November 1, 2012
November 1, 2012
JÉRÉMIE, HAITI – A health care worker wearing a stethoscope around his neck sits in his office at a clinic in Jérémie, a small town in southwestern Haiti, on an overcast and rainy day. Declining to be named because of patient confidentiality requirements here, he recounts patients who have died of AIDS, leaving orphans behind.
He first talks about Wanitha, who died of AIDS at age 49.
“She left five children behind,” he says. “The children’s father had died some time ago, also of AIDS.”
The clinic had provided her with extra food and a hygiene kit, but her health continued to decline until she died.
“Wanitha was the sole support of her family,” says the worker wearing a brown shirt, blue pants and black shoes. “That is how HIV/AIDS makes Haiti’s misery even worse.”
Tears well up in his eyes as he talks about how HIV and AIDS are ravaging his country, both in the city as well as in the countryside. His voice changes, and he pauses before continuing.
He pulls out a patient’s chart and puts it on his desk. Then, he pulls out a second chart. He stands up and then sits down again.
He says that HIV and AIDS are a crisis for a vulnerable country like Haiti. Orphans of parents who die from AIDS are especially vulnerable.
“With the misery and poverty that exists in the country, the parents abdicate their responsibility for their children,” he says. “That’s the reason girls go into prostitution.”
He says that people living with HIV need to act more responsibly.
“When a guy has some money, he sleeps with every young girl, even when he knows he is infected,” he says.
He mentions one man in particular who was financially well-off and knew that he was HIV-positive.
“This guy had a wife and maybe two, three or four women on the side,” he says with sadness in his voice. “I would like to know where that will end. Isn’t it a crime that should be brought before a judge?”
He recounts an incident from 2011.
“Three pretty women from Jérémie who knew they were HIV-positive, and people in Jérémie know them, they came with three tents and set them up on the beach,” he says. “They attracted people. Young guys went in and out of the tents.”
He says authorities in Jérémie received word about the operation.
“Thank God, hospital personnel along with the civil protection agents and the police came out to the beach, tore up the tents and took them to jail,” he says.
This health care worker says that it’s important that the Ministry of Public Health, the mayor’s office, the Department of Civil Protection and the police track people living with HIV who are trying to infect others.
“These people who are infected tend to move to [an]other area once people in their area know of their status,” he says. “They then take partners in their new environment.”
He says that current education is not enough.
“Even though people with positive HIV status receive a lot of education, they are a great danger to the community, who already has a good number of people who are infected,” he says.
Orphans whose parents or guardians have died from AIDS in Haiti struggle to obtain basic amenities such as shelter, food and education. Citizens attribute the transmission of HIV locally to multiple sexual partners and resistance to or lack of awareness about contraceptives and testing. Health care professionals recommend education and improved care to reduce the number of deaths from AIDS. The government and nongovernmental organizations have launched initiatives to raise awareness and to support parents living with HIV and/or AIDS.
HIV prevalence among adults ages 15 to 49 in Haiti is 1.9 percent, according to UNICEF.
The number of deaths caused by AIDS in Haiti increased from about 500 in 1990 to about 8,000 in 2002, according to the World Health Organization. But the number has since leveled and even slightly declined to 7,000 as of 2007.
There are 93,000 children who are orphans because of AIDS in Haiti, according to the Joint United Nations Programme on HIV/AIDS.
Franck Jean, a nurse who works in Dame-Marie, another small town in southwestern Haiti, says that the conditions under which HIV orphans live is inhumane.
“As a professional, it breaks my heart when I see a parent die of AIDS and leaving a house with children behind,” he says.
He sits with two other young men and protects his eyes from the sun with his hand. These children who have lost one or two members of their families already know a lot of pain, he says.
Without parents, they do not get any affection. Some live on the street, some stay with other community members in poor conditions, and others receive shelter from local organizations.
“Kids do not know anything, and they should not be victims,” he says.
The government needs to take care of these children, make sure they go to school and have enough to eat, Jean says. Haitian parents also must take care of themselves so that they can care for their children.
“I think the parents need to make a lot of effort so that the lives of their children are protected,” he says.
Young people in Haiti attribute the transmission of HIV to economic hardship, multiple sexual partners, and lack of awareness about or resistance to contraceptives and HIV testing.
Monique Janvier, a 29-year-old woman who lives in Dame-Marie, holds a small child by the hand. She says that women are the primary victims of HIV in Haiti because the economic power is concentrated in the hands of men. Because of this economic power, men can have sexual relations with two, three or four women at the same time.
It is difficult to get them to use condoms or to take an HIV test in order to prevent the transmission of the virus, says the tall woman wearing blue pants, a white blouse and black shoes.
“I live in fear because I see what AIDS does,” Janvier says. “And the guy I am living with is not faithful, and he never wants to use protection.”
But Sherlie Sully, a 19-year-old woman wearing a gray hat, a white dress and sky-blue sandals, says that HIV victimizes men more than women because women nowadays are the ones who are not faithful to their partners.
“Long time ago, it was the guy who had several women at the same time,” she says. “But now, it is the women who go out with four guys.”
Meanwhile, Simeus Charles, a young man who lives in Anzdeno, a fishing village southwest of Dame-Marie, attributes the spread of HIV to the lack of formal sexual and reproductive health education in school.
“They do not know that an HIV test should be taken every three months and that there is no cure for the illness,” says Charles as he sits on the veranda of his yellow and green house. “They have sex without protection, and even if they take the test, they don’t know that their partner also needs to be tested.”
People are resistant to getting tested, he says.
“I know the cases of several women who are pregnant, and when the doctor tells them they are infected and need to bring their partners in for testing, they refuse,” he says. “That’s a lack of education.”
He says that the lack of education is especially noticeable among young people, more so in rural areas. Because of this gap in information, many do not believe HIV or AIDS exists.
The lack of information leads others to believe that AIDS is the consequence of a spell. Because of this, young people do not know that they need to protect themselves while they are sexually active, even if they know they are infected.
Charles calls for a collaborative effort by the government and health care personnel to educate young Haitians in order to stop the spread of the virus.
“People living with HIV need information and education, that’s true,” he says. “But it is better we put more stress on those who are not infected yet.”
Georgeman St. Louis, a health care worker who works for the Ministry of Public Health, says education is important for people living with HIV and AIDS too.
“They are people,” he says. “They have the right to food, to go to school, to get health care and to live well.”
It is important that people living with HIV as well as the orphans of parents who have died from AIDS get the social and moral support they need, he says.
“I think if we educate people living with HIV, they live better,” he says. “And we are protected better also.”
St. Louis asks the state to introduce an educational program for adults as well as for children.
Jean asks the Ministry of Public Health to create support groups in every community for people living with HIV to provide them with moral and psychological support. He also asks the ministry to make sure they have information about nutrition and access to healthy food.
“Help them in any way possible,” he says. “To help people living with HIV, to help them live long lives helps protect everybody. They are people too.”
He also recommends practicing safe sex.
“But let’s not have sex without protection,” he says. “Use condoms, because life can be good.”
Marie Gersky Lourdy Vendredy, a student at the School of Nursing in Jérémie, says that the Ministry of Public Health has a program for people with HIV and/or AIDS. The program offers patient education, nutritional support and medication.
“In all public hospitals, the Ministry of Public Health has a department that takes care of patients living with HIV/AIDS,” Vendredy says. “That is very important work that is done in Haiti because it allows patients living with HIV/AIDS to live longer.”
At times, the ministry will also pay for the funerals of people who die of AIDS and pay for orphans’ school fees.
There are also various successful nongovernmental initiatives.
Nelie Chery, 28, a nurse who works with Fondation pour la Santé Reproductrice et l’Education Familiale, says that the organization’s objective is to raise awareness about HIV prevention.
Chery says that the foundation focuses on educating teenagers. It also strives to mobilize the community at large through meeting with community associations and using megaphones to disseminate messages about HIV in local neighborhoods.
“We believe that we have been able to slow down the spread of HIV in Jérémie,” Chery says.
Marie Ninoche Emile, a nurse who works with Catholic Relief Services, says that the international humanitarian agency has a special program in Jérémie called the Community Health and AIDS Mitigation Project. The goal is to reduce the impact of HIV and AIDS on the community.
“CRS supports, enables and trains people living with HIV to reduce the level of infections,” she says.
The organization also supports the families of people living with HIV by paying school fees for children, supplying food, giving lessons on health-related issues, providing psychological support and conducting home visits.
The Haitian Health Foundation in Jérémie, which works to improve local health, organizes soccer tournaments every summer for girls, who don’t usually play soccer in Haiti. In order for the girls to qualify for a spot on one of the 27 teams, they must take a course in sexuality and self-care, which covers HIV and AIDS. Organizers also broadcast health messages regarding HIV prevention over the loudspeakers to the thousands of spectators who attend the soccer tournaments.
Editor’s note: Renate Schneider, country editor of the Haiti News Desk, was formerly the director of the Haitian Health Foundation’s Center of Hope. She has not had ties with the center since 2009.