Christian Peregin
Illegal migrants 'should be tested' for HIV on arrival
Illegal migrants should be tested for HIV on arrival and if found to have the disease they should be given treatment accordingly, the Labour Party spokesman for social affairs, Michael Farrugia said yesterday.
He was quick to add, however, that Malta should not shoulder the responsibility alone and other EU countries should share the burden holistically, not just with funding but also by providing medical treatment and taking on a portion of those immigrants granted protection.
Dr Farrugia was reacting to an article in The Sunday Times which said that half of the HIV cases being treated in Malta involved African immigrants and that the number of HIV cases had quadrupled over the past two years, from between seven and 10 cases a year to 30 - 40. The figures, however, could not be telling the whole picture because immigrants are not screened for HIV on arrival.
"I am not surprised by the figures. It is well known that HIV is rampant in the countries that most of these immigrants come from," Dr Farrugia said.
He said the problem had to be tackled from all angles and that this should also come up during the parliamentary debate on illegal immigration the opposition had demanded.
Dr Farrugia, a doctor by profession, explained that the increase in HIV needed to be tackled first and foremost through education that discouraged casual sex and one-night-stands, not only with illegal immigrants but with foreigners and locals alike.
"Before getting involved with someone sexually, you should make sure you know the person well, including whether they are HIV positive, and this is something that we need to stress," he said.
But another problem was that if immigrants were given treatment they might not be able to comply with the strictly-timed regime and would develop resistant strains. But, even for this, he said, education was the key.
"You cannot force someone to comply with the treatment but then not everyone will respond in the same way. Yet, those who want to be treated, and are educated accordingly, they will be able to comply as best as possible."
He stressed that another important factor was to teach infected people not to infect others by taking extra precautions and not hiding their disease from their partners. "They have a legal responsibility to do this," he warned.
When asked whether all foreigners should be checked for HIV, he made it clear that it would be impractical to give a blood-test to everyone entering the country, so there was a limit to what could be done. However, when it came to illegal immigrants, because of where the migrants were coming from, the conditions of how they arrived and the fact that they would be processed by a large number of professional personnel, all tests necessary should be carried out.
If they were found to be HIV positive, then treatment must be provided, he said.
"Our responsibility to take care of them doesn't end when one of them gets sick. Just as we provide shelter, food and water, we must provide medical treatment but we cannot do it alone," he added, calling for stronger burden-sharing agreements.
"Burden-sharing cannot be seen simply as a question of how many immigrants are arriving or how big the country is. There's the question of resources and the strain on the various institutions, including the hospital, for instance. The EU must contribute holistically to help us overcome this challenge."
Christopher Barbara, Malta's only virologist in service and chairman of Mater Dei Hospital's Pathology Department, told The Sunday Times that, although screening was not expensive, treating an HIV-positive patient would cost about €500 a month for the rest of their lives.
"If the test is positive we have to offer treatment. Otherwise, why are we screening them in the first place? And it would be ethically incorrect to screen somebody selfishly, just so that we can label them HIV-positive."
He explained that if infected immigrants did not take the treatment properly, they might become resistant to the drugs and develop untreatable strains of the virus.
"I'm still not convinced screening is the solution. Initially, I thought we should help these people and treat them. Today, the more I study the situation the more convinced I am that we shouldn't," he said.
When contacted, the Parliamentary Secretary for Health, Joe Cassar said the government was addressing the matter and taking advice from consultants on the best way forward.
The Ministry for Justice and Home Affairs refused to comment, saying this was a public health issue not an immigration one.
The debate of whether or not to test illegal immigrants on arrival for infectious diseases such as HIV and Tuberculosis has been going on around Europe for a while but so far no ideal or practical solution has been found.
The problem will get worse once certain Eastern European countries, which tend to have high rates of HIV, join the EU and their citizens would, of course, have the freedom to move anywhere around Europe.
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Joe Xuereb
Mar 8th 2009, 18:25
Thanks Denis Catania. I have been away from MY country for almost half a century. My residence rights in UK were never an issue (I came in 1961). For this reason, although I sometimes thought it might be beneficial for me to possess a British document, I never did anything about it because it would have meant relinquishing my Maltese one. No way! Of course, after Malta's accession to the EU the issue became an irrelevance overnight so to speak. And I have the honour of being able to say, I stayed with my document. I am from Malta. I am a Ħamruniż. I do not know your age Denis but, like you, intend to remain a chip off the old block until the end. Insellimlek ħabib.
Denis Catania
Mar 6th 2009, 19:31
@Corinne Vella: That concerned non-Citizen you are referring to, has a valid Maltese passport # 881794. I understand you and your type of friends might renounce your Maltese citizenship when an opportunity arises. Not this Maltese. This Maltese will be a Maltese citizen for the rest of his life.
Joe Xuereb
Mar 6th 2009, 11:24
Apologies, in my last comment, the second line should have read ' it is unwise and unfair NOT to recognise (and acknowledge) the measure of frustration and anger that they represent. There, I can now sleep easy.
Joe Xuereb
Mar 5th 2009, 20:38
However spurious a knee-jerk reaction, however distasteful and objectionable any suggestion, direct or implied, to break the law, it is unwise and unfair to recognise in these the measure of frustration and anger that they represent.. Equally interesting at least to note commentators opting to sit on the face, ever ready to quote '''respectable' citizens chapter and verse without ever any true personal feelings. It is sad to think that so many are crying out to vent their true feelings but hold back for reasons known only to them. Sad because some if not all of those reaons have no real validityso their striven-after altruism will never get any recognition anywhere, and especially in places that do not even exist, or only in one's febrile imagination. Apologies if I cannot put it any other way but I am feeling rather shallow this evening. It is the winter gloom I guess. Specifically, the London gloom. Away from the bright lights, in suburbia.
Joe Xuereb
Mar 5th 2009, 18:44
cont./ Meaning. I can look at a woman and not see her as an object (sensible women would and do give anything to experience this). I can, and have the wherewithal, to evaluat a woman's true worth. I am relieved of the obfuscating obsession that is the measurements of a female's various girths. To put it in words even you would understand, I do coffee but not babies. You and I, as things stand (and objectively-speaking, remember) could never even do coffee at Cefe` Premier. As for babies.......ugh! the very thought!
Joe Xuereb
Mar 5th 2009, 18:34
Camels and virgins quoted out of context are indeed not funny. But camels are known to be obstinate. Virgins, in context or not, are not funny. Any more than whores of Babylon are. But their mention in context was more than apt. So no apologies ther./e. In any case, it is not a big deal. We are all virgins until the day we get laid. Besides all this, the matter in hand is very serious but that should not mean a lack of humour. Maybe I am lucky in that I have a Government that has my interest at heart. I vote and I pay my taxes. So all is in order.
I have no axe to grind, no hidden agendas, The State, if not the Church, is behind me all the way (we are still in foreign parts by the way). If people do not like it, they can lump it. I am in what some might see as enviable situation, and some as horrendous. cont./
Marianna Galea Xuereb
Mar 5th 2009, 17:16
@Corinne Vella
“If you're worried about becoming infected, use a condom or practise abstinence”
Please stop promoting the myth that a condom offers 100% protection against HIV and other sexually transmitted diseases. The use of a condom merely REDUCES the risk of acquiring an STD and DOES NOT TOTALLY ELIMINATE THE RISK. And there are as yet no condoms for the mouth and tongue……
Moreover, even abstinence is not a sure fire guarantee against infection.
Kindly keep in mind that many STDs - including HIV - may be transmitted through body fluids such as urine, blood, saliva, open skin cuts or wounds etc. and not just through semen.
