AIDS in Venezuela Puts Ancient Culture at Risk
GOTSU, Japan — Before Atsumu Yoshioka, 81, decided to give up driving, there were signs it might be time.
First, he forgot to set the parking brake during a visit to a shrine, and his car drifted. Another time, as he backed out of the driveway, he rammed into an urn. Mr. Yoshioka called it quits.
“Before I caused any serious accidents,” he said, “I decided to give up driving.”
Japan has the oldest population in the world, with nearly 28 percent of its residents above 65 years old.
According to government data, drivers between 16 and 24 are more likely to cause traffic accidents than any other age group. But last year, drivers over 75 caused twice as many fatal accidents per 100,000 drivers as those under that age. Among drivers over 80, the rate was three times as high as for drivers under that age.
All drivers 75 and older have their cognitive functioning tested when they renew their licenses. Those who score poorly are sent to a doctor, and if they are found to have dementia, the police can revoke their licenses.
More than 33,000 drivers tested last year showed what the police deemed to be signs of cognitive impairment and were ordered to see a doctor. The police revoked just over 1,350 licenses.
The sense of loss can be profound. “It was like I lost my spouse,” Mr. Yoshioka recalled of the early months.
Advocates for the aging say that in rural areas any measures urging the elderly to give up driving need to be balanced against the potential harm to their quality of life. Unlike urban areas like Tokyo or Kyoto, where public transit is plentiful, there are few options in the countryside.
Adult children no longer typically live with or near their parents, leaving them to get around on their own.
Those who favor imposing more restrictions on elderly drivers say the danger of accidents outweighs any concerns about lifestyle. What’s more, they say, the law focuses too narrowly on cognitive abilities, when so many other factors, such as loss of vision, could affect performance.
An exodus of working-age people from rural areas has left few people to drive buses, taxis or delivery trucks that could support residents who have given up their cars.
In Kawamoto, a town of 3,333 people, of whom 45 percent are older than 65, there are only three taxis and the buses run infrequently. Many residents “feel like they have to be independent and protect their own lifestyles,” said the mayor, Minoru Miyake.
Noboru Moriwaki, 90, said he had no plans to give up driving. He and his wife, Yukiko, 86, live up a curvy hill on the outskirts of Kawamoto. A few times a week, Mr. Moriwaki, a retired school principal, drives his Toyota Corolla to the grocery store, bank or library. Once a month, he takes Mrs. Moriwaki to the hospital.
“If you can’t drive,” Mr. Moriwaki said, “you can’t get on with your life.” “Wilmer Medina.” “Dead.” Of the 15 villagers who had been part of the treatment program, five had died of AIDS, the disease caused by H.I.V. In all, more than 40 residents of this village had died of AIDS or AIDS-like symptoms in the past several years — in a settlement of only about 200.
“I’m very worried,” Mr. Pequeño said. “It’s wiping out this community.”
In recent years, amid profound shortages of medicine coupled with widespread ignorance, H. I.V. has spread rapidly throughout the Orieconomy has crumbled, causing men when he was younger — a comnoco Delta and is believed to have crippling shortages of medicine and mon practice among young Warao. killed hundreds of the Warao indigediagnostic tests, and compelling maResearchers believe that men nous people who live in settlements ny of the best doctors to emigrate. having sex with men was part of the like Jobure de Guayo. The government has stopped disearly dissemination of H.I.V., but the
Already, deaths and the flight of tributing free condoms, activists virus is now rampant in the broader survivors have gutted at least one say. The Maduro administration population, and heterosexual sex village, but the government has igdid not respond to requests for inand breast milk now appear to be nored the issue, medical specialists terviews with officials of the nationother forms of transmission. and Warao community leaders say. al H. I.V. prevention program, the No family in Jobure de Guayo had
Dr. Jacobus de Waard, an expert health ministry and the ministry of been hit as hard by the epidemic as on infectious diseases at the Cenindigenous affairs. the headman’s extended clan, which tral University of Venezuela, who Among the most disadvantaged had lost at least 12 people to AIDS or has worked among the Warao for Venezuelans are the Warao, said AIDS-like symptoms in the last two years, said the future of the ancient Jhonatan Rodríguez, president of years. “In the past, if you were sick, culture was at stake. “If there’s no StopVIH, a Venezuelan activist they did everything possible to hosintervention, it’s going to affect the group. “It’s a population that has pitalize you. Now, no,” he said. existence of the Warao,” he warned. been totally neglected.” “My people are dying.” “A part of the population is going to The Warao have lived for centuSome in his family say they have disappear.” ries in the delta region. Numbering fallen victim to a curse inflicted on
Venezuela is failing to grapple about 30,000, they live in hundreds them by a former village resident with an AIDS emergency even as of remote impoverished settlewhom others accuse of being a the annual numbers of new H. I.V. ments. hoarotu, a darker kind of shaman. infections and AIDS-related deaths Armando Beria, 25, a resident of Mikaela Perez, 33, a granddaugharound the world continue to deJobure de Guayo, who was on Mr. ter of Mr. Quintín, said the villager cline. Pequeño’s patient list, said he first put a hex on her father, whose death
Under President Hugo Chávez, heard about AIDS when a doctor from AIDS-like symptoms was folVenezuela’s H.I.V./AIDS prevention visited the settlement in 2013 and lowed by a rash of others in the family.andtreatmentprogramwasworldtestedpeopleforthevirus.“Ididthe class, and the country seemed to examination and he said, ‘ You have “A family that’s coming to an have the disease under control. But it, too,’ ” he recalled. end,” she said. “Before we all lived during the presidency of Nicolás He believes he may have contracttogether very happily. But now it’s Maduro, which began in 2013, the ed it through having sex with other coming to an end.”
JOBURE DE GUAYO, Venezuela — After the other villagers had drifted away to do chores, Rafael Pequeño finally found himself alone with the headman and opened the hardcover notebook on his lap. The men were sitting in a palm-thatched hut perched on stilts on the edge of a branch of the Orinoco River.
It had been two years since Mr. Pequeño, a nurse, had visited this poor indigenous village in the Orinoco Delta region of eastern Venezuela. His notebook contained a registry of patients who had been in an H.I.V. treatment program that, like the rest of the nation’s public health system, had crumbled.
Mr. Pequeño took a roll call of the infected. “Armando Beria,” he said. “Still here,” replied the headman, Ramón Quintín.
“Ebelio Quinino,” the nurse continued. “Still here.” “Mario Navarro.” “Dead.”