Saudis jail, deport foreigners with HIV

By MARK MACKINNON

Tuesday, August 9, 2005 Updated at 4:55 AM EDT

From Tuesday’s Globe and Mail

Jeddah, Saudi Arabia — Mohammed spends his days in a crowded cage, dying of a treatable disease for which the richest country in the Middle East won’t provide medicines.

The Palestinian is HIV positive and has been kept in a cell at the King Saud Hospital for Infectious Diseases for three months, along with two roommates who also are infected with the virus. They live behind a brown steel door with barred windows, victims of a closed society that would rather deport people, such as Mohammed, than talk about sex, drug use or AIDS.

Saudi Arabia can afford the antiretroviral medication that slows the spread of HIV and often prolongs the life of those infected, and does give the drugs to Saudi nationals who have contracted the illness. It refuses, however, to extend the same treatment to the more than 4,200 foreigners in the country who have tested positive for HIV.

Foreign workers, many of whom hail from South Asia and come to Saudi Arabia looking for better-paying jobs than they could find back home, make up 25 per cent of the country’s population, and 54 per cent of those known to have HIV.

Burly and hale-looking despite his illness, Mohammed said the only medications he has received in the past three months are basic pain relievers and anti-allergy pills. He says he was allowed out of his cell — which is bolted and padlocked from the outside — just once in recent weeks.

That time, he said, he was put into an ambulance and taken to finish his deportation proceedings. When it was determined the necessary documents were not yet ready, he was driven back to the hospital and again locked up.

"We are prisoners here. They treat us like animals," Mohammed said during a short discussion of his circumstances through the bars of his cage before hospital security guards arrived and ended the interview.

There was another, gaunt-looking African man in the caged hospital room — who also has AIDS — and Mohammed said all foreigners with AIDS were treated the same way. There are often six people in the caged ward at the same time, he said. "They say we’re dangerous, so we can’t go out. We get no medicines at all."

When The Globe and Mail returned the next day, it was impossible to speak to Mohammed. The wing of the hospital where the caged foreigners with AIDS are kept, which was open to visitors the day before, was suddenly under guard by triple the number of security guards.

Mohammed said one of his former cellmates, a man named Ismael who was born in Saudi Arabia to illegal immigrants and thus considered a non-citizen, was deported to Myanmar (formerly called Burma) recently after being kept under lock and key for a year without access to antiretrovirals.

One doctor at the hospital, speaking on condition of anonymity, said Ismael and Mohammed were both lucky and have survived thus far because they are young and arrived at the hospital while still relatively healthy. Many others, he said, died in front of him while awaiting their deportation, an infuriating experience for a medical professional who knew he could do more to help them.

Like Mohammed, he said foreigners with AIDS who arrived at King Saud were treated like "prisoners, not patients."

"They get no medicine, no care, nothing. I tried my best, I talked to the director of the hospital about this many times. They told me: ’These are the rules of the country. You cannot change this.’ "

The doctor said since Saudi Arabia treats its own citizens who contract HIV reasonably well, the lack of care given to foreigners with AIDS can be attributed to racism alone.

Doctors say the antiretroviral medication costs the equivalent of about $1,500 a month a person.

The country views AIDS as an imported phenomenon, and in a 2004 report the Ministry of Health said Saudi Arabia’s policy for dealing with foreigners with AIDS is to treat them until they are stable enough to be deported.

The low number of AIDS cases in the country is frequently attributed to the kingdom’s strict Islamic laws, which prohibit premarital sex, relations outside marriage and homosexuality. Penalties for adultery and drug use include imprisonment, public stoning or beheading.

Saudi Arabia’s economy is heavily reliant on foreign labourers, who nonetheless have few rights and are treated as an underclass. The largest number have settled in Jeddah, a vibrant port city of 2.8 million people near Islam’s holy sites of Mecca and Medina. Unknown thousands live in rundown neighbourhoods and makeshift refugee camps where intravenous drug use and prostitution — almost unheard of in the rest of the country — have become rampant. Over half of the country’s reported AIDS cases are in Jeddah.

Many of those who end up at the King Saud hospital work in the country for years beforehand and only discover they have AIDS when they’re brought to hospital after a workplace or traffic accident. There, they receive a mandatory HIV test. After that, they’re forcibly taken to hospital and confined there to await deportation or death, whichever comes first.

Wealthier foreign workers, such as oil-industry specialists and education professionals, are unlikely to use Saudi Arabia’s public health-care system and thereby avoid the scrutiny of the government.

How long those locked up with AIDS remain inside the hospital often depends on their nationality. Some countries, such as the Philippines, move relatively quickly to take their nationals home for treatment. But in cases like Ismael’s and Mohammed’s, where the patient hails from a country with little or no diplomatic presence in Saudi Arabia, the wait is much longer.

Christoph Wilcke, Saudi Arabia researcher for the New York-based Human Rights Watch, said this was the first time he had heard about the practice of jailing and withholding medication from the country’s foreigners with HIV and AIDS. He called the practice "despicable."