Turning the tide on tradition
by Catherine Lengyel
One of the biggest clouds threatening
the Caribbean horizon is the growing prevalence of HIV/AIDS.
The Dominican Red Cross, part of the Caribbean AIDS Network,
is tackling the problem by supporting people living with the
virus and running prevention programmes to curb the infection.
Teresa is a trim, petite Dominicana. Her face is lively and
her eyes sparkle as she agrees, after the briefest of hesitations,
to tell us her story. It is a story like so many others, although
the pain - and the courage - are uniquely her own.
"Something was wrong. I could tell. So I listened on
the phone extension. That's how I found out that my husband
had AIDS. He had known about it for months and had not told
me. I felt cold all over. I knew that I must have it too.
Six months later, he died."
The statistics are alarming. The Caribbean is the second
most affected region in the world, with an overall prevalence
of HIV/AIDS of approximately 2.2 per cent among adults. According
to the latest UNAIDS/ World Health Organization (WHO) figures,
at the end of 2001 there were approximately 420,000 people
in the area living with the virus - although some put this
figure at closer to 700,000. Today, AIDS is the leading cause
of death among 15-44 year olds.
The truth about AIDS
As the HIV/AIDS pandemic in the Caribbean and throughout
the world reaches massive proportions with little sign of
abating, the need for a global response is vital.
This year the Federation, in collaboration with 60 National
Societies, launched a worldwide campaign to reduce HIV/AIDS-related
stigma and discrimination, "The truth About AIDS. Pass
it on...". The tragedy of AIDS is that while stigma and
discrimination have many different forms, the end result is
the same. The infected and sick - and often their families
- are shunned, ostracized, even denied access to social and
Attacking stigma and discrimination against those living
with HIV/AIDS is not enough on its own. That is why this campaign
includes a three-fold approach that also supports prevention
programmes and care and support for those already infected
by the disease.
As secretary general, Didier Cherpitel, explained in his
speech to launch the global campaign, "For 'The truth
' is that it is sweeping away whole generations
of young people; it is making orphans of millions of children;
it is destroying communities; it is impoverishing countries.
'The truth about AIDS' is that stigma and discrimination against
people living with the disease are fuelling the pandemic and
condemning millions to misery, fear and loneliness."
For more information on the campaign visit the Federation's
web site at www.ifrc.org
Lucas, a Dominican Red Cross volunteer, sits in front of
one of the banners used in the campaign to raise awareness
about HIV/AIDS and drug abuse among the country's youth.
Price of silence
In the Caribbean, HIV/AIDS is something one simply does not
talk about. Strong cultural taboos prevent people from dealing
with the problem openly.
Support, back in 1997 when Teresa found out, was not readily
available and remains insufficient. Teresa is quite graphic:
"There was a lot of whispering in the neighbourhood,
but I carried on as if nothing was wrong. I made sure that
I looked good and smiled a lot. After three months, my neighbours
started talking to me again. But not about HIV. I haven't
told my family either. I only allow myself to cry at night,
when my children are asleep."
In some ways, Teresa is one of the lucky ones. The Dominican
Republic, which has the third highest rate of reported HIV/AIDS
in the Caribbean (estimated at 2.8 per cent) after Haiti and
the Bahamas, is one of the countries that is trying to face
up to the problem. There is HIV testing for pregnant women
and a law on HIV/AIDS which deals with diagnosis and reporting,
prevention measures, and individual and collective rights
For Teresa, there was eventually a helping hand that pulled
her into the Dominican Network of People Living with HIV/AIDS
(REDOVIH+). From there, she arrived at the Dominican Red Cross,
where she now acts as a volunteer counsellor.
Franklin Gomez, national director of the Dominican Red Cross's
health department, explains that the National Society has
been active on the HIV/AIDS issue since the epidemic was first
identified in the early 1980s. "Today, I can say that
the Dominican Red Cross is one of the institutions most readily
identified with HIV/AIDS-related work - because of the security
of our blood bank, our readily accessible and confidential
testing facilities, our volunteer training programme, as well
as our growing commitment to advocacy." He is proud of
the changes he has seen within the organization over the years
and of the National Society's continuing commitment.
Ruben del Prado, UNAIDS inter-country programme advisor for
the Caribbean, does not mince his words. "The Red Cross
is traditional, it has dignity, it has respect. It has National
Societies everywhere and volunteers who actually capture the
power of humanity. It is one of our most important partners
in the Caribbean."
A woman's problem
As always though, there are crucial gaps in the system and
women are particularly prone to them. Of particular concern
is the dramatic and constant increase of HIV/AIDS among women
and girls. In the Dominican Republic alone, ten years ago
there were seven men living with the virus for every woman
similarly affected. Today, women have achieved an unhappy
parity - a result of both their greater physical vulnerability
and lack of power to negotiate safer sex practices with their
male partners. Furthermore, as the number of HIV-infected
women grows, the number of children born with virus also increases.
Lissette, ex-president of REDO VIH+, explains that although
treatment for HIV-positive pregnant women is now available
in the Dominican Republic, free access to milk is not. Many
women cannot afford to buy it and, again, attitudes play their
part. "In the same way that 'real' men do not use condoms
in our culture, because it's not macho, so women have no option
but to breastfeed despite the risks to their newborn. They
are often frightened to admit to their husbands that they
are HIV-positive - even though he is most likely the cause
of their infection," she explains wryly.
The numbers coldly reflect the attitudes. At the end of 2001,
UNAIDS estimated that there were more than 20,000 children
living with HIV/AIDS in the Caribbean - of whom 5,800 were
in the Dominican Republic.
"If our parents hadn't had so many taboos, there would
not be so many problems in our communities today", says
Jonathan Sanchez, a youth educator with the Dominican NGO
PROFAMILIA. "The problem is that youth don't want to
know. They think condoms are uncomfortable and they certainly
don't want to be preached at adults. They think it's all a
lie, a strategy to get them to 'behave'."
Reaching out to young people is a national priority and the
Red Cross is a key partner for youth-related prevention programmes.
Federation regional health delegate, Raul Gallegos, confirms
that providing young people with candid information and lifeskills
is a prerequisite for success in any AIDS response, especially
in a region where more than half the population is under 24,
and where teenage pregnancy rates can reach 25 per cent.
This is where an innovative programme, initiated by the Netherlands
Red Cross in partnership with the Dominican Red Cross, comes
into the picture. Through sports and other leisure activities,
it attracts vulnerable youth from the barrios and provides
them with information on, among other things, drug abuse and
HIV/AIDS. These youngsters are then trained to carry the message
on to others.
The dust and swarms of mosquitoes cannot dim the bright faces
and enthusiasm of this group in La Caleta, a suburb of the
Dominican capital. Talking to them, it is obvious that the
programme is a success. Gaby, a gangly 18-year-old who can't
sit still, is quite candid. "I was 100 per cent at risk.
If it hadn't been for this project, I know I would be HIV-positive
by now." The others giggle, yet nod their heads in agreement.
Obviously, such initiatives will need to be multiplied if
the Caribbean is to see a wave of change. The Red Cross clearly
recognizes this. Teresa sees herself as part of this change.
She may be out of work and certainly cannot afford treatment,
but as she says, she is "doing OK".
Catherine Lengyel is a freelance writer currently living in
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