U.S. Bases, Politics Involved : Philippines Face Difficult Obstacles in AIDS Fight

Sometime in February, 1986, the Philippine Health Department discovered that Christy was infected with AIDS.

But when health workers went back to the go-go bar where the 20-year-old prostitute had been tested just a few days earlier, Christy was gone. She had moved to another of the dozens of sleazy strip joints and nightclubs that cater to the thousands of U.S. Navy personnel stationed at Subic Bay Naval Base in the city of Olongapo, north of Manila.

At that club and at the half-dozen others where Christy worked in the months after her AIDS test, she continued to practice the trade of tens of thousands of Philippine women. She was, after all, the sole breadwinner for her two children, five brothers and two aging parents.

It took five months for government health authorities to track Christy down. But by then, the young woman recalled nervously last week, she had had sex with at least 100 men, most of them Americans stationed at the base.

Today, though, Christy--who asked that her real name be withheld--is still working in the nightclubs of Olongapo, still having sex with men and, quite possibly, still spreading the deadly AIDS virus in a nation that has only now begun to realize that it is facing an AIDS crisis potentially worse than that of the United States.

The looming crisis here does not yet show up in government statistics. Of the 41,927 Filipinos tested for acquired immune deficiency syndrome since May, 1985, only 44 have been found to have AIDS antibodies, a sign that they have the AIDS virus. And the Philippines has had only three confirmed AIDS cases, compared to more than 31,000 cases in the United States.

Hiroshi Nakajima, the World Health Organization’s director for the Western Pacific, said in a recent interview that the AIDS virus has yet to infect Asia on a massive scale. He called Asia “the last frontier for AIDS”--the only major region of the world where the disease has yet to gain a strong foothold.

Potential Time Bomb

But Nakajima and other health officials in Manila agree that the Philippines in particular is a potential AIDS time bomb that could easily touch off an unparalleled health crisis if nothing is done to educate the public here.

The reason is that the virus already is spreading here, and spreading fast.

In a seminar last week for Filipino journalists that was designed to increase public awareness about AIDS in the Philippines, government health authorities confirmed that most, if not all, of the 44 prostitutes who were found to have AIDS antibodies since the health department began its testing program two years ago are still working as prostitutes.

Health authorities said the government cannot stop them. In most cases, as with Christy, it can take weeks or months just to trace an infected woman in the nation’s highly transient prostitute population.

Even after the women are informed that they are carriers of the disease, they cannot legally be quarantined or confined. The licenses under which the women work as “hospitality girls” or “entertainers” are issued locally, not by the national government. And the near-bankrupt federal government cannot afford to provide the women with alternative employment that pays anything close to what they can earn in the nightclubs.

The salary of a government worker in the Philippines is about 2,000 pesos ($100) a month. A bar girl can make nearly twice that in a week.

Logistical, Political Problems

But the problem facing the government’s newly formed AIDS Prevention and Control Committee as it tries to prevent an AIDS epidemic here is not just economic. It is both logistical and political as well.

So far, the government has focused its AIDS testing program only on female prostitutes, primarily those working in bars around the two U.S. military bases in Angeles City and Olongapo, and in Manila’s tourist belt of Ermita. Of the 41,927 Filipinos tested, 38,429 have been classified as “hospitality girls,” and all but 5,508 of them were in those three cities.

Health authorities concede that they have yet to start a testing program on either women or men in the nation’s 73 other provincial capitals, where tens of thousands of other women are working as prostitutes.

More significantly, the government has tested only 686 homosexuals, the highest-risk category for AIDS, in a nation where the homosexual population is believed to run into the millions.

“We want to screen more homosexuals, but it is easier said than done,” said Dr. Manuel Dayrit, coordinator of the government’s newly formed AIDS committee. “They don’t want to come forward, and they are not, so to speak, a captive population like the prostitutes working in licensed bars.”

Further confounding the attempts of Dayrit’s committee to isolate and trace the source of the disease is the international politics surrounding the U.S. bases, where many Filipinos believe the AIDS disease first entered the Philippines.

Heaviest Concentration

According to the department’s statistics released last week, the heaviest concentration of AIDS-infected cases are in and around Clark Air Base in Angeles City and Subic Bay Naval Base in Olongapo. Of the 44 prostitutes who tested positive for antibodies of the disease, 37 had been working only in bars near the bases.

In addition, health authorities tested 5,600 prostitutes in Manila and confirmed just two cases of women with AIDS antibodies.

The problem, Dayrit said, has been in getting similar statistics from the U.S. military, which has been testing all of the nearly 20,000 personnel at the two bases as part of an international AIDS screening program for all 2.2 million American men and women in uniform.

