Thursday, August 18, 2011

From AIDS to Drugs, Native Speaking Teachers

On October 14, 2009, Newsis published the following report about foreign public school teachers:
From AIDS to Drugs, Native Speaking Teachers

It has come to light that deviant behavior by native speaking teachers, such as using narcotics or testing positive for AIDS (HIV), is becoming serious.

According to administrative affairs audit material submitted by the Gyeonggi Office of Education to the provincial education committee on the 14th, a total of ten native speaking teachers resigned partway through their contract for various kinds of unacceptable behavior or were kicked out during the hiring process after 2007.

By type, 6 had faked their academic backgrounds or graduated from unauthorized universities, 3 tested positive for AIDS, and one was charged with narcotic use.

Last October 1, during the hiring process, a female teacher at a middle school in Gapyeong was found to have caught HIV from her husband while in another country and was deported 9 days later.

Earlier this year, two native speakers at a middle school in Icheon and a middle school in Paju had their employment canceled when they tested positive for HIV during their health check.

On September 23, 2008, a teacher who had worked at an elementary school in Icheon for only six months was investigated for taking narcotics the previous March 25 and resigned.

When it came to light in October 2007 that a teacher at a high school in Ansan had faked his academic background, he was fired.
I hadn't realized testing positive for HIV was 'deviant' behavior. Nor, since it's matched with narcotic use, that it was illegal. At any rate, you have to love the title. I don't have exact figures, but considering there were 933 in June 2007, by 2008 there were certainly over 1000 teachers in Gyeonggi public schools, so for 10 to have caused 'problems' like being HIV positive, you're looking at less than 1%. Obviously, the thing to do when writing an article is to ignore the 99% not causing problems and zero in on the others.


Anonymous said...

Not to mention the common and immediate assumption that HIV positive equals having AIDs, certainly hope no kids gave those deviants any hugs while they were teaching (most likely while high). If they did, I also hope an immediate quarantine was set up.
Seriously though, that article would have first come out right when I got to Korea, I feel like (or at least hope) things have gotten better over the past 2.5 years.

kushibo said...

The title of the 2009 article is bad and irresponsible, though I think quibbling over "deviant" is sort of beside the point. (일탈 can mean "deviant" as in differing from the norm, but it's a loaded word choice; if you were to take someone who was appropriately called some kind of "deviant" in English and translated that into Korean, 일탈 would not be the best word choice, methinks.)

Anyway, I think this case underscores some of issues surrounding HIV testing. Korea mandates HIV treatment for all HIV-positive people, with the government footing the bill (this is called human rights abuse by some groups). With 1 in 6000 ROK residents testing positive for HIV, this expensive system is affordable, but it would face fiscal ruin if there were a flood of new cases. American residents are thirty more times likely to be HIV infected, at 1 in 200. Given the discrepancies in HIV infection rates AND coverage of mandatory treatment, ROK officials are being reasonable for having testing of foreign nationals who are coming to work in South Korea (but this does NOT excuse demonizing a group, as the headline of the 2009 article does).

On the other hand, what about an E-series visa holder who becomes infected with HIV while residing in South Korea? If we look at the deport-HIV-positive-newbies policy as sound actuarial practice, then it cuts both ways: a person who arrived in South Korea HIV-free but who is now infected should fall under the same treatment regimen as a ROK national also living in South Korea, if they want it.

I outlined such a viewpoint here:

1. Mandatory testing for anyone with a visa that allows them to stay in South Korea beyond the period of a tourist visa (preferably in line with mandatory testing for all ROK nationals residing in South Korea as well).

2. Deny long-term visa if they test positive (except perhaps for F-series family visas)

3. Provide foreign residents who test positive during their residency in South Korea with the same comprehensive HIV treatment that ROK nationals would receive. Provide a long-term medical treatment visa for such individuals, if necessary, so they don't fear deportation if they lose their work status.

Point #3 is what I think ATEK and other groups should push for, perhaps as quid pro quo for dropping opposition to HIV testing for newcomers.

Anonymous said...

It still blows my mind that Korea does blood tests _after_ you've been given a contract and work visa.

God forbid they follow the Japanese model and have applicants get tested in their home country and send in a notarized doctor's letter beforehand.

That would be so, I dunno, logical.

Anonymous said...

@ kushibo

Those are some pretty dubious statistics. Are you suggesting that 1 in 200 U.S. college grads are likely to test positive for HIV?

I'm always interested in arguments citing discrepancies in rates of HIV infection between non-Koreans and Koreans as a reasonable justification for the E-2 visa HIV tests so feel free to add to your comment.

kushibo said...

