Sorcery and fear of AIDS in the jungle villages of Papua New Guinea has seen infected people thrown into rivers to drown, dumped in graves to die or abandoned to starve to death, according to those fighting the disease.
To have HIV-AIDS in Papua New Guinea, a jungle-clad, mountainous South Pacific island nation, is to be an outcast in a country struggling with the modern world, where some villages only encountered Western civilization in the 1930s.
"If they haven't seen it before they think it must be sorcery," said Franciscan Father Jude, who has worked in the jungles for 30 years, and runs an HIV-AIDS clinic in Port Moresby.
"They throw HIV-infected people into the river or dig a grave and put them in it and let them die, or just leave them down the backyard and refuse to feed them," Jude told Reuters.
Officially there are only about 12,000 people infected with HIV-AIDS in PNG, but AIDS workers estimate that under-reporting and reluctance to be tested mean the real number ranges from 80,000 to 120,000.
The island's 5.4 million people, most of whom live a rural subsistence life, presently face an epidemic on a par with Cambodia, Myanmar and Thailand.
But AIDS experts say that, with an annual infection rate of 33 percent, PNG is on the verge of an African-style epidemic that could kill millions and destroy the economy.
"This is the tip of the iceberg," said Dr Alphonse Tay, head of Port Moresby General Hospital. "In 10 to 20 years' time about 50 percent of the population is going to be affected by HIV."
The disease has found fertile ground in PNG, where polygamy is common and rape and sexual violence widespread.
There have been 151 rapes reported in Port Moresby so far this year and a recent human rights report said a culture of police violence sees officers engaging in gang rapes and spreading HIV-AIDS by beating those who carry condoms.
Many HIV-positive husbands knowingly infect their wives by refusing to wear condoms, believing it lessens their manhood.
"Money in this country justifies anything," said Father Jude. "If one picks up a 13-year-old for sex, it's illegal, but if one pays compensation to the family, it's okay."
Ruth Timon, 26, lies asleep on a dirty bed in the unofficial AIDS ward in Port Moresby General Hospital. She has been in the ward for two weeks and rarely does anyone come to visit. She has been disowned by her family, nurses say, left alone to die.
There is no official AIDS ward as the stigma attached to the disease would leave such a place empty, says Dr Tay, adding 10 percent of the 64 beds in Ward 4B are occupied by AIDS patients.
On the nurses' counter nearby is a cardboard box with "Death Certificates" written in large letters -- death is never far away here. There are no name cards on the beds, just a number. Each bed has a single sheet that scarcely covers the emaciated bodies.
While anti-viral medicines are free for those with HIV, patients rely on families to bring food and drink. Many come from remote villages, meaning that mothers and wives must sleep under the beds when they need a rest from nursing their sick loved ones.
"We don't do any nursing. The families do the nursing. The nurses just give the drugs," said ward sister Elizabeth Waken.
Waken is frustrated by a lack of staff, medicines and supplies to run her ward. There are no bedpans and the tropical heat is oppressive as most fans hang lifeless, many broken.
PNG's health system is ailing. Hospitals routinely run out of simple medicines, and equipment is not repaired or replaced.
The 2005 health budget is $37 million, of which a mere $6,333 goes to fight AIDS and sexually transmitted diseases. The fight against AIDS relies on aid donors, who say they are also frustrated in delivering services.
At night, families ashamed of AIDS leave bodies at the Port Moresby General Hospital entrance. Some 60 to 80 bodies, not all AIDS-related, are dumped each month.
The morgue is overflowing with 116 bodies, half of which are AIDS deaths. The morgue's cooling system is broken. Rocks keep the cool rooms closed, but bodies decompose, as staff prepare two nearby shipping containers to act as a makeshift morgue.
"A lot of bodies in the hospital morgue are HIV-AIDS but people are not coming to claim them. They are in fear of getting infected," said Dr Tay. Each month there are mass burials.
At Nine Mile Cemetery on the outskirts of the city, plastic flowers mark row upon row of graves beneath the cracked earth. It is here that Father Jude carries out mass burials of AIDS babies.
Cemetery workers sometimes find AIDS bodies dumped overnight in freshly dug graves. "A lot of people are buried all over the place quietly," said Father Jude as he walked through the graves.
Much of the HIV-AIDS work in PNG is done by churches, but some zealous religious groups are hindering treatment.
On the walls of the entrance to the Port Moresby General Hospital are posters proclaiming: "There's a cure for HIV-AIDS". The posters by the Revival Centers of PNG Fellowship show three smiling people who claim God had cured them of full-blown AIDS.
For those trying to educate people that HIV-AIDS is just another disease that can be treated, discretion is vital.
In central Port Moresby is a tin shed inside a compound, like many in the city surrounded by a high fence and razor wire.
The shed is the Salvation Army's HIV-AIDS care center.
There are no signs and the center is kept secret for fear the patients inside will be ostracized and become homeless.
"The relatives don't know they come here every week," said Salvation Army Major Araga Rawali.
"They ask us not to come to their homes."
People are so scared that most refuse to speak about their illness. "People watch me, it is shame (I feel)," said Anna, infected with HIV by her husband one drunken night.