Ban them, says - Prof. Sakyi Amoa

Manicure and pedicure are threatening to roll back the gains made in the fight against the spread of HIV/AIDS, following the influx of peddlers of the service, from neighbouring West African countries, particularly Burkina Faso, Niger, and Mali.

The Ghana Aids Commission (GAC) admits that the activities of these aliens, who ply their trade mainly in Accra, Kumasi, and other major cities, have serious health implications, but says, there is nothing they could do at present, to control the dangers they posed to the public. This is because, according to the Commission, the providers of the service are not organized - a fact that puts any meaningful regulation of their activities, out of the question.

The major health hazards they pose, according to the GAC, are: Reproductive Tract Infections (RTIs), such as the Iatrogenic types, generally regarded as "silent epidemic," and HIV/AIDS.

The danger is borne out of the fact that the practitioners and their clients, who live under circumstances that may expose them to the viruses, are ignorant about the risk of infection. Some practitioners, the Weekend Agenda spoke to concerning the hazards of the trade, showed complete ignorance about the risk of infection.

One of them, who appeared aware of the risk, said that, at the close of every working day, he sterilized his equipments by boiling them in water. Experts claim however, that, mere boiling in water, is not an entirely reliable way of destroying the HIV/AIDS virus,

Amadou Umar, is a 24 year old peddler of manicure and pedicure services from Mali. He arrived in Ghana two years ago, having plied his trade for 3 years in Burkina Faso. He has had no formal education, neither has he had any training in his trade. Since arriving in Ghana, Amadou has worked in Tamale, Kumasi, Obuasi, and Takoradi. He moved camps to Accra three months ago. He makes about ?50,000 a day, charging ?1,000 per client. By simple arithmetic inference, he handles about 50 clients in a day, exposing close to 5000 people to infections, including HIV/AIDS, in a month.

Speaking to the Weekend Agenda in an exclusive interview on the issue, Professor Awuku Sakyi Amoa said that, the activities of the practitioners are far more serious than can be imagined, and went on, to call for their prohibition.

It appears from simple analogy, that beauty salons, that offer the service, also present a similar risk of infection. The GAC says, however, that, because the salon operators are organized, it is possible to educate them on pre-cautionary measures.

Professor Amoa noted that behavioural change among Ghanaians was one of the key instruments for the success of the national response programme, but which he said, was suffering some set backs because of the Individual's low risk perception.

" People of high social class who are aware of their high risk behaviour take the risk factor for granted. People must now recognise the factors that exposed them to the risk and strive to avoid them", he advised.

He advised Ghanaians not to patronize the services of these manicurists and pedicurists, adding that those who submit themselves to their services are placing themselves under great danger.

He likened the activities of the unregistered manicurists and pedicurists, and their clients to that of prostitutes, explaining that, the only difference between the two, is that prostitutes and their clients work under the cover of darkness, while the former work in the open. The two groups, he said, can be placed within the same risk category.

He said the greatest challenge facing the country in its fight against the pandemic is how to translate the knowledge gained, into appreciable levels of responsible behaviour, and called on the media to adopt an aggressive campaign to complement ongoing efforts at containing the spread.

Prof. Amoa advocated for the formation of a network of journalists to join the national campaign to fight the infection as pertains in Uganda.

According to GAC figures, the national HIV/AIDS prevalence increased from 2.6% in 1994 to 4.6% in 1998. The latest (2003) figure is 3.4%. Data from the 2003 HIV Sentinel Survey give a regional variance in prevalence with the lowest of 2.1% in the Northern Region and highest of 6.1% in the Eastern Region. The high prevalence is said to be where exponential increase is likely, and control measures are less effective. In addition, certain population groups have much higher rates than the general population. For example, prevalence among STI clients in Kumasi was 9.6%, and among Commercial Sex Workers (CSWs) was 75.8% in Accra, and 82% in Kumasi (1998 figures).

The non-existence of figures for infections through manicure and pedicure services, makes it difficult to make an empirical based assessment of the gravity of the problem. But could also be because, we are only now becoming aware of it.

For now, it appears all HIV/AIDS infections are blamed on the sexual mode of transmission. The harping on the sexual transmission mode creates the impression that, only promiscuous people are at risk of HIV/AIDS, which is the reason why patients are stigmatized.