Conversations with the Living: The Haitian AIDS Crisis

The official blog of Conversations with the Living

Archive for the ‘Tent Cities In Haiti’ Category

CWTL Production Diary: A Cholera Update

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Even for someone who has been following the cholera epidemic in Haiti, last weeks FSRN report on the recent increase of cholera infections was startling.

The outbreak of cholera, confirmed in Haiti on October 21, 2010, has killed 6000 people and more than 350,000 have been infected. There were 1000 new cases of the disease each day last month alone.

At the on-set of the outbreak there were several organizations focused on providing support and offering immediate and short-term, life-saving solutions, but now fewer and fewer are continuing their efforts and providing services focused on the long-term solutions.

Plans to improve conditions in Haiti exist, but progress in slow, as government agencies and non-governmental organizations have limited funding. Additionally millions in pledged aid has not arrived; money, which could be used to implement programs, including water sanitation and home reconstruction for the thousands still homeless since the January earthquake.

The cholera epidemic is ongoing and infections rates are increasing at an alarming rate. Although cholera is a preventable and manageable disease it has been extremely difficult to control, because of Haiti’s lacking infrastructure, sanitation and overall access to resources by the affected population. Medical aid and education on how to avoid infection is essential and is available in certain areas, but these critical resources and information are not reaching everyone in Haiti, especially those in rural areas where fewer services are available and resources are beyond scarce.

HAITI AND DISEASE

The report highlighted Cate Oswald who co-ordinates the Partners in Health clinics in Haiti. Oswald cited reasons for the increased infection rates; reasons that seem to parallel reasons given for high infections rates of other disease in Haiti.

The impact of the infection and its affect on Haitians has caused confusion and fear. There is an overarching theme – the way the cholera is being viewed is much like other diseases with a history in Haiti such as HIV/AIDS. The general public’s inability to cope and fear of becoming infected from sick family members and community has created a social stigma that is producing deadly results.
As a resource poor nation, Haiti has struggled to combat preventable and manageable diseases such as tuberculosis and HIV for decades, but cholera is new, and with all that Haiti has to contend with, the stigma attached to the disease has resulted in fewer people seeking help and thousands of people dying as a result. Instances of families taking people to treatment centers, only to abandon them because of fear of becoming sick or people dying in their homes, because they are afraid to admit that they have cholera are all too common and have contributed to increased infections and deaths.
RESOURCE POOR NATION

As doctors and medical facilities work to cope with the cholera infection with little to no resources, they are up against the additional task of informing the public of the proper steps to take to avoid becoming sick. Those who are aware of how to avoid infection are still faced with the reality of unavailable drinking water, soap to wash their hands, proper latrines and easily accessible medical facilities.
When it comes to day-to-day survival in Haiti, the general public remains strong and is doing what they can to get by without food, water, proper shelter and sanitation, and the greater issue of Haitian welfare remains in the hands of the Haitian government and foreign governments who have vowed to implement long overdue solutions.
And so the Haitian people wait; fear of infection is real and until the people are provided with the support and basic resources to avoid infections and feel secure, the stigma will persist and cholera, a fully preventable and manageable disease will continue to take lives.

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Increasing Threat of HIV in Haiti

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Wednesday, December 1st was World AIDS Day. Tomorrow is Wednesday, December 8th. Based on current figures, within the past week an estimated 35,000 people have died of AIDS-related-illnesses globally.

World AIDS Day is one day, every year, dedicated to raising money, fighting prejudice, increasing awareness, improving education and helping people understand the facts surrounding HIV/AIDS globally. World AIDS Day is a way to remind people that AIDS is still a serious issue affecting millions of people each year. Although numerous organizations and activists work everyday to address the issue of HIV/AIDS, the global crisis goes relatively unnoticed in the mainstream media. Oftentimes, unless directly affected, people tend to know very little about HIV/AIDS in their own communities, cities, and countries.

Throughout the world as many as 2.6 million people will become infected with HIV within the next year, that is over seven thousand people a day. There are currently 33 million people living with HIV. Last year 1.8 million HIV-positive persons died of Aids-related-illnesses. HIV is a threat to men, women and children on all continents around the world.

This year’s World AIDS Day theme is Universal Access and Human Rights, a theme explored in the documentary film Conversations With the Living: Globalization and the Haitian AIDS Crisis, which explores the current HIV/AIDS crisis in Haiti and the history of the disease there. Prior to January’s earthquake organizations like Partner’s In Health (PIH), GHESKIO and UNAIDS were making positive strides and seeing progress amongst the affected population. Now, nearly a year later, some aid organizations have redirected funds to other important initiatives, and HIV, although there is certain risk of increased infections, has received very little attention. With the recent media attention paid to the cholera outbreak and the elections, it is important to also focus on the growing concern of health care workers and patients that the constant state of crisis in Haiti is sure to lead to an increase in HIV infections and deaths if prevention and treatment do not become a focus in Haiti’s recovery.

