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For Iran's Isolated HIV Patients, Outreach and Treatment
By offering a cup of tea and a safe place to talk, two Iranian brothers were able to coax stigmatized drug addicts and people with HIV out of social isolation and into a bare, one-room clinic.
Arash and Kamiar Alaei, doctors from the western town of Khorramshahr, struck up friendships with people they met by going over names and addresses listed in prison surveys, Arash Alaei said. Iranian families often ostracize their sons and daughters with HIV, casting them out into the street or treating them as strangers in their homes.
"When Kamiar shook hands with one man, he cried," Arash Alaei said in an interview Thursday, referring to a patient whose relatives had banished him to a room, refusing to eat with him or touch him.
Arash Alaei was one of 14 Iranian doctors who visited Washington this week to take part in discussions hosted by the Aspen Institute, a nonprofit international organization that supports dialogue on contemporary issues. The Iranians and their American counterparts, including Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, discussed their health systems, realities and challenges. The visit by the Iranians was the first such State Department-sanctioned event since 1979.
Dina Habib Powell, assistant secretary of state for educational and cultural affairs, described the participants as an "impressive group of medical professionals."
When the Alaei brothers started their outreach program in 1997, it drew about one patient a week, Arash Alaei said. But after a year, word had spread, and 50 to 60 patients were showing up daily. Today, 70 such clinics operate nationwide, providing antiretroviral drugs and other treatments.
The first Iranian member of parliament to champion HIV programs and secure funding from the national assembly for nine HIV hospitals in Khorramshahr was voted out of office in the next elections. After being the leading candidate, he received a mere 100 votes in the city of 1 million. Outraged residents demonstrated against the programs, shattering glass in his office and saying that if their city became known for HIV-AIDS clinics, no one would marry their sons and daughters.
The funds he had lobbied for, though approved, were not disbursed, and the program was scrapped. Alaei declined to name the lawmaker.
Supported by private and government funding, and buttressed by committees of doctors, mullahs, women and local officials, the brothers' innovative approach grew into a nationwide model showcased on the World Health Organization's Web site and recognized for its "best practices."
At the behest of Fariba Mansouri, deputy chancellor of the Shaheed Beheshti hospital, Health Ministry officials visited the program in Khorramshahr. The tour prompted the Disease Management Center, Iran's equivalent of the U.S. Centers for Disease Control and Prevention, to solicit a five-year plan from the Alaeis and their partners. Arash Alaei credited Mansouri with providing space in her hospital, which allowed the brothers to begin their work.
The plan has drawn funding of $3 million for each of the five years from the U.N.-sponsored Global Fund to Fight AIDS, Tuberculosis and Malaria, partially backed by the U.S. government, the William J. Clinton Foundation, the Bill and Melinda Gates Foundation and other countries. The Iranian government will provide an additional $8 million to $12 million a year, Alaei said.
He said 68 percent of HIV-AIDS patients in Iran have "a history of needle-sharing." The distribution of condoms and sterilized and disposable needles has begun, thanks in part to police protection of the program. This year, a media campaign was finally kicked off, and high school students are being given lectures and a pamphlet prepared by Alaei and his colleagues.
Quoting Iran's 13th-century poet Sadi, Alaei said, "When the calamity of time afflicts one limb, the other limbs cannot remain at rest."
By offering a cup of tea and a safe place to talk, two Iranian brothers were able to coax stigmatized drug addicts and people with HIV out of social isolation and into a bare, one-room clinic.
Arash and Kamiar Alaei, doctors from the western town of Khorramshahr, struck up friendships with people they met by going over names and addresses listed in prison surveys, Arash Alaei said. Iranian families often ostracize their sons and daughters with HIV, casting them out into the street or treating them as strangers in their homes.
"When Kamiar shook hands with one man, he cried," Arash Alaei said in an interview Thursday, referring to a patient whose relatives had banished him to a room, refusing to eat with him or touch him.
Arash Alaei was one of 14 Iranian doctors who visited Washington this week to take part in discussions hosted by the Aspen Institute, a nonprofit international organization that supports dialogue on contemporary issues. The Iranians and their American counterparts, including Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, discussed their health systems, realities and challenges. The visit by the Iranians was the first such State Department-sanctioned event since 1979.
Dina Habib Powell, assistant secretary of state for educational and cultural affairs, described the participants as an "impressive group of medical professionals."
When the Alaei brothers started their outreach program in 1997, it drew about one patient a week, Arash Alaei said. But after a year, word had spread, and 50 to 60 patients were showing up daily. Today, 70 such clinics operate nationwide, providing antiretroviral drugs and other treatments.
The first Iranian member of parliament to champion HIV programs and secure funding from the national assembly for nine HIV hospitals in Khorramshahr was voted out of office in the next elections. After being the leading candidate, he received a mere 100 votes in the city of 1 million. Outraged residents demonstrated against the programs, shattering glass in his office and saying that if their city became known for HIV-AIDS clinics, no one would marry their sons and daughters.
The funds he had lobbied for, though approved, were not disbursed, and the program was scrapped. Alaei declined to name the lawmaker.
Supported by private and government funding, and buttressed by committees of doctors, mullahs, women and local officials, the brothers' innovative approach grew into a nationwide model showcased on the World Health Organization's Web site and recognized for its "best practices."
At the behest of Fariba Mansouri, deputy chancellor of the Shaheed Beheshti hospital, Health Ministry officials visited the program in Khorramshahr. The tour prompted the Disease Management Center, Iran's equivalent of the U.S. Centers for Disease Control and Prevention, to solicit a five-year plan from the Alaeis and their partners. Arash Alaei credited Mansouri with providing space in her hospital, which allowed the brothers to begin their work.
The plan has drawn funding of $3 million for each of the five years from the U.N.-sponsored Global Fund to Fight AIDS, Tuberculosis and Malaria, partially backed by the U.S. government, the William J. Clinton Foundation, the Bill and Melinda Gates Foundation and other countries. The Iranian government will provide an additional $8 million to $12 million a year, Alaei said.
He said 68 percent of HIV-AIDS patients in Iran have "a history of needle-sharing." The distribution of condoms and sterilized and disposable needles has begun, thanks in part to police protection of the program. This year, a media campaign was finally kicked off, and high school students are being given lectures and a pamphlet prepared by Alaei and his colleagues.
Quoting Iran's 13th-century poet Sadi, Alaei said, "When the calamity of time afflicts one limb, the other limbs cannot remain at rest."
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