Homeless AIDS victims left on the streets
  Reuters
March 20, 2001
SINGAPORE


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JEAN Paul tossed and turned on the cold cement slab in a Singapore park.

The tall, gaunt man has been sleeping under the stars on-and-off for more than a year after his wife and mother-in-law kicked him out for being HIV-positive. "I never expected this to happen to me," he said.

The 46-year-old ethnic Chinese man, who goes by his baptized name, is an unusual sight in wealthy Singapore where few signs of homelessness exist.

"One of the things that does stand out about the AIDS situation here is the tremendous stigma associated with the disease," said George Bishop, a health psychologist at the National University of Singapore.

"Basically the notion is, they deserve it. That's a very common view on people with AIDS."

Toting a small bag holding all his possessions, Jean Paul shuttles between the park and a fast food stall for a meal -- when he can afford it. A navigator's watch hanging from his scrawny wrist is the only reminder of his previous life as a diver and yacht captain.

He exhausted his savings after quitting his job at the end of 1998 because he was too weak to work. That was the year he was diagnosed with HIV, the virus that causes AIDS, which he says he contracted from casual sex.

His plight is unlikely to change. Two HIV/AIDS support groups have failed to win backing for a shelter. All HIV/AIDS cases are treated at the government-run Communicable Disease Center, which estimates that about 10 HIV-infected people end up homeless each year.

Action for AIDS, the city state's main organization for people suffering from the disease, tried for more than three years to set up a refuge for patients who are too ill to work, are ostracized by relatives or have few family ties.

"We couldn't get the resources. It costs a lot of money to run a halfway house," AFA president Roy Chan told Reuters.

A total of 1325 Singaporeans have contracted HIV since 1985 in a total population of 4 million. Some 462 have died.

The numbers have risen steadily in recent years. Most people with HIV are middle-aged, heterosexual men who caught the virus via casual sex or sex with prostitutes. The death penalty for drug trafficking may have helped minimize HIV infection from needle-sharing, a common cause of transmission among drug users in other countries.

HONG KONG DOES WHAT SINGAPORE WON'T

Foreigners arriving to work are tested for HIV and those found to be infected are sent home. While most Singaporeans are aware of how HIV is transmitted, there is discrimination by the public and even health professionals, experts say.

"One of the things that made the stigma so bad in Singapore is people can truthfully say they don't know anybody with HIV or AIDS," Bishop said. "People with AIDS and people with HIV are essentially a kind of abstract concept."

Only one Singapore AIDS activist, Paddy Chew, publicly declared he had the disease. Chew died in August 1999.

Singapore has been efficient with public AIDS prevention campaigns but care and support has been less forthcoming. patients have no legal protection against discrimination and support groups receive no government funding for day-to-day activities and only limited sums for projects.

In comparison, Hong Kong, with 1545 HIV-infected people since 1985 in a population of about 6 million, has set up a government AIDS Trust Fund to dispense money to help groups. Medication is nearly free at public hospitals there and HIV/AIDS patients are protected under a Disability Discrimination Ordinance, according to William Kam, deputy chief executive of the Hong Kong AIDS Foundation.

Singapore's government-run CDC has been caught in the dilemma of knowing homeless patients have nowhere to go once they are released from hospital. "For humane reasons we can't throw them in the streets, but we honestly do not have the facilities for them to stay on," a CDC spokeswoman said.

The cost of the hospital stay and basic medication at the 25-bed CDC center for sick HIV/AIDS patients is paid under a government grant for the poverty-stricken, but anti-HIV medication, classified as non-standard, is not covered.

The government says it limits health subsidies to "standard treatment of disease conditions, which are of proven value and offer the best chance of recovery at reasonable cost."

Jean Paul spends most of what he gets from a government insurance policy on medication. His policy runs out in 18 months.

The self-funded AFA sought help from the Health Ministry to find a suitable space for a shelter but to no avail, Chan said, so it has taken to renting rooms in budget hostels to house homeless HIV patients who seek their help.

"We don't have the resources to organize our own halfway home at this time. There are other demands ... education, prevention and continuing our medical subsidies," Chan said.

Another AIDS outreach group, The Cyrenes, has also struggled unsuccessfully to get funds for a shelter for HIV-infected homeless people.

With the government offering no subsidies for anti-HIV drugs, less than a third of those infected can afford the optimum dose. But Jean Paul hopes publicity may help reduce the stigma attached to HIV/AIDS in Singapore.

"I'm open to an interview because I want the public to understand more about we HIV people," he said, reflecting on how his friends bolted when they discovered he was infected.