With access to proper medication, progress has been made. That’s the challenge; making progress in all regions affected and maintaining that progress has proven difficult when conditions are deplorable and a mere portion of people in desperate need of medication have access to antiretroviral treatment.

AIDS in Haiti is as destructive as any natural disaster and has infected as many as 5 million people, and killed over 1 million people in Haiti since the 1990s.

Prior to the earthquake:

• 40% of the Haitian population did not have access to primary health care.
• Haiti was ranked 146th out of 177 countries according to the United Nations Development
Programme Human Development Index with 76% of Haitian’s living on US$2 per day and 56% on
less that US$1 per day, significantly below the poverty line.
• 46% of the entire population was malnourished, a figure the Global Hunger Index notes as
“Alarming”, and this percentage has only increased since the deadly earthquake.
• The United Nations estimates 2% of Haitians are infected with HIV/AIDS, the highest rate in the
Western Hemisphere.

An estimated 40,000 people die of AIDS in Haiti every year; grim numbers when considering the size of the country, which is roughly the size of New York City. When taking into account that a large percentage of at-risk Haitians who do not get tested due to access and fear of social stigma, experts believe the national statistic is much higher than recorded; some believe as high as 11%.

No one should ever die of a treatable disease. Haiti’s struggles with AIDS and the elements of history that have contributed to its prevalence still exist and continue to exacerbate the issue. The failure to provide access and address the societal issues surrounding HIV in Haiti only maintains and perpetuates a system that produces more death, deprivation, and disease.

– LC

Constant State of Emergency

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Photo Courtesy of Bryan Fletchall

The people of Haiti are fighters. A glimpse into the history of this proud and spirited nation will reveal that even amongst the most intense suffering; Haitian people are proud of and embrace their heritage, their culture, and their country.

There are so many incredibly beautiful things about Haiti; there is so much good lost and forgotten amidst the tragedy. As so rightly stated by Haitian-American author, Edwidge Danticat, “I think Haiti is a place that suffers so much from neglect that people only want to hear about it when it’s at its extreme. And that’s what they end up knowing about it. “

The people of Haiti are beautiful, their roots run deep, and their telling story of strength and resilience is one that has been written out of the history books. Even as they exist is a constant state of emergency, historically underserved and under acknowledged, they continue to fight and hope for a better future for Haiti and her people. Haiti’s historical suffering bleeds into the present, an ever-gaping wound of injustice, making the inaction of both Haitian and foreign governments to the continued crisis unsurprising, as it is nothing short of dismal, if not criminal.

Amongst the flooded tent cities surrounded by rubble, the cholera crisis deepens, killing hundreds and infecting thousands. Haiti has long struggled with poverty and disease, both directly linked to the nation’s history of exploitation by foreign powers with sinister agendas; agendas that have claimed millions of lives for the sake of international interests.

Curable and Manageable Disease

Curable and manageable disease has killed millions of people in Haiti and other developing countries for decades, even while the medicines to treat the affected population are available. The affected populations’ inability to access these medications is a human rights violation of the most basic and harmful kind. International government policy has long dictated access to these medications and a major component in facilitating their effective use – proper nourishment, i.e. food and water.

Impoverished governments unable to afford medications and trade agreements that have controlled the production, distribution and affordability of food and medicine have put Haiti and other developing countries in a constant state of emergency, because they have not had the opportunity to even build, let alone maintain a proper health care, industrial or agricultural infrastructure.

The current cholera epidemic in Haiti is another hurdle amongst a series of obstacles in a nation of fighters. The struggle to combat cholera is all too familiar, as Haiti has battled high infection rates of malaria, hepatitis, tuberculosis, and HIV/AIDS in the past and continues to in the present. Money and bureaucracy have always managed to hinder access to life-saving medicine, and as a result lives continue to be lost.

With limited access the major factor in determining the welfare of millions in mind, the following section discusses a pending trade agreement between the European Union and India that threatens to even further decrease access to medications in developing countries.

Pending Trade Agreement Possible Threat to HIV Sufferers

Patent laws have created a system where pharmaceutical companies stand to gain enormous profits from obtaining rights to create and distribute drugs at a price they see fit to gain profit with little regard for those who need access them. High demand equals expensive medicine and healthy profits for developers, while those who need the medications the most can’t acquire them. Simply, the pharmaceutical industry, without argument, control’s the fate of the world’s sick.

