[Haiti] Doctors in Haiti fight superstition, poverty in war against AIDS

From The North County Times

By: ALFRED de MONTESQUIOU - Associated Press

PORT-AU-PRINCE, Haiti -- Inside a clinic, a doctor edges past hundreds of people -- some nervously awaiting results of an HIV test, others appearing emaciated and resigned as they wait for antiretroviral drugs to fight AIDS.

Doctors are battling AIDS on two fronts in Haiti. Obtaining and providing the drugs is vital. But in a nation where Voodoo, superstition, poverty and a lack of education are prevalent, getting people to take the medicine and practice safe sex is just as important.

"The challenge isn't to just give people the drugs. It's to make sure they take them," said Dr. Rose Irene Verdier of GHESKIO, a clinic in a rundown seaside neighborhood that is Haiti's largest treatment center for sexually transmitted diseases.

Elisabeth Dumay, a 42-year-old social worker at the center, knows all too well that ignorance can increase the risk of AIDS. About 350,000 Haitians have the virus.

Dumay said she realized in the 1990s that her husband was HIV positive but continued having unprotected sex with him. He died in 1997. The next year, she tested positive for HIV.

"I thought God would protect me, but he didn't," Dumay said.

During her treatment, Dumay was hired as a social worker by GHESKIO -- which in French stands for the Haitian Group for the Study of Kaposi's sarcoma and Opportunistic Infections. Kaposi's sarcoma is a cancer associated with AIDS.

Dumay now helps patients cope with the shock of learning they are HIV positive, regularly calling them to make sure they take their drugs.

In a country with 80 percent unemployment and where only 20 percent of Haitians can read and write, educating people about the virus is crucial, she said.

"We counsel spouses, family members, even Voodoo priests or anyone that has some influence on the community," Dumay said in an interview in her small office.

Dumay said many patients initially are dubious about antiretroviral drugs, or horrified by their side effects.

"It's true it can be very unpleasant at first," Dumay said, explaining that the drugs triggered nausea, hallucinations and sleeplessness for a week in her own case.

She is a role model for those with HIV, showing that you can survive and succeed with the virus.

"I tell them I have a 10-year-old daughter who's HIV negative, and even a new boyfriend who's negative also," she said.

The clinic has an elaborate system of support, offering food, phone cards and even taxi rides to advanced AIDS patients.

"It's a chain, teamwork," Verdier said. "We've adapted medical methods to succeed in the critical conditions of Haiti."

Dr. Jean William Pape, who founded GHESKIO in 1982, said 2,600 patients have received antiretroviral drugs this year. He hopes to reach up to 8,000 people next year. The clinic has treated more than 1 million people since it opened.

The center's $2.6 million yearly budget is paid by donations from international aid programs and foundations, Pape said, explaining that all medications are free to patients. It costs $1,600 per patient each year to provide the drugs.

Standing amid coughing AIDS patients, Verdier said she is convinced AIDS will be beaten within a decade or so.

In the early 1990s, the percentage of Haitians with the virus stood at more than 6 percent. Many experts predicted as many as 30 percent eventually would become infected.

"Yet we're at 3 percent. We're winning this battle," Verdier said.