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Haiti: missing healthcare on the frontline of HIV

Treatment for a patient in Hinche

Treatment for a patient in Hinche US Aid Agency under a Creative Commons Licence

The first documented case of HIV in Haiti was at the Clinique Bon Sauveur in the Central Plateau in 1986. Within two years, the clinic had introduced a programme of free testing, counselling, condoms, HIV education and prevention. By the early 1990s 25 per cent of admissions to the clinic were related to HIV; by 1995 this had risen to 40 per cent.

Despite the presence of dedicated HIV/AIDs clinics such as the Bon Sauveur, and support network access for many, treatment for HIV remains limited and the path to getting it is full of obstacles. The story of 16-year-old Emile Charles* is representative of thousands of Haitians struggling to access medical care which is supposed to be accessible and free.

Emile’s family was from Hinche in central Haiti. His parents and younger sister all died of AIDS-related illnesses. He is not sure, but thinks he was six when his father died and he came to live with his uncle in Port-au-Prince. In 2008 or 2009 he became very ill and was taken to hospital, where he ended up spending a year. Because Emile was a minor, his uncle was told about his nