Breast-feeding babies infected with HIV pass virus to their mothers
Thursday, April 10, 2008
OSH, Kyrgyzstan -- Not long ago, she was a wife, mother and teacher. Now Dilfuza Mustafakulova is HIV-positive and has lost her husband and her job.
Mustafakulova's baby son was among 72 children infected with the virus at two Kyrgyz hospitals. Sixteen mothers also have contracted it -- in some cases by breast-feeding their children.
The scandal has led to charges of negligence against 14 medical workers in the impoverished former Soviet republic, where investigators suspect the children were infected by tainted blood and the reuse of needles.
Although HIV infection from breast-feeding is rare, it is possible, usually when the baby has mouth sores and the mother has lesions on her nipples, according to AIDS experts. Mustafakulova, whose son was 7 months old at the time, said her breasts were cracked and bleeding.
Now, abandoned by her husband and shunned by her in-laws, she struggles to feed herself and her three children with little government support.
Moms denied treatment
Since the first cases were discovered in July, hundreds of children and their parents have been tested in southern Kyrgyzstan. Health Minister Marat Mambetov announced Tuesday that the infections, which began in the summer of 2006, had been contained.
Some 1,600 people are infected with HIV in the Central Asian nation of 5 million people, according to official figures -- 15 times more than in 2002. AIDS experts estimate the real number is closer to 6,000. The majority of cases stem from intravenous drug use.
The infected children are getting free antiretroviral drugs, but their mothers have been denied treatment.
Erkin Bakiyev, deputy director of the national AIDS center, said the women are not entitled to free drugs if they are in the early stages of infection, as Mustafakulova is. And the women have no money to buy the drugs themselves.
"These women are having huge financial difficulties. They should be getting nutritious food, but they are not able to get jobs or to provide decent food for themselves or their children," said Fatima Koshokova, director of Rainbow, a nongovernmental agency assisting Mustafakulova and other infected mothers.
Mustafakulova's troubles began in June, when her son developed a high fever. She took him to the Nookat hospital, where she said doctors put him on an intravenous drip.
When he did not get better, she took him to the hospital in Osh, the country's second-largest city.
After more than a month in the hospital, her son still was not well and she was also feeling weak, so they returned to their village of Zhani-Nookat, about 45 miles southwest of Osh. In October, they both tested positive for HIV.
Mustafakulova's husband and two older sons, aged 6 and 12, tested negative.
It has not been established where the infection originated. Of the 72 children infected, some were treated only in Nookat and others only in Osh, so both hospitals are suspected.
"Where else could my child and I become infected if I don't use narcotics and don't live an immoral life?" Mustafakulova said during a recent visit to Rainbow. "This could only be the irresponsibility of doctors."
She was abandoned by her husband, who like many Kyrgyz men spends much of his time in Russia, where he can find work. No longer welcome in her in-laws' home, she and her children moved in with her parents. She sold her only possession, a small plot of land, to pay for her son's medical treatment.
"I have no faith in the future," said Mustafakulova, looking exhausted and thin, her eyes vacant. "What will become of my sons?"
The story of Mustafakulova's fellow villager, Zarifa Shamshiyeva, is remarkably similar. She took her daughter to the Nookat hospital in June 2006, where her little girl, then about 1, was put on an intravenous drip before being transferred to the bigger hospital in Osh. She and her child both tested positive in November.
Her husband, who tested negative, left her, though he occasionally sends money for food.
She has hidden her infection from her neighbors and even from her two teenage daughters, 14 and 16. The eldest is of marriageable age. "How could she find a good husband if our neighbors and everyone else knew about our diagnosis?" asked Shamshiyeva, 34.
Both children are being treated with antiretroviral drugs from the Nookat hospital. But Shamshiyeva said the doctor told her: "You're strong. You'll live as long as God wills."
Neither woman qualifies for welfare since they are still legally married. Their HIV-infected children are entitled to monthly payments of $23, a pittance even in Kyrgyzstan.
Their case has been taken up by Rainbow, which provides free legal assistance to people living with HIV/AIDS.
"The husbands of many of these women leave when they learn the diagnosis, and these women are left alone with their grief," said Fatima Khabibullina, a lawyer at the center.