SIDA

AIDS is a taboo subject here. I found out yesterday that people who are dying of AIDS or infected with the HIV virus are not told that they have AIDS – only family members are privy to that information. As an explanation, I was told “people die faster if they know what they are sick from, so they are not told so that they do not give up.”

This logic is so flawed that needn’t be discussed here – but the concept is no less disturbing. In an English lesson yesterday with two aspiring interpreters, we went over the chapter on health related terminology (I figured I could pick up some Creole at the same time). When we got to the word AIDS (sida, in Creole), I asked them. “Is there much AIDS in Haiti?” Jean-Willy responded, “Well, people say that the tests come up positive, but how can we believe them because no body here is dying from it.” That is disturbing.

One non-profit estimate that there are 190,000 people living with HIV in Haiti – 3.8% of the adult population - and 16,000 deaths a year from it. However, I am not sure that I trust these statistics. Tests for HIV are hard to come by and people are even more reluctant to go for testing because after a positive outcome – many services are rendered impossible, not to mention the social ostracism that must ensue. The EMT who is traveling with us explained to me that at the hospital in Gonieve where he had previously done some work, the surgeons did not perform surgery on HIV positive people out of fear. In this small village of LaCroix, I know of one woman who is dying (although she does not know it is from AIDS) and two who just died, orphaning a two year old who visited our clinic (he looked healthy, which is a good sign).

There is no public campaign here, from what I can see. There are no signs like “SIDA kills”, or a drawing of a scary monster chasing a healthy white blood cell present on the streets. I have not seen one condom at the clinic or on the street as trash. None of my patients report using condoms – if they are honest about having sex to begin with. In a conversation with Pastor Pierre, who is the resident expert on many topics, he said, “all the cases of HIV in Haiti come from people who travel to the Dominican Republic.” While there truth to the transmition via Dominican prostitutes and Haitian truck drivers, it is not good that the most educated man in town believes that if someone hasn’t been to, or isn’t sleeping with someone who has been to the DR, that there chances are nil. 190,000 people suggests that it is more wide spread.
I worry that it will become a public campaign when it is at crisis proportions. Dating publicly before marriage here is not ok – but people are certainly having sex. Haitian thoughts about the disease are mixed with ideas of voodoo causing sickness, of fear, of social taboos around sex, and most importantly, of a gaping lack of sexual and basic education. This is not the trip to tackle it – but it is on my mind and repeated fungal infections and thrush in young adults makes me wonder…