Expats with HIV face a trip home

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Expats with HIV face a trip home

It was a phone call that tore apart his life in Korea. Before leaving for a trip outside of the peninsula, the foreign worker had gone to a hospital for an annual checkup required by most companies.
His company provided medical insurance that covered the cost of the exam, but he didn’t know that it would be privy to the results. And the results were not good.
The company called him to let him know his services were no longer required. He had tested positive for the human immunodeficiency virus, which can cause AIDS. To make matters worse, he was also told he would be denied entry into Korea.
The company called him to let him know his services were no longer required. He had tested positive for the human immunodeficiency virus, which can cause AIDS, and the company wanted to terminate all associations. To make matters worse, he was also told he would be denied entry into Korea.
After much deliberation, he flew back to his home country instead, leaving behind his home, furnishings, clothes, bank account and friends. .
When it comes to foreigners who are HIV-positive, Korea has a no-tolerance policy. Immigration law states that a non-Korean citizen with a disease that is contagious or harmful to the public can be denied entry or be deported.
“AIDS is considered a contagious disease,” says Ko Eun-young, a researcher with the AIDS department of the Korea Center for Disease Control and Prevention.
The Korea UNAIDS Information Support Center estimates more than 50 foreigners were deported last year. The Korean Immigration Office refuses to release any statistics, only saying that there are many cases and that the numbers are growing and will continue to increase.
About 535 new HIV cases among Koreans were reported in 2003, according to the Korea Center for Disease Control, 400 more than the number of new cases five years ago.
The first AIDS case reported in Korea was a foreigner in June 1985. The second case, in February 1987, was a Korean who had traveled abroad. Health officials, noting the lack of condom usage in general, were worried that it could become an epidemic. They were particularly worried about illegal migrant male workers who they feared were ignorant about sexual health.
Many countries have laws barring entry to those with certain potentially deadly illnesses. But just what diseases are considered dangerous differ from country to country. Some countries such as Denmark have ruled that a deadly disease is one that causes death within 10 to 15 years. Due to advancements in treatment, AIDS does not fall under this category.
“Of course, discrimination due to health is a violation of human rights,” Peter Wiessner of the German AIDS Federation, which has been fighting for the rights of people with HIV and AIDS, says in an e-mail interview. “But who cares?”
The United Nation does, for one. “There is no public health rationale for restricting liberty of movements or choice of residence on the grounds of HIV status. ... Therefore, any restrictions on these rights based on suspected or real HIV status alone, including HIV screening of international travelers, are discriminatory and cannot be justified by public health concerns,” according to a 1998 U.N. report.
But many countries choose to ignore the U.N. recommendation. Last year, the German AIDS Federation, in cooperation with AIDS Info Docu Switzerland, published an international travel and residence guide for people with HIV and AIDS. Out of 169 countries surveyed, about 100 have entry regulations based on health, and 20 countries deport people who are known to have HIV. Most of these deportations can be traced back to mandatory screenings, like the one the foreign worker in Korea went through.

Minimal privacy
Many foreigners do not know that medical privacy is minimal in Korea. Medical procedures such as HIV tests are supposed to be confidential. The government began enacting laws in 1986 to protect those with HIV or AIDS, but the reality is that these measures can be circumvented.
“Sometimes a company will call to find out what type of medical insurance bills they are paying,” says Lee Chang-wu, secretarial manager with the Korean Alliance to Defeat AIDS. “And if AIDS treatment is on it, they’ll find out.”
Korean doctors are required to report HIV-positive test results to the local Public Health Center. Unless a test is anonymous, doctors will report the patient’s identity as well.
If a test comes back HIV-positive, the Public Health Center runs additional tests, and if the results match the hospital exam, the case is passed on to the Korea Center for Disease Control. After two more exams at the Korea Center for Disease Control, the patient can be listed as an HIV carrier.
The government subsidizes treatment for Korean HIV carriers, which would cost 1 million won a month otherwise.
But some Koreans leave the country for exams and treatment to protect their confidentiality. When illegal discrimination against HIV-positive and AIDS patients occurs in Korea, but many are afraid to publicly step forward with a lawsuit that would include their names.

Threat of deportation
Expatriates found to have HIV don’t have the option of staying for treatment. When the HIV-positive status is verified, either the company or the National Institute of Health notifies immigration.
Mr. Wiessner of Deutsche AIDS-Hilfe argues that while mandatory screening is a recognized measure to prevent the spread of infectious diseases such as tuberculosis or SARS, the general population is not at risk of getting HIV and that people who test positive for HIV can take preventative measures.
He also says mandatory HIV testing is a violation of human rights and the right to privacy and a tool of discrimination.
The foreign worker who was barred from Korea is using that argument in petitioning the Korean government. He has appealed to the Human Rights Commission, the Human Rights and Social Affairs division of the Ministry of Foreign Affairs and Immigration, and he has asked his country’s embassy for help.
The embassy that is representing him says the case is still open.
The Human Rights Commission denies receiving any letter from the foreigner or having ever been involved with an AIDS case.
The Human Rights and Social Affairs Division also denies having received any letter. The immigration division of the Ministry of Justice refused to comment on the case.
Lim Chae-im, with the Ministry of Justice, says petitions can take some time, adding, “If a person is here legally, we usually give them time to get their affairs in order. They are encouraged to leave as soon as possible.”
The immigration office doesn’t set a deadline for departure, and each case differs. Mr. Lim says many HIV-positive foreigners want to stay, especially illegal migrant workers, who believe life in Korea is still better than in their home countries. “Sometimes we forcibly send them back to the country they came from,” he says.
The majority of foreigners who are deported because of their HIV status are here illegally and so are without recourse. “Sometimes, they’re escorted to the airport,” says one counselor at a local AIDS organization.”
Immigration makes allowances for people who are too sick to travel. One man from southeast Asia came to Korea on a tourist visa. His relative set him up with a job, where he worked with other illegal migrant workers. One day, he collapsed. When he went to the hospital, he was found to be HIV-positive.
He didn’t have the funds to pay for his bills and had to be helped by a non-profit organization. The doctors did not find him healthy enough to travel, so the airlines declined to let him board until the doctor said otherwise. The migrant worker’s health worsened, and he died last year.

Help for foreigners
Even if foreigners with HIV are allowed to stay, getting treatment is another problem. Some hospitals refuse to treat HIV-positive patients, and no system exists to treat foreign HIV patients.
When another illegal immigrant from a southeast Asian country collapsed, a pastor took him to the emergency room. Brain surgery was required, but the hospital declined to perform any surgery as he not only had AIDS, he was an expatriate. The patient died in the emergency room.
In a nondescript building on a busy street near Itaewon, one AIDS help center for foreigners quietly set up shop a year ago. The only way to find the location is if you know where it is. They don’t advertise their presence, having a sign that displays only the group’s acronym.
“We had so much difficulty finding a building owner who would let us sign a lease,” says Nalina Taneja, a counselor there. To get their current office space, they hid that they were an AIDS organization. The other tenants are still unaware that the office space is for AIDS counseling.
The organization was created to fill a need in the foreign community by offering help while maintaining confidentiality. The center answers questions about HIV testing, prevention and treatment in English, Hindi, Urdu and Korean. Others call or send e-mails asking for help.
The center also provides help getting anonymous testing at select clinics. They have blanketed the illegal migrant community with information on AIDS prevention. “Some people have never even heard of AIDS,” says Kim Hoon-soo, the group’s director.
Last November, the group organized 600 people for an AIDS awareness walk on Mount Namsan, giving a chance for members of the foreign community to join forces. Now, some of the embassies are stepping up efforts to raise awareness on AIDS prevention methods.
Korean participation was minimal. “Who would want to publically show their face for a cause like this?” Mr. Kim says.
But the group is still trying to reach out to Koreans. AIDS education might also ease discrimination against foreigners with HIV or AIDS. It has joined other AIDS organizations in the red-light district at Chyeongryangri in northern Seoul to promote condom use among prostitutes.
They have also been involved in counseling expatriates who are being deported. Immigration often calls the support center for help.
The center’s officials hope that in the future, treatment will be readily available to expatriates. And internationally, organizations have been launching “Stop the Ban” campaigns to rewrite entry regulations.
But it’s an uphill battle, says Mr. Wiessner. “It’s time to launch a campaign, but there are not so many partners, and the knowledge about it is limited,” he says.

by Joe Yong-hee

Additional reporting by Choi Ji-seon and Park Yun-ji.

For more information on the help center, e-mail kaids@aidsnews.net.
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