Providing Treatment and Restoring Hope in Haiti
November 17, 2006, Fonds des Negres, Haiti —
The image of teenage students tending small crops behind their school is a lasting memory for Mychelle Farmer after her most recent trip to Haiti.
The students were preparing to plant dozens of young olive trees. And small piles of okra, habanero peppers and peas were set aside for consumption or sale at local markets, Mychelle, a CRS program specialist, remembers.
The agricultural program at the Armée du Salut-Desruisseauwas school was established by Bethel Clinic, a full-scale medical facility located in the rural Fond des Negres area of southern Haiti. The program is part of the clinic’s multidimensional approach to helping families and children overcome the many ripple effects of AIDS.
Any one of the students may be HIV-positive themselves, or come from a home where their parents have died or are ill from the disease. Learning how to till crops is one way the students can provide both income and food for their families — not only now, but for years to come.
This program and others like it are open to all interested students. Such inclusiveness means that students affected by AIDS aren’t stigmatized. As the students worked diligently in the garden, Mychelle says, they exuded the confidence of building for their futures.
“You got a sense that they have a little bit more community awareness, a sense of comfort and empowerment,” Mychelle remembers.
With the support of CRS staff in Haiti, Bethel Clinic offers food assistance, educational support and outreach to families caring for orphans. Like the agricultural program, the activities are designed to provide a range of support to individuals and families affected by AIDS.
According to UNAIDS, the Joint United Nations Programme on HIV and AIDS, an estimated 190,000 of Haiti’s 8.5 million people live with HIV. And that number would be even higher if more people were tested.
Yet despite Haiti’s extreme poverty, high HIV infection rate and political instability, the Bethel Clinic and its CRS-led programs offer a beacon of hope.
Much of Bethel Clinic’s HIV and AIDS programming is supported by CRS. In 2004, CRS initiated the AIDSRelief program, a five-member consortium led by CRS that delivers lifesaving antiretroviral therapy to poor and underserved men, women and children in nine countries in Africa, Latin America and the Caribbean. CRS Haiti has an active AIDSRelief program, and Bethel Clinic is one of its clinical partners. CRS Haiti also manages additional grants that strengthen Bethel Clinic’s programs for orphans and vulnerable children.
The clinic has a long-standing partnership with CRS, but the bulk of new funding for these programs started about three years ago, says Dorothy Brewster-Lee, HIV and AIDS technical advisor for CRS.
At first, programs for adults and children were addressed separately. But about six months ago, the Bethel Clinic staff and CRS agreed to integrate the programs, allowing them to meet a broader range of needs.
Voluntary counseling and testing are fully integrated into the clinic’s programming. Bethel provides same-day service to all patients, and treatment support specialists make frequent visits to patient homes. Support and education groups meet weekly, and patients receive reimbursement for transportation.
Bethel Clinic now serves more than 800 patients, but anticipates expanding its reach to 3,000 by 2008.
In addition to volunteers, Bethel’s staff includes three physicians, five nurses, 26 nurses’ aides and six lab technicians. Comprehensive medical care is available seven days a week, 24 hours a day.
As a result of the clinic’s patient education efforts, more people are coming in for counseling and testing. And stigma is noticeably reduced in the community, so much so that local ministers are now encouraging their church members to be tested for HIV before they marry.
Even so, Dorothy says stigma attached to HIV and AIDS still keeps many adults and children from getting tested.
Children orphaned by AIDS, for example, are often not told the reason their parents died. Often these children are not tested until they are gravely ill.
But as a result of Bethel Clinic’s success in reaching out to the community, more people living with HIV and AIDS are speaking openly about their status, while more uninfected people are treating them with dignity and acceptance.
Everyday stories of acceptance are encouraging: A local school teacher testified publicly of his HIV status and was allowed to continue teaching. A pastor retained the woman that cleans the school after she revealed her positive status. A mother in a crowded clinic waiting room said loudly to a health worker, “I cannot breastfeed because I’m positive.”
The medical staff reports nearly 100 percent compliance among patients receiving treatment, including a reduction in HIV-related opportunistic infections. In fact, patients are improving so quickly and at such a high rate that the clinic’s administrator says he didn’t have a chance to take “before” photos to document the transformations.
Of course, success increases demand, and the clinic’s waiting lines are longer than ever. Sometimes patients arrive as early as 5 a.m.
With AIDSRelief, many more patients will receive antiretroviral drug therapy. As a result, more patients can think about the future in a way they couldn’t dare before. Bethel Clinic’s health care team is encouraged by the new treatment programs it can offer its patients — and its role as one of Haiti’s many sources of hope.