The impact of flooding on people living with HIV: a case study from the Ohangwena Region, Namibia.
The impact of flooding on people living with HIV: a case study from the Ohangwena Region, Namibia.
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DOI：
10.3402/gha.v8.26441
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发表时间：
2015
影响因子：
2.6
通讯作者：
Kistemann T
中科院分区：
文献类型：
--
作者：
Anthonj C;Nkongolo OT;Schmitz P;Hango JN;Kistemann T
洪水对所有受影响的人口，特别是社区内的弱势群体，如儿童、孤儿、妇女以及艾滋病毒和艾滋病等慢性病患者来说，都是一种灾难。他们需要有效的卫生保健、环境卫生和个人卫生、安全饮用水和健康食品供应，并严重依赖其社会关怀和支持网络。在纳米比亚Ohangwena地区开展的一项研究旨在更深入地了解洪水对艾滋病毒感染者以及该地区艾滋病毒服务提供者的影响，该地区的艾滋病毒感染率很高，而且经常发生大范围的洪水。应用扎根理论的定性研究包括与艾滋病病毒感染者的半结构化访谈、与艾滋病病毒服务提供者的焦点小组讨论和全国反馈会议。使用可持续生计框架、自然灾害研究方法和健康行为理论解释了这些发现。研究显示，水浸对艾滋病毒感染者的日常生活构成重大问题，影响他们的生计、工作、收入和生活条件。在正常情况下威胁他们的因素——贫穷、营养不良、不安全的水、环境卫生和个人卫生、获得保健设施的机会有限、健康状况不佳和耻辱——由于与洪水有关的基础设施崩溃、不安全、营养不良和在洪水过程中演变的疾病而加剧。她们的健康面临潜在的双重风险：由于无法获得保健服务和抗逆转录病毒治疗，感染和患病的风险增加。制定了一个艾滋病毒和洪水框架来显示结果。这项研究表明，如果不解决和确保获得艾滋病毒预防、治疗、护理和支持，在洪水等灾害情况下，艾滋病毒感染者的脆弱性和健康风险将增加。这些发现和《艾滋病毒与洪水框架》并不是Ohangwena所特有的，它们可以推广到任何艾滋病毒感染率高、主要依赖自给农业的受洪水影响的地区。它们是分析灾害条件下与卫生和卫生服务提供有关的脆弱性的典型案例。影响将根据该地区和受影响人群的自然、地理、气候、社会和行为特征而有所不同。在Ohangwena地区，灾害风险管理机制已经到位，可以在洪水期间解决艾滋病毒感染者的问题。然而，通过应用《艾滋病毒和洪水框架》，可以进一步改善防范工作。
Floods are a disaster situation for all affected populations and especially for vulnerable groups within communities such as children, orphans, women, and people with chronic diseases such as HIV and AIDS. They need functioning health care, sanitation and hygiene, safe water, and healthy food supply, and are critically dependent on their social care and support networks. A study carried out in the Ohangwena region, Namibia, where HIV prevalence is high and extensive flooding frequently occurs, aims to provide a deeper understanding of the impact that flooding has on people living with HIV (PLWHIV) as well as on HIV service providers in the region. The qualitative research applying grounded theory included semi-structured interviews with PLWHIV, focus group discussions with HIV service providers, and a national feedback meeting. The findings were interpreted using the sustainable livelihoods framework, the natural hazard research approach, and health behaviour theories. The study reveals that flooding poses major problems to PLWHIV in terms of their everyday lives, affecting livelihoods, work, income, and living conditions. The factors threatening them under normal conditions – poverty, malnutrition, unsafe water, sanitation and hygiene, limited access to health facilities, a weak health status, and stigma – are intensified by flood-related breakdown of infrastructure, insecurity, malnutrition, and diseases evolving over the course of a flood. A potential dual risk exists for their health: the increased risk both of infection and disease due to the inaccessibility of health services and antiretroviral treatment. A HIV and Flooding Framework was developed to display the results. This study demonstrates that vulnerabilities and health risks of PLWHIV will increase in a disaster situation like flooding if access to HIV prevention, treatment, care and support are not addressed and ensured. The findings and the HIV and Flooding Framework are not specific to Ohangwena and can be transferred to any flood-affected region that has a high HIV prevalence and relies mainly on subsistence agriculture. They serve as a model case for analysing vulnerabilities related to health and health service provision under disaster conditions. The impact will vary according to the physical, geographical, climatological, social, and behavioural characteristics of the region and the people affected. In the Ohangwena region, a disaster risk management mechanism is already in place which addresses people with HIV during flooding. However, preparedness could be improved further by applying the HIV and Flooding Framework.