A possible international trade agreement between the European Union (EU) and India has medical professionals, activists, and patients concerned that millions of HIV sufferers in the developing world will be without the drugs they need to survive.

India’s generic pharmaceutical industry competes with these profit driven drug producers. Having been coined the “developing world’s pharmacy”, India, under its patent laws produces generic drugs that are distributed around the world, “bypassing a system designed to ensure drug developers are rewarded with a period of exclusive sales rights for new medicines.” As a result India has become the source of medicine for many of the world’s developing countries in order to treat the critically ill.

With access to generic drugs, the cost of treating patients with HIV has fallen from around $10,000 dollars a year in 2000 to just $70 a year today.

Not only has India’s generic production of medicines meant that its own population has benefitted from access to life-saving drugs, but as stated by Hans V. Hogerzeil, Director of Medicines Policy and Standards at the World Health Organization, “at least half of the five million Aids patients in Africa already on treatment rely on Indian generic medicines for their treatment.”

Although the European Union denies that the agreement will negatively impact India’s generic medicine industry, until a draft of the agreement is made available criticism and concern over its contents will continue from medical professionals, HIV/AIDS activists and patients.

Individuals infected with HIV/AIDS and other diseases can live long and productive lives if provided adequate nutrition and medicine. If treatment for the critically ill is made available and lives can been saved in developing countries where food, clean water and medical supplies are difficult to come by, a diagnosis once tantamount to a death sentence can be regarded as a manageable disease.

A link to the full article regarding the pending trade agreement is below.

Link: http://english.aljazeera.net/indepth/2010/10/2010102920031160477.html

– LC

Hurricane Tomas and Decades of Failed Policy

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The people of Haiti are dealing with the impact of Hurricane Tomas currently threatening the Caribbean nation and endangering millions of Haitians living in IDP camps who are already at risk, living in unsafe and unsanitary conditions with no protection from environmental elements.

It is reported that heavy rain, flooding and landslides have killed at least seven people. Although it appears Haiti has avoided a “direct hit”, there is pending danger of flash floods and mudslides that could threaten residents of IDP camps.

The Haitian government and UN are asking millions of Haitians to leave their tents and tarps, which have been their only form of protection since the January 12th earthquake, however much like the issue of forced evictions, the Haitian government has no plan to house or provide aid to displaced individuals. People are hesitant to leave the camps, concerned that they will lose whatever form of home they have and their few remaining possessions.

With the problems facing Haiti, many of which are issues the nation has been facing for years, including the housing crisis, food crisis, health care crisis, and an endless list of social and economic challenges, Haitians now face another natural disaster. Even if rain and flooding is minimal there is fear that the efforts to contain the deadly cholera outbreak will be stifled, an outbreak that has claimed the lives of at least “442 people and sickened more than 6,700.”

Jean-Max Bellerive, Haiti’s prime minister states, “the government is doing all it can to provide aid and better shelter to the most vulnerable, but we simply do not have the resources to help many of them.”

Haitian youth, John-Smith Deshommes, is having a difficult time understanding why one obstacle after another is putting Haitians further and further into crisis.” Things have always been difficult, but I don’t know what is happening with Haiti. Eight months ago we met an earthquake that destroyed Haiti, some months later, we met cholera, and now we are facing hurricane Tomas. Everybody is being called to move; meanwhile, they have nowhere to go and nowhere to live. Why all these problems?”

Although the January 12th earthquake and Hurricane Tomas are natural disasters, many of the crises Haiti is dealing with are man-made disasters whose causes are rooted in decades of poverty, poor governance, and policies that have resulted in Haitians being vulnerable to these environmental threats.

Any real analysis of Haiti’s issues, including the earthquake that destroyed much of the nation, the recent cholera outbreak, the damage and deaths due to the storm, and problems with avoiding additional spread of disease across the country must include an objective examination of how policy is or is not safeguarding Haiti’s citizens. A thorough assessment of the policies implemented by the government of Haiti and the international community both before and after the earthquake offer some answers to the question – Why all these problems?

Flawed policies have plagued Haiti for decades, including trade policies resulting in mass deforestation, dependence on foreign food, medicine and additional imports, questionable distribution of international aid, debt to foreign governments, and illegal elections, all of which have minimized the ability to provide and maintain basic services.

One of the main reasons for the 2010 earthquake’s lethality was because of Haiti’s extreme poverty on every level. Governmental poverty created the weak physical infrastructure that crumbled during the earthquake, and the public health system that ceased to function in the immediate aftermath of the disaster because it was already crippled to begin with. The earthquake shattered much of Haiti, but the country was broken long before the disaster struck. How many lives could have been saved had the poverty not been so severe?

