The “facebook causes syphilis” story (a great summary here ) has reminded me of another syphilis storm that I was following a few years ago, in Madagascar.
“Syphilis emergency in Madagascar”
Health scares – and particularly sexual health ones – are of course often used as a weapon in other battles. This story about an explosion of syphilis – and a consequent declaration of a “state of emergency” – in Fort Dauphin in the south of Madagascar is a very good example. Syphilis prevalence has been very high in the region for a long time, though nothing like as high as 30%. On the other hand Fort Dauphin is one of the most marginalised regions in the country in terms of health promotion and health care. Nonetheless the politics were such that the government presented a figure from a very small sample as being representative, then blamed it on sex workers and on foreign migrant workers. And decided to take action because “there are fears the condition could provide an entry route for HIV/Aids”… So you ignore a massive syphilis epidemic – and all manner of other sexual and reproductive health problems – until you can tag it to foreign workers and HIV?
I’m going to try to write more about Madagascar, where I helped run an HIV and sexual health programme for 3 years. But this is just a taster of the sorts of challenges we faced in getting stuff done, in particular as we were working with some of the most stigmatised groups – including a fantastically dynamic sex worker collective in Fort Dauphin.
Fort Dauphin also happens to be – in my opinion – one of the most stunning places in the world, so I think that deserves a pretty picture.