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Posts Tagged ‘Haiti’

This post is by the Global Center’s Rabita Aziz.

Photos and video by David Bryden.

A panel consisting of Haitian HIV advocates spoke today about the situation of HIV patients in a post-earthquake Haiti at a Senate briefing called “Report from the Frontlines: Living with HIV/AIDS in Haiti Post-Earthquake.”  The briefing was sponsored by Senator Kirsten Gillibrand, a member of the Foreign Relations Committee who is visiting Haiti this week with Delegate Eleanor Holmes Norton and Senator Mary Landrieu, who sits on the Appropriations Committee.   Other sponsors include Health GAP, UNAIDS, Partners in Health and Housing Works

With an HIV prevalence rate between four and five percent in the capital of Port-au-Prince, Haiti faces an even larger HIV epidemic on top of a humanitarian crisis thanks to the 7.0 magnitude earthquake.

The panelists, two of whom are living with HIV, discussed the problems faced by people living with HIV in a country where most of the health infrastructure was destroyed during the January 12th earthquake.

While the survivors praised past U.S. contributions to the fight against HIV/AIDS, they expressed disappointment that President Obama’s FY 2010 Haiti Supplemental Request for USAID and the State Department, which includes $893 million for recovery and reconstruction efforts, has no mention of funding for responding to the HIV/AIDS epidemic. 

The panelists stated that this lack of funding could result in thousands more becoming infected with HIV, and the reversal of ground gained thanks to PEPFAR dollars.  Fewer than 40 percent of Haitians who were receiving AIDS-related care prior to the earthquake are receiving it now. 

The lack of access to treatment may result in higher viral loads in patients, which increases the likelihood for transmission.  The advocates stressed that treatment must be scaled up to save lives and prevent new infections from occurring.

At the time of the earthquake Liony Accelus, president of the HIV/AIDS advocacy group REHPIHIV, was at a Country Coordinating Mechanism meeting to decide on which aid groups would be primary recipients of Global Fund dollars.  Everyone present at the meeting began to run out as the building began to crumble.  At this point he witnessed hundreds of other people fleeing into the streets to avoid being crushed by crumbling buildings.

Liony Accelus speaks about living in Haiti after the earthquake.

Upon discovering that all phone lines were down Accelus went to his home, only to discover that it had been destroyed.  For the next week, Accelus and his family lived in the streets and slept under the stars.  He was eventually able to obtain a tent, and is living in the tent with his family to this day.  Although he continues to live in such dismal conditions, he considers himself lucky in comparison to other people living with HIV who have no access to shelter or food, let alone to treatment. 

Haiti has an HIV prevalence rate of 2.2 percent.  At the time of the earthquake, there were approximately 120,000 people living with HIV, of whom 43,000 were in line to receive treatment.  The earthquake destroyed 46 hospitals and clinics and severely damaged 38 more, and has made it extremely difficult to obtain HIV drugs. 

The panelists stated that most HIV patients are now without shelter, and on top of that face an eight hour wait in a distribution line to receive food.  These conditions will greatly exacerbate their conditions while increasing chances for new infections.

Esther Boucicault, president of PHAP+ and FEBS, both coalitions made up of people living with HIV, discussed the response by other HIV advocacy groups after the earthquake.  Boucicault first reached out to Housing Works, a cosponsor of the briefing, which helped put together three clinics to address the medical needs of HIV patients.  Partners in Health (PIH), another sponsor of the event, provided medications and ARV treatment within days as well. 

Boucicault said she received no reply from the government when her groups reached out for direct assistance.  Although these groups provided much needed assistance, they don’t have the capacity to provide assistance for the tens of thousands of patients who need it.  Boucicault stated that the earthquake had taken the lives of between 200,000 and 300,000 people, and that the same number would become infected with HIV if further actions are not taken to address the problem. 

Edner Boucicaut, chief communications officer for CECOSIDA, spoke of the high risk of new infections due to the lack of access to treatment and medications, and to proper housing.  “Conditions remain the same,” he said when speaking of the daily fight people have to endure to obtain the most basic necessities.  With just two clinics in Port-au-Prince providing HIV medications, he spoke of the daily struggle of HIV patients to get their drugs. 

He stated that marginalized groups are at a great risk to contract HIV.  In many shanty towns and tent cities, women are forced to engage in prostitution at night to obtain vouchers to get food the next morning.  Patients living in close quarters with relatives face stigma and discrimination when their HIV status is disclosed to relatives. 

Dr. Wesler Lambert, director of monitoring and evaluation for Zanmi Lasante, PIH’s flagship project in Haiti, gave an account of how PEPFAR funding has turned around Haiti’s HIV epidemic in recent years.  Zanmi Lasante provided ART to 2,377 patients in 2006, and that number jumped to 4,716 in 2009 due to PEPFAR funding.  While more than 39,000 were tested and received counseling in 2005, more than 77,000 received the same services in 2009. 

The organization has set up mobile clinics in Port-au-Prince since the earthquake, and has treated over 45,000 patients.  Of the 4,127 tested for HIV, 75 tested positive.  Dr. Lambert called for an increase in PEPFAR funding to address the emerging threat of new infections caused by the failure of health systems.

John Hassell discusses the need for increased funding to respond to the HIV situation in Haiti.

In his closing remarks John Hassell, the Washington director of UNAIDS, expressed his concern over the lack of language about HIV/AIDS in the 2010 Haiti supplemental funding request.  No funding is included to help rebuild the HIV response through PEPFAR.  PEPFAR dollars allocated to Haiti for this year are insufficient to meet the increased post-earthquake needs for reconstruction of physical infrastructure, recruitment and employment of health workers, and purchase and distribution of commodities such as condoms and drugs. 