Corinne Vella
Mar 5th 2009, 14:43
Joe Xuereb: I couldn't put it any better than Dr Ray Busuttil, director of public health, in his reply to a letter from a concerned non-citizen:
Irregular migrants that come to Malta are screened for those medical conditions which are deemed to cause a public health threat. Such conditions usually involve airborne/droplet-transmitted infections and those transmitted by direct contact. This primarily involves tuberculosis and other contagious skin manifestations. Sexually-transmitted and blood-borne diseases are not considered to cause such a threat. Their mode of transmission is behaviour-determined and therefore if the latter is addressed there is no need for screening. If screening was to be advocated for such conditions, then we should also be screening the local population as well as all the tourists coming to Malta, as they too pose the same risk to the rest of the population. In this regard, irregular migrants are treated in the same way as local nationals and testing for the presence of the conditions mentioned is only carried out if it is clinically indicated.
Now run off and patronise someone else, will you?
Joe Xuereb
Mar 5th 2009, 11:24
Corinne, instead of only picking on the guys that you think pass for comments (oh well, as long as there's a signature to them) would it not be useful to you, if nobody else, to regale us (note the use of the word) with your take on these matters? There's a good girl!
Corinne Vella
Mar 4th 2009, 23:40
Joe Xuereb: You might be a little more convincing if you were a lot less disparaging and much better informed. You could start by dropping the jokes about camels and virgins and boning up on arithmetic.
Corinne Vella
Mar 4th 2009, 23:33
Eric Soames: If you're worried about becoming infected, use a condom or practise abstinence.
Joe Xuereb (London UK)
Mar 4th 2009, 19:24
cont./ Being homosexual and therefore considered to be in a high-risk group, I was bombarded with more information than I could cope with. But it was never enough. So I did my own research, read widely, attended self-help groups and visited strangers and friends in hospitals. Saw colleagues (from work) and friends fade away and die. I owed it to myself to remain healthy and burying my head in the sand was not an option.
So you see Dr. Busuttil. If an ordinary man with just a First Aid certificate and enough commitment to confront a scourge, any scourge, head on....if such a man can do it, so could you. Me it did not break. And I did it without patronising anyone. And if there is a person who is bleeding for his country, believe you me, it is this one. Alarming?! Yes. But not if you keep your head out of the sand.
Joe Xuereb
Mar 4th 2009, 19:13
I would like to add a rider to my previous comment. Seeing that Dr. Busuttil seems unwilling to honour his responsibilities, Andrew Cassar (and very many in Malta who reason like him) who advises men not to engage in sexual congress with African men (broad-minded, or what?!) or women and they will have nought to worry about. And Helena Psaila of course, who, believing that HIV could never touch her or hers, professes continuing allegiance to her country provided it does not lock up people diagnosed with HIV (as if!). I have a yellowish, tattered certificicate in First Aid plus more recent credentials concerning HIV transmission, if only by default. Many it seems want illegal immigrants to be integrated. Assuming this to be a seamless process, one or a hundred embark on a catering career, Alarming? Not yet. Some may be HIV and not know it. And even less about health hygiene, transmission of airborne infections, cuts on fingers (kitchens, knives, serving tables, etc.). You get the picture.
I may only have a First Aid certificate but I informed myself concerning possible modes of transmission of viruses through normal daily contact (as in the catering industry). cont./
Joe Xuereb (London UK)
Mar 4th 2009, 12:39
@ Andrew Cassar. I think it is churlish to expect people to have sex, or not have sex, at your bidding It is none of your business. Irrelevant in any case. I guess you have heard of rape where the woman (usually a woman but not necessarily) is not consenting. Orwellian indeed!
As for putting down someone because of their poor mathematics - careful now! If out of a hundred patients testing-positive for HIV 50 are from this illegal influx, and considering that this group is still a minority group in terms of numbers, does this not indicate that the privalence of HIV positive status among these people is quite high. Now, I am no mathematician but to me this seems obvious. Does it not to you?
@ Helena Psaila. One must of course love one's country. Part and parcel of this is the love that one has towards oneself. Of a given situation endangers the individual, that individual must take precautions if he/she is going to be of any value to his/her country. Unfortunately, we live in a country where 'indoctrination 'not to love the self' is deep rooted. The whole point is missed. Quite a hurdle.
Joe Xuereb (london UK)
Mar 4th 2009, 12:16
Is anybody in Malta at all accountable to anything. I never voted in Malta (away 50 years) so no axe to grind. PM Gonzi is concerned but may be incapable. In which case he should step down and make way for someone who is.
Illegal immigrants must be sent back. If they are 'allowed' in, they must be tested for HIV and a whole load of other stuff (like documentation to ascertain whether they are running away from danger). If found to be positive, they could be sent to rich Saudi Arabia. At least it would reverse the proposal (The Times of two days ago) that Malta should and could open up to Saudi tourism. We have a ready arrangement. Send the positive-testing guys with loads of Saudi money printed in Malta. Instant job. Instant courier. Surely he would be welcome (if he ever turns up at all that is. Camels are known to have a mind of their own. And if he (Mr. Courier) persists in his belief that bedding a virgin will rid him of HIV, he will be laughing all the way.
Sounds like in Malta, heads must roll. Including some commentators'.
jimmy vella
Mar 2nd 2009, 19:18
I thought it was our health service it`s looking more like the world health service with one exception only locals pay the rest get it for free.ON YOUR BIKE DR FARRUGIA
lgalea
Mar 2nd 2009, 18:43
Just get all the illegal immigrats out of Malta and let their countries and their ex-colonizers shoulder the burden.
Charles Sammut
Mar 2nd 2009, 17:05
@ Dennis Catania
That reply from the health authorities might be politically correct but is otherwise very much wrong.
What the respondent has failed to address is the fact that in some countries of origin of these illegal immigrants, the HIV infection rate is 30%+.
What's more, they themselves might not even be aware of the dangers they pose, hence the high prevalence of HIV/AIDS in Africa.
Let us not allow political correctness be the undoing of our country and society. The way Dr Busuttil worded the reply borders on irresponsibility.
Charles Sammut
Mar 2nd 2009, 16:57
@ Brian Maloret
I think that you misunderstood my post. My first paragraph was quoting what Dr Michael Farrugia (PL shadow minister for health) said according to the article. I DO NOT agree with him.
The rest of my post should leave no doubt as to what my opinion is.
Helena Psaila
Mar 2nd 2009, 16:44
The day we start locking people up for being HIV+ is the day I will stop loving my country.
louise vella
Mar 2nd 2009, 15:58
I thank the Sunday Times for its eye-opening article "50% of HIV cases involve African immigrants" (1 March) and Dr Christopher Barbara for indicating that treatment costs €500 per month or €6000 per year for each case. Before suggesting that they be all tested on arrival, have we calculated the cost? Can Malta afford it? Who will pay for it - UNHCR, the NGOs, the EU? There is more than cost of course. Have we all thought about the consequences on the standard of health of the Maltese people if they are exposed to all kinds of new diseases?
This is the best answer to all those who repeat like parrots "international obligations, international obligation, international obligations". Do we have an international obligation to expose ourselves to health risks on such a scale. Have the parrots of "international obligations" calculated the cost to Malta's social fabric, its safety, its security, our taxes and the general standard of living of the common Maltese people?
Andrew Cassar
Mar 2nd 2009, 15:57
@ Chris Mifsud, Brian Marolet, Dennis Catania
We are not Saudi Arabia, Iran or North Korea, thank God. We do not lock up people for being HIV , Hep B, Hep C positive, or for having TB, leprosy etc etc. We have come a long way since the middle ages. Unless you have uncontrollable urges to have unprotected sex with african immigrants I don't think you have any worries.