Dayrit said the health department has asked U.S. authorities many times for figures on the number of American military personnel here who have undergone AIDS screening and tested positive for the virus, but the information had not been provided.

“All we got were two brief memos saying the testing is still going on and will be completed in March,” Dayrit told reporters. “We are upset. It’s like you have to collect rent from your tenant and he’s not giving it.”

Statistics released in Washington last week indicated that 2,100 U.S. military personnel worldwide have tested positive for the AIDS virus, but there was no breakdown by region or base.

Dayrit said U.S. officials last year told the Philippine armed forces chief of staff, Gen. Fidel V. Ramos, that any American serviceman or woman found to have been infected with the deadly virus would be sent home. But Dayrit said his committee needs more. It needs, for example, the names and locations of the people with whom the infected Americans may have had sex before being transferred.

Part of Lease Talks

Dayrit said his department needs complete figures on the U.S. military testing program to help in formulating its own AIDS prevention program, and he added that Philippine health authorities are considering asking President Corazon Aquino to include discussions of AIDS in negotiations set to begin next year on the future of the American bases here. The current lease expires in 1991.

Most of the nation’s increasingly powerful leftist groups also have discovered AIDS, and they have begun using it as an emotional issue in their campaign to drive the bases out permanently.

One Philippine women’s group, called Gabriela, has been circulating a petition for several months as part of its own campaign against AIDS. The petition demands that the U.S. government compensate Filipino AIDS victims and their families, that the U.S. military test all American servicemen and women before they are allowed to enter the Philippines and that the bases ultimately be removed because they are responsible for “infecting an entire nation with a fatal disease.”

Philippine health authorities do not join in blaming the U.S. bases for the introduction and spread of the disease in the Philippines, where AIDS screening began only after the U.S. government and the World Health Organization supplied tens of thousands of testing kits two years ago.

“The evidence indicates there is a lot of AIDS-HIV (the AIDS virus) infection around the U.S. bases, but what do the statistics say?” Dayrit said. “Most of the testing in the Philippines has been done around the U.S. bases, and the actual percentage of infected prostitutes around the bases is about the same as the percentage in metro Manila.

“In the department, we view AIDS as an infection that is coming in through multiple sources--from tourists traveling here not only from the U.S. but also from Japan, Australia and Western Europe, from returning Filipino residents who have been living abroad and from U.S. servicemen.”

Education Needed

Dayrit said that tracing the source is less important at the moment than educating a largely rural and isolated population about the disease and containing it in a society that has what he and many others have called “a generally promiscuous life style.”

“How many of you, for example, had even basic sex education in school?” Dayrit asked the two dozen Filipino journalists in the seminar last week.

Only one raised his hand.

“You see how important it is for us to teach our children just coming out of school right now,” Dayrit said. “We must teach them that there is safe sex with a condom, but, before we even do that, we have to tell them what the risks are if they don’t.”

Dr. Ofelia Monzon, a researcher with the government’s Research Institute for Tropical Medicine, which is actually administering the screening program, added that “to understand AIDS in the Philippines, you have to put it in perspective.”

“You know, thousands of Filipinos are still dying each year of stomach disorders, tuberculosis and pneumonia--curable diseases--because they live in places where modern medicine still does not reach them.

“Here, we’re talking about containing an incurable disease that has only begun to show up when we cannot even save the lives of people who suffer from diseases we can cure.”

Dayrit agreed that it will be difficult to get large amounts of public funds to combat AIDS in a country that is struggling to find adequate resources to provide basic medical care for the majority of its people.

Instead, he said, the government is concentrating on education, trying to create a network either through the school system or by using the nation’s public hospitals that will distribute free condoms and information about AIDS.

DIFFICULT TASK

The World Health Organization also is trying to help. It is providing scriptwriters, financing and medical advice for a special edition of the nation’s most popular evening soap opera that will focus exclusively on AIDS later this year.

In the bars of Olongapo and Angeles City, and on the world-famous Ermita “strip” in Manila, though, it is clear just what the Philippine health department is up against.

Despite a recent publicity blitz by health authorities on the subject of AIDS, the bars are still packed with prostitutes and carefree customers every night. Most of the women interviewed said they do not insist that their customers use condoms, although some men do use them. And many of the women said they had never even heard of AIDS, let alone information about how to prevent it.

Even Christy, although she knew that condoms somehow help prevent the spread of the disease, said she could not afford to lose customers because of the disease. When asked whether she is still having sex with her customers, Christy, who is now beginning to show symptoms of AIDS-related illnesses, said, “Yes, but now I have to use condoms every time.”

Does she tell her customers that she might be transmitting AIDS?

“No,” she replied.

Had she told her employer and the other girls working with her?

“No,” Christy said softly. “I cannot tell anybody. I might lose job.”