Haiti is the poorest country in the Western hemisphere, a known and indisputable fact. Every country’s ability to provide a sound infrastructure is directly linked to its economy. Haiti is poor, therefore its infrastructure is lacking in every arena and currently has no ability to protect its citizens from environmental threat. Haitians can and will rebuild, but the Haitian government and international governments must be held accountable for the flawed policies of the past and for the future of Haiti as a nation. Their policy decisions affect the lives of nearly seven million people, begging the question; why is it so difficult for those in a position to radically improve these lives to do what they know is right on behalf of the Haitian people?

-LC

IDPs, NGOs and Human Rights

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Mark Schuller, a professor of African American Studies and Anthropology at York College, the City University of New York, and tireless advocate for Haitian human rights recently published the report Unstable Foundations: Impact of NGOs on Human Rights for Port-au-Prince’s Internally Displaced People, which discusses the consequences of NGO involvement in the displacement camps in Haiti.

Schuller’s research on the ground in Haiti along with eight Haitian University students and a colleague at the Faculté d’Ethnologie, Université d’État d’Haïti was conducted over a six-week period. “Quantitative and qualitative surveys were taken in three inter-related areas: conditions and services within the camps, residents’ level of understanding and involvement in the camp committees, and interviews with committee representatives.”

Results show once again that the exclusion of Haiti’s people in decisions made regarding their livelihoods and rights as citizens does very little to change the urgent situation in Haiti, and that NGO relationships with Haitians have numerous unintended negative impacts.

“Despite the fact that many NGOs empower camp committees to select recipients and distribute aid — most notably food, until the government stopped general distribution in April — most official committees do not involve the population. Less than a third of people living in camps are aware of the strategy or even the name of the committees. Two-thirds of members are men, despite well-documented concerns about gender-based violence. While to most NGOs managing camps or offering services these camps represent their “local participation,” it is clear that the present structure leaves much to be desired”.

Schuller outlines specific policy recommendations, noting that “It is not too late to rebuild on solid foundations”, but the foundations are still unstable and recovery is being hindered by the slow delivery of promised aid.

Below is a link to the report summary published in the Huffington Post and a PDF download of the full report.

http://www.huffingtonpost.com/mark-schuller/unstable-foundations-huma_b_749924.html

http://ijdh.org/wordpress/wp-content/uploads/2010/10/Report-unstable-foundations-final-2.pd

Exclusion In Upcoming Haitian Elections

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Isn’t what is supposed to be so attractive about a Democratic system of government is that the governing power is derived from the people?

If not carefully legislated there will certainly be an uneven distribution of power where the virtues of liberty, justice, and rights that are constitutionally given to the people are obstructed or even disappear. If not overseen, then a system of government could accumulate power that excludes populations, and forfeits the rights of its citizens, becoming undemocratic – sounds like the U.S. to me, but this is about Haiti.

The upcoming elections in Haiti exclude over a dozen political parties – including the country’s largest party, Fanmi Lavalas. If only we could just get rid of politicians and political parties whose interests and views don’t align with our own. If only we could completely disregard the constitution of the United States and omit Democrats and Republicans from running for political office in an upcoming “democratic” election. What of the majority rule? Who needs to represent the masses? If the masses are weak, then the powerful minority is well, powerful, and if they aren’t already wealthy, they smell money.

I smell tyranny.  This imbalance is nothing new for the people of Haiti, just another election poised to go terribly wrong. Where is the voice of the people? Silenced in a tent city? Silenced in perpetual poverty and hunger? Perpetually silenced? This question is vitally important as Haiti struggles with a natural disaster, an endless list of pre-existing and ever-growing social, economic, and medical challenges, and a history of corrupt and poor governance. 

Can they really exclude 90% of the population who might benefit from a fair election if candidates of interest were on the ballot? Why make an appearance if your constituents aren’t represented?  There is no more surefire way of controlling the outcome of an election than to make it illegal and postured for the benefit of a few candidates and their constituents. In addition, the government has yet to address how it will register and identify the nearly 2 million Haitians who lost their homes and documents in the January 12th earthquake.

If the electoral council in Haiti won’t even let the most popular party participate in the election where is the popular vote? Absent, without governmental or constitutional protections of individual liberties given to them through their constitution. Give a reason to the people for an illegal election in the guise of democracy. Give the people their country!

If an elected official of their choice does not represent them how will they really rebuild? Foreign interests and investment might appear to represent opportunity, but with the current U.S. and European monetary and political support of “illegal” elections in Haiti, and historical support of oppressive and unstable government, our interests are clearly not noble or humanitarian, as many Americans would like to believe. What are our interests? Occupy? Militarize? Industrialize? Claim and exploit resources and people? But where are the people? Do they intend to let the majority of Haitians play a part? Sadly Haiti’s history has proven the answer to be no. I fear that Haitians will continue to have very little control over their future.

Regardless of where you stand on the issues facing Haitians in the upcoming election, any election’s credibility is based on the respect of its laws and regulations.  An election based on exclusion is illegal and the people have a very real fear of where their country is headed, continued instability, oppression, and even death.

Haitians want and deserve real change. The same behavior that mirrors elections past is frightening.  Why can’t the Haitian government and international community let Haitians work to make their country a better place? What is the plan really? Let them vote without exclusion; let them work for a better Haiti. They are ready and willing.

We’ve Been Forgotten

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Today I received a text message from a dear friend in Haiti. “Please message me and tell me how you are doing. When I have minutes at the Internet café, I will respond. I hope you haven’t forgotten about me. I am still writing my stories, I hope one day you will read them. I will translate them for you. I am writing a book about Haiti. We hope for a better Haiti. My family is ok. We are tired and I would like to find work. It is difficult to have no one to count on. We miss you. We love you. When will you return?”

I stared at my phone from my desk at work, and my only concern was to respond to him immediately. We message almost daily and I slowly feel him losing hope. It is not characteristic of him, or of the Haitian people to relinquish that hope, a driving force for survival and strength when circumstances are dire. As a Carrefour native, with very little before the earthquake, he now lives like 1.3 million others in Haiti – in a tent city – with his mother and two siblings. Because of the economic struggles of his family in Haiti and abroad in the US, he no longer receives any relief, and worries for his family and his country, still buried in rubble.

He says, ” I want to study to become a doctor so I can help my country. I want to write so I can share my stories with the world. I know I have talent, but will I ever see my dreams realized?”

I have to believe he will. He can certainly count on himself if no one else, but he wants to trust someone will help, something will change, that promises made to his country are not empty.  As an educated youth in Haiti, he is not the norm, but the exception, and he knows Haiti’s people and their youth deserve better. He is amongst the many that take nothing for granted and if provided the proper tools will build a future for themselves that now seems so far from reach. He feels forgotten, and I sense through his words, it is not about him alone, it is about his country  – he feels they have been forgotten. He wants to be counted on to do great things; he wants the chance to do great things.

Something happened when the earthquake hit Haiti – the world woke up, remembered that Haiti exists, and reacted in a combined effort of humanitarian relief and compassion. Amongst the devastation lingered hope that the response from the world would not cease, that that pre-existing need in Haiti would be recognized and the urgent need to rebuild would be the fuel to power a new and better Haiti. Eight months later, not much has changed, and in a tent, only 26, he writes a fictional story about a young man near his age in Haiti who through finding love and opportunity manages to fulfill his dreams. I can only imagine where his inspiration comes from in this fictional story, riddled with the realities of his life, his hope bleeds onto the page in a haunting tale fueled by his passion to succeed in life, and be of service to his people. He is telling his story, and he is holding on to that happy ending.

He is a representation of the struggle of so many; millions with the capacity and will to rebuild a better Haiti if afforded the opportunity, millions who feel they have been once again been forgotten by the international community.

Sitting at my desk at work I e-mailed him to let him know I have not forgotten about him. I tell him if he keeps working he will succeed, to not lose hope, and that I will do everything in my power to help him. Words I hope will comfort him and continue to motivate me to continue my work in Haiti and maintain the life changing relationships that I have created with the people and organizations that work everyday for a better Haiti.

The Institute for Justice and Democracy in Haiti (IJDH) has released a report of a human rights investigation into displacement camp conditions, titled We’ve Been For­got­ten”: Con­di­tions in Haiti’s Dis­place­ment Camps Eight Months After the Earth­quake, which outlines the desperation in Haiti’s camps and promotes a rights-based approach to relief and reconstruction.

The hope is that this report will give a voice to the people of Haiti, Victims of not only the earth quake, but of a history of instability who are facing grave conditions.  Discussing the lack of basic necessities and human rights, such as food, water, sanitation, housing, medical care, education,  and  employment, while providing an approach that maintains the ever-present spirit and integrity of the Haitian people  and their desire to assist in rebuilding their nation.

Presented by the University of San Francisco, the Institute for Justice and Democracy (IJDH), Bureau Avocats Internationaux (BAI) and Lamp  for Haiti , this document can be  read and downloaded at the link below.

http://ijdh.org/archives/14678