted with it, or referral to government hospitals directly for refugees free of charge.
“stis are not just hiv”
It is worth noting the general trend of not paying attention to any of the other sexually transmitted diseases, focusing on HIV alone, and not providing sufficient information and awareness about other bacterial and viral infections, such as hepatitis, syphilis, gonorrhea, chlamydia, papilloma, and other diseases that pose a danger to the bodies of refugees in general and to queer refugees in particular because of their being the weakest link in the care system, and the reluctance to provide urgent medical care when it comes to the sexual health of queer people.
There is also a lack of full disclosure to individuals who have been subjected to sexual assaults in the host country or the country from which they were displaced, when giving them medications to prevent the spread of HIV in the event of exposure to it, while not disclosing their importance, and the how important it is to continue taking them for a full month, which violates all protocols stipulated in various conventions issued by the United Nations regarding the provision of medical services to refugees and people living with HIV in particular, and they are provided in plastic bags without any explanation of the type of treatment or its reasons to the violated individuals, which prompts the beneficiaries to throw the treatment in the garbage because they are not sure of its importance or even what it is.
Civil society and its members working in places providing services and medical care to refugees living with HIV must be extremely careful, and be reminded of the importance of the system, its impact, the vital and effective role in the lives of refugees living with HIV, how they dependent on it, and their being a safe refuge, away from the home, the street, the family, and all the places where they cannot reveal the truth about their health condition and the extent of their need to seek help. In the end, every individual living with HIV is both the weakest and the strongest link in the same chain, their health, safety, and psychological well-being are the only way to ensure the elimination of any new infection with HIV.
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