B_Wagner, you say these numbers are dubious. In fact, I have seen numbers that were extrapolated from certain assumptions that put the Korean rate at closer to 1 in 3000. What numbers do you wish to work with?

HIV/AIDS is a young people's disease. In the US, people under 25 make up over half the new cases, and in the US infections have long since made the jump into the larger heterosexual population.

But let's say, for the sake of argument, that ROK infection rates are the same as in the US. Heck, let's say that they're higher than that of the average prospective English teacher, migrant worker, or anybody who might be subject to a testing-before-residency regimen before coming to South Korea. Why should South Korea, which largely has the disease under control both in terms of infection rates AND intensive treatment, be forced to take on new infections?

And even if there weren't a comprehensive and mandatory HIV regimen for HIV-positive people in Korea that would be endangered by taking on new cases, what is the thing wrong with testing everyone who comes in to the country in order to prevent further infections? In the US we do that with ROK students and tuberculosis, a prudent thing to do given that TB rates in South Korea are some eight times higher than in the US. Why not with HIV in South Korea?

People in the medical health field have started to make the switch from treating HIV primarily as a human rights issue to treating it as a public health issue. The CDC recommends all persons who enter a health setting be tested for HIV (but with a nod to the residual "human rights" notion that they be allowed to opt out).

Testing is now cheap enough and effective enough that it can save lives by (a) preventing infected people from infecting new people and (b) allowing those who are unknowingly infected to get treatment soon enough that they will live with HIV as a chronic condition instead of AIDS as a fatal disease.

That some foolish parents want foreign teachers tested so their little kiddies at the hagwon won't get AIDS does not negate the need for comprehensive testing. It is a sound policy.

kushibo said...

I wrote, "all persons who enter a health setting be tested for HIV," which was a little bit flubbed. Best to cite the CDC themselves for the revisions...

For patients in all health-care settings:

• HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening).

• Persons at high risk for HIV infection should be screened for HIV at least annually.

• Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.

• Prevention counseling should not be required with HIV diagnostic testing or as part of HIV screening programs in health-care settings.

For pregnant women:

• HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women.
HIV screening is recommended after the patient is notified that testing will be performed unless the patient declines (opt-out screening).

• Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.

• Repeat screening in the third trimester is recommended in certain jurisdictions with elevated rates of HIV infection among pregnant women.

Anonymous said...

Let's start with where I think we are in agreement. People should get tested. From a public policy perspective, the question is how does one go about ensuring that people get tested.

You've suggested that should be achieved through mandatory tests for all ROK nationals and all long-term sojourners. You're familiar with why I support voluntary testing as we've discussed the issue elsewhere.

As for the likely HIV positive rate of E-2s, I think you're off base in suggesting it's 1 in 200. CDC data suggests US college grad rates are somewhere at 1 in 500 (and even that number would have to be adjusted for the demographics of E-2s.)

Also recall that E-2 rules for deporting HIV+ teachers are designed to "protect children and young students" as per the MOJ. Deportations are not conducted because of concerns about health care treatment costs.

As for the statistical discrimination argument that rates of HIV infection are higher among non-Koreans than Koreans so race-based testing is justified - in addition to it being problematic from a human rights perspective, I'd suggest that a rational basis is lacking as well.

Even if the difference in HIV infection rates are what you suggest you need to remember that there are considerably more Korean teachers than foreign teachers. Take the public school system, you've got about 480,000 Korean teachers and about 8,500 foreign teachers. Unless one assumes that foreign teachers are more likely to sexually assault children how is it that children more likely to contract AIDS from a foreign teacher than a Korean teacher even if the difference in HIV infection rates are what you suggest?

I don't suggest these figures are accurate, but for the sake of argument let's accept the most extreme differential and say that 1 in 200 non-Korean teachers have HIV/AIDS and only 1 in 6000 Korean teachers have HIV/AIDs. You still end up with about double the number of Korean teachers with HIV/AIDS teaching Korean children.

Anonymous said...

I should add that I'm not suggesting you support a discriminatory approach to testing, you're made it very clear that you've in favor of universal testing. I should also add that I'm not necessarily opposed to universal testing, I'm just not convinced that it's appropriate and feasible in this context - that said, I'm open to arguments.

I actually think we are in agreement on many points. I think where we part ways is attributing value to human rights based concerns. I'd suggest that not only do they have value in themselves, but they work toward achieving lower rates of infection by reducing stigma and encouraging voluntary testing. Recall that the battle to institute mandatory testing for E-2s began with citing stats that many English teachers were seeking voluntary testing. Thank goodness they've put a stop to that, eh?