@Dennis Catania
Please use up your valuable time to convince the health authorities to include the word condom in the HIV prevention campaigns, and not asking them to become something out of Orwell's 1984!
@Joseph Cauchi
Please read carefuly before you try your luck at mathematics. Half the 100 patients being treated for HIV in Malta are africans i.e. 50......and not half of african migrants are HIV positive!
A Cardona
Mar 2nd 2009, 14:53
L-aqwa li dhalna fl-ewropa u sirna moderni u sinjuruni bil-miljuni... allavolja sirna qisna dhalna f'qiegh l-Afrika. Naqbel ma' min qal Quo Vadis Malta
l borg
Mar 2nd 2009, 14:30
the health department should tell how postive people got the virus in malta so it will deter others and they will be careful
P Debono
Mar 2nd 2009, 14:14
"The Ministry for Justice and Home Affairs refused to comment, saying this was a public health issue not an immigration one."
They will learn when we answer them with our vote.
Eric Soames
Mar 2nd 2009, 13:59
A ticking time bomb. People step up. Lobby your MP, pester them into action.
Mari van Rooy
Mar 2nd 2009, 13:24
January 2009 went to Abu Dhabi,for the permit to enter the country for work .On the airport you get an eyescan/the authorities make a video of my face.
From there to the hospital for a HIV test and a foto from my lungs,evrything oke you enter not oke you dont enter very simple,.In or out.
John A. Borg
Mar 2nd 2009, 13:06
I would like to thank all the look-gooders in government and the NGOs for bringing and wanting to continue bringing all sorts of maladies on our shores and for saying that intermingling of the locals with them is not a problem.
Well done and keep up the good work and your philanthropy towards Maltese society. You have really done your Maltese brethren a great service!
Denis Catania
Mar 2nd 2009, 13:05
#3 My final respose and last communication on this issue.
Dear Dr.R Busuttil,
This is appalling. To place illegal immigrants in the same position as our
valued tourists and the Maltese population. These illegals come from parts of
the world where HIV is high among their citizens. As stated by the World Health
Organization.
Please understand in no way I'm saying to quarantine anyone. But when an
immigrant legal or not. Know that he is HIV positive. I believe they can enjoy
life and be safe to others through education. I'm sorry you don't feel
the need to test all immigrant legal or not for HIV. When applying to enter
Malta or captured at sea trying to enter illegally.
This put illegals, Maltese population and our valued tourist in great danger.
Immigration whether it's legal or not is a privilege and not a right. I guess
in Malta it becomes a right.
As a concerned Maltese Citizen I would have to call for your resignation.
Regards,
Denis
Catania.
Denis Catania
Mar 2nd 2009, 12:59
#2 their response. To: deniscatania@yahoo.com Cc: "Debono Michael at MFSS" , "Info at MFSS" , "Busuttil Ray at MHEC" Mr Denis Catania Pls find reply from Dr R. Busuttil, Director General, Public Health Regulation. Regards Desiree’ D’Amato Irregular migrants that come to Malta are screened for those medical conditions which are deemed to cause a public health threat. Such conditions usually involve airborne/droplet transmitted infections and those transmitted by direct contact. This primarily involves tuberculosis and other contagious skin manifestations. Sexually transmitted and blood borne diseases are not considered to cause such a threat. Their mode of transmission is behaviour determined and therefore if the latter is addressed there is no need for screening. If screening was to be advocated for such conditions, then we should also be screening the local population as well as all the tourists coming to Malta as they too pose the same risk to the rest of the population. In this regard irregular migrants are treated in the same way as local nationals and testing for the presence of the conditions mentioned is only carried out if it is clinically indicated. R. Busuttil Director General Public Health Regulation
Denis Catania
Mar 2nd 2009, 12:55
#1 Letter from me concerning this issue on Feb 3rd 2009. From: Denis Catania [mailto:deniscatania@yahoo.com] Sent: 03 February 2009 22:03 To: Info at MFSS Subject: health Dear John Dalli, I'm appalled at the fact that illegal immigrants are not given HIV test and we don't keep records on Hepatitis B or C on illegal immigrants.How can we not know if infected HIV illegal immigrants are still in Malta. If this policy is not reversed. I believe you should resign. Regards, Denis Catania.
Michelle Dali
Mar 2nd 2009, 12:30
@ d. borg. 'How naive can we get.' You are so right. The other EU countries don't want illegal immigrants at all, much less if they know they are HIV positive. How ridiculous to think they would ever take in anyone who is going to need expensive treatment for the rest of their lives! It seems that Malta is the only EU country that is FORCED to take in illegal immigrants. The smallest and most overpopulated EU country! It is well and truly about time the government makes it known that Malta is is no position to accept anymore illegal immigrants, no matter what. This is simple common sense.
Adrian Gouder
Mar 2nd 2009, 12:28
In addition to the below, treating such immigrants would most certainly serve to promote Malta as a centre for the treatment of AIDS.... for illegal immigrants. Can we afford it?
Brian Maloret
Mar 2nd 2009, 12:20
Charles Sammut (1 hour, 5 minutes ago) "If the test is positive we have to offer treatment. Otherwise, why are we screening them in the first place? I suggest that screening is necessary to protect the health of the population of Malta that might be put at risk by illegal immigrants coming to the Island carrying not only sexual diseases but other potential contageous and lethal diseases. I agree with Chris Mifsud that any illegal immigrant found to have a disease should be detained until the time that he/she is deported.
d. borg
Mar 2nd 2009, 11:54
"Our responsibility to take care of them doesn't end when one of them gets sick. Just as we provide shelter, food and water, we must provide medical treatment but we cannot do it alone," he added, calling for stronger burden-sharing agreements.
How naive can we get. As if any EU country is going to take immigrants with HIV. Burden sharing my foot. They did'nt come forward after signing the pact, let alone after reading this article. The govt. should deport those who are found positive immediately. What are we waiting for - an epidemic of some sort? Not only of HIV but of the many viruses that exist in African countries and to which we have no immunity whatsoever.
Joseph Cauchi
Mar 2nd 2009, 11:36
If 50% of HIV cases involve African immigrants, and each patient cost Euro 500 a month, i.e Euro 6000.00 per annum and the immigrant population is around 5000 (1/2 of 5000 = 2500)
Then the annual cost to Malta’s health services would be
Euro 6000.00 X 2,500 = Euro 15,000,000.00 per annum!
Who will be making good on this expenditure of 15 Million Euro per year until these patients are still in our country?
This answer is very simple. We, the Maltese tax-payer!
Just think about it!
Quo Vadis Malta?
../..
Charles Sammut
Mar 2nd 2009, 11:07
"If the test is positive we have to offer treatment. Otherwise, why are we screening them in the first place? And it would be ethically incorrect to screen somebody selfishly, just so that we can label them HIV-positive."
Since when is protecting and safeguarding your own people, selfish?
An aspiring Minister of Health should be ashamed to say things like that. He should have gotten his facts right and learnt that most of the illegal immigrants who are HIV +ve do not turn up for continued treatment anyway. This is going to result in the development of drug resistent strains of the virus.
Moreover these people have their own ways of treating the disease. Like having unprotected sex with virgins or using voodoo and witch doctors. We must respect their culture, or should we?
Chris Mifsud
Mar 2nd 2009, 10:58
I agree that the illegal immigrants be screened for aids/hiv and other diseases upon arrival .
But once they are found to have H.I.V etc.. then they should be locked up and only be released to be deported .
While this may sound drastic , we have to take into consideration that the mentality of the immigrant differs from ours and they reason differently . It would be dangerous leaving them roam freely and the serious consequences .
Locking them up is the only way that we can ensure that the disease is contained and eliminating the risk of it spreading .