In Support of those with AIDS
Constantin was over 6 feet tall, broad-shouldered, a big smile and a bigger heart. He was my personal "guardian angel" when I first arrived to live in Haiti. Then he got sick. I'll never forget the day, lying flat on his hospital bed with his hands to his eyes to block the tears, when he whispered the dreaded name of his disease: "SIDA". (AIDS in French.) He said, "The doctors said there is no hope for life."
-Valerie Mossman-Celestin, Executive Director, HEARD for Haitians
AIDS and Attitudes
In Haiti, it is estimated that 10.5 percent of the population will be infected with HIV/AIDS by the year 2015. The incidence of tuberculosis, a common secondary disease prevalent in HIV-patients, is endemic and today is the sixth largest cause of death in Haiti.
Constantin was admitted for tuberculosis. Once the diagnosis of HIV was made, the attending physician REMOVED him from tb treatment because, in her opinion, treating a walking dead man was a waste of time and precious drugs. An expedient death was the desired outcome in the interest of public health. Prevention of transmission was the only 'treatment' available to the poor. The prevalent medical community attitude towards the treatment of AIDS in third-world countries has been that it's "too expensive" and that treatment will not be effective because the illiterate poor will not adhere to the prescribed regimen of taking the drugs on a daily basis, in measured doses, and they would suffer undesirable side effects because they lack adequate levels of nutrition.
Compounding the issue, a common societal attitude of ignorance regards AIDS as a 'punishment' for poor personal choices, stigmatizing and isolating the individual. In the case of Haiti, the punishment, stigma and isolation was cast upon a nation, identifying them as one of the '4 HIV risk factors': homosexuals, hemophiliacs, heroin users and Haitians.
The medical staff would pass by the door to Constantin's room, unwilling to enter. Only Constantin's closest family and friends knew the true nature of the disease that claimed his life within weeks. Constantin feared the rejection of his neighbors, of the congregation members that gathered at his house porch to pray, of rejection that could carryover to his wife and three sons following his death. Constantin died in secrecy and shame.
The medical records indicate Constantin died of AIDS with complications of tuberculosis, but the true, insidious and intertwining roots of Constantin's death are inequality, poverty, and social stigma. We cannot accurately count how many 'Constantin's' are suffering in silence throughout Haiti's plateaus, mountains, or sprawling slums-not because they are ignorant of their disease-but rather because of their knowledge that "there is no hope."
Hope is Sprouting
Limited progress is being made in bringing equitable AIDS treatment to third world countries. Innovative community health worker models have had tremendous success. Patients fortunate to receive the anti-retroviral drugs are 'miracle' stories to their neighbors, as they are transformed from walking skeletons to healthy, contributing members of the community.
Max Clersaint lives in Les Cayes, the third largest city in Haiti, located in a coastal plain along the southern pennisula. He tested HIV-positive in 2003. Les Cayes has no AIDS clinic to provide T-cell testing or anti-retroviral drugs, but a clinic had recently opened in Port-au-Prince, five sweltering and body-jolting bus ride hours away. The cost of transportation was prohibitive. Max was too ill to work and provide for his wife and children. The family was hungry, but a choice was made for treatment. After 5 hours of travel, Max waited hours in the waiting room, hoping for a chance to be seen the same day and catch the late bus because he had no money to stay the night. Max was seen and has been closely monitored since for changes in his t-cell levels and development of secondary infections.
The availability of skilled medical personnel, diagnostic equipment and drugs-coupled with Max's personal perseverance and family sacrifice in seeking out the highly-limited resources-have made Max one of the walking 'miracles.'
Max has chosen to share the miracle of his life to reach out to others. He started speaking out in churches, acknowledging his infection and advocating abstinence before marriage to youth. Clinique Lumiere in Les Cayes hired Max to admit patients for HIV testing, to counsel those who test positive and to educate them that HIV doesn't have to be an immediate death sentence.
Max's approach to AIDS includes pastoral care, treatment and prevention. His first response is always to spiritually minister to the person first: do they have Jesus in their life? He initiated an HIV/AIDS support group. Participants are served a meal at the meeting. They pray together and encourage one another.
Max began actively working in the community to identify HIV-infected individuals-the hidden 'Constantin's.' Many of them, along with their families, are resigned and without hope. If they have knowledge of where to get treatment, they have no money or strength for the journey. Another AIDS clinic opened in Fond de Neg, an hour's drive from Les Cayes. Max and missionary Rod Wray, of Lumiere Medical Ministries, developed a relationship with the Fond de Neg clinic and began referring and transporting HIV-positve patients from Clinique Lumiere to Fond de Neg for treatment. Clinique Lumiere has a limited community health worker program; therefore, each patient must be accompanied by a family member who is capable of learning and administering follow-up care. More 'miracles' are blossoming through the tireless efforts of Max and Rod.
"Sonel is the man on the back of the motorbike with Max. He was dying with AIDS 6 months ago. He lives in a village about 1-1/2 hours from Les Cayes. We had told the family members that Sonel needed to start the ARV medicine at Fond De Negres Hospital, but the family and Sonel himself had accepted the fact that he was going to die. Max went and got Sonel on the motorbike, and got him started on the medicine, and today, Sonel is healthy, and strong. He has made an amazing recovery, and all the family and neighbors are amazed and it is a great testimony of God's power."
Rod Wray, Lumiere Medical Ministries
Children are too often the victims of this terrible disease:
"Last week Max got word to us that Pepetit a 12 year girl who lives near us, was very sick. Her mom died not too long ago of aids and so Rod took the children to be tested. Pepetit and her 9 year old brother both have aids. Rod and I took the motorbike down to her very poor little hut to find Petpetit sitting in a fragile looking chair out in the yard. She cried steadily throughout the visit, but as we visited and Rod gave her some toys, the crying faded. As she cried we could see the bad sores in her mouth and she complained of bad headaches and a very sore stomach. What a terrible disease!
The next day we brought the family a sack of rice and beans, hoping that they would make it for her and she would gain strength. After visiting a third day and seeing her wrapped in a sheet on her makeshift bed, Rod also took a "sport drink" which are full of nutrients in hopes that Petetit could swallow some. As she struggled to swallow, Rod watched and waited for her to take some. We knew that if we left, other members would drink it as they are all very hungry and desperate for their own survival. After a few days of taking the drink, she is sitting up again and even has the occasional smile. She is very fragile, and weak, but she is fighting to stay alive."
An Once of Prevention is Worth a Pound of Cure!
Camp Elim is a facility that provides an opportunity for young people to go to camp for one week during the summer vacation. Most of the young people are between the ages of 15 to 25 years old.
This year as part of Clinique Lumiere "AIDS" program, Max and Rod put together a drama team featuring a presentation about sexual purity, abstinence until marriage, and faithfulness after marriage.
The skit was performed across six weeks of camp, to a total audience of 753 campers. These youth came from many different areas of southern Haiti, and they will carry the message of abstinence and sexual purity back to their homes and communities.
"Our goals are to continue presenting the message in churches, and communities here in Southern Haiti. We are hoping to make some videos showing the reality and seriousness of "AIDS". Today we just heard of two young people who are going to be married. Before getting married, the pastor advised them to be tested for aids. The results were that they are both positive." Rod Wray
Max and Rod are managing the components of the AIDS program: support group, transportation to treatment, limited food supplies, and drama team on $400 US per month. It's not nearly enough. Transportation expenses: to receive ARV drugs and t-cell monitoring, to make community visits, to transport the drama team to camps and churches-drain the majority of the budget-and there an increasing number of families whose lives depend on accessibility to the drugs. Max and Rod need immediate monthly pledges to Clinique Lumiere's AIDS program to maintain and grow the service. Every dollar makes a difference!
Photo: Les Cayes girl whose father died of AIDS and whose mother is HIV-positive
Consider: 850,000 HIV-positive individuals in a population of greater than 8 million by the year 2015. If on average, each of these persons is part of a family unit of 6, an infection rate of 10.5% will directly impact 4.5 million family members. Fully half of the already impoverished population pushed deeper into the cycle of poverty as the meager daily earnings are slashed by incapacitated parents. Children, if not also infected, will suffer greater malnutrition and lack of education. More young women and girls will turn to prostitution as a means to survive. Orphanages will grow faster than hospitals or schools. Is there an option for the poor? Yes. Education, equal access to anti-retroviral drugs, nutrition and medical care.