The organizations involved in the briefing recommend that an additional $100 million in supplemental funding be included for FY 2010 to rebuild clinics, provide drugs, train health workers, and set up prevention programs.  UNAIDS has released a paper which provides a situational analysis of the AIDS response in Haiti, and details what needs to be done to deal with the problem.  The paper can be found here

Watch Esther Boucicault discuss the AIDS response in Haiti after the earthquake here.

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Where is the plan for Haitians living with AIDS?

That was the question posted last week by a Haitan protest delegation, which convened at the United Nations to demand attention to their plight.

“The protesters said that uncoordinated relief efforts are leaving Haitians vulnerable to AIDS and endangering Haitians living with the disease,” reports Housing Works’ blog. “Activists are demanding that the U.N. and the U.S. adopt and execute a targeted relief effort before it’s too late.” Read the full story from Housing Works here.

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Amid the continuing effort to provide desperately needed medical care to earthquake victims in Haiti, the CDC today released guidelines for clinicians traveling to Haiti and for those treating patients returning from the country.

This link lists some of the infectious diseases, such as tuberculosis, that providers may encounter while treating refugees or returning relief workers. And this link includes guidance and resources for clinicians who want to help with the US response, including what vaccines are needed and other advice.

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Coping with HIV/AIDS in Haiti is difficult enough in normal times. But post-earthquake, getting access to care and life-saving drugs has suddenly become much harder.

In response, Housing Works and other HIV groups have launched a new effort to help people with HIV/AIDS in Haiti. “We have formed a coalition with Aid for AIDS, Diaspora, and the Caribbean Women’s Health Association that is going to facilitate the opening of PHAP+’s clinic for people living with AIDS and HIV,” writes Housing Works President Charles King in this blog, posted as he returned from a trip to Haiti’s ravaged capital.

“We are also going to support the reopening of the Diaspora-sponsored family health center, and we are going to help the folk in San Marc assess their need for a clinic for PWA’s who have fled to that City.” Click here to read more of King’s posts on his trip to Haiti or here to find other ways to help with the medical relief efforts in Haiti.

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“Please save my baby!” Jeudy Francia, a woman in her 20s, shrieked outside the St.-Esprit Hospital in the city on Wednesday. Her child, a girl about 4 years old, writhed in pain in the hospital’s chaotic courtyard, near where a handful of bodies lay under white blankets. “There is no one, nothing, no medicines, no explanations for why my daughter is going to die.”

That gut-wrenching scene is from this morning’s New York Times, one snipet among thousands demonstrating the urgent desperation facing residents of Haiti’s capital city in the wake of Tuesday’s earthquake. Tens of thousands dead. Three million people affected. Those are initial estimates of the terrible damage wrought by the 7.0 quake.

What can you do? The U.S. Agency for International Development, with its newly confirmed chief, is heading up the US response. Two leading nonprofit medical groups are also deeply involved in the relief effort—Partners in Health and Doctors without Borders. Both are seeking immediate financial help.

Here’s some info from each group about what they are doing and how you can help.

From Partners in Health:

“We have already begun to implement a two-part strategy to address the immediate need for emergency medical care in Port-au-Prince. First, we are organizing the logistics to get the medical staff and supplies needed for setting up field hospital sites in Port-au-Prince where we can triage patients, provide emergency care, and send those who need surgery or more complex treatment to our functioning hospitals and surgical facilities. To do this, we are creating a supply chain through the Dominican Republic. Second, we are ensuring that our facilities in the Central Plateau are ready to serve the flow of patients from Port-au-Prince. Operating and procedure rooms are staffed, supplied, and equipped for surgeries and we have converted a church in Cange into a large triage area. Already our sites in Cange and Hinche are reporting a steady flow of people coming with medical needs from the capital city. In the days that come we will need to make sure our pharmacies and supplies stay stocked and our staff continue to be able to respond.”

To donate click here and for more info click here.

From Doctors without Borders:

“There are hundreds of thousands of people who are sleeping in the streets because they are homeless,” MSF coordinator, Hans van Dillen, said. “We see open fractures, head injuries. The problem is that we cannot forward people to proper surgery at this stage.” First reports are now emerging from MSF’s teams who were already working on medical projects Haiti when an earthquake measuring 7.0 on the Richter Scale struck the country early January 12. MSF staff immediately started treating hundreds of people injured and have been setting up clinics in tents to replace their own damaged medical facilities.

To donate click here and to learn more click here.

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A delegation of HIV-positive Haitains recently visited Washington to lobby for robust funding for PEPFAR. Read their compelling stories in this blog, which details how HIV-positive patients have access to HIV drugs but not necessarilly to a glass of water to wash the pills down or food to make the medicines tolerable and effective.

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Did Paul Farmer get a consolation prize from Bill Clinton? That’s one possible reading of the news that the ex-president appointed Farmer, founder of Partners in Health and chair of Harvard University’s Department of Global Health and Social Medicine, to be UN deputy special envoy to Haiti.

Until last week, Farmer was rumored to be the leading candidate to head USAID, but then Farmer either pulled out, or the Obama Administration yanked him from the running. The Haiti post is certainly a good fit for Farmer, who has spent decades working in that country, pioneering innovative ways to treat HIV & TB in resource-poor settings. But deputy UN envoy is not quite the powerful perch some global HIV and TB advocates had envisioned for an infectious disease doctor who had dedicated his career to strengthening health care in the developing world.

Click here to read the UN news release about the appointment or here to read the AP story about Farmer’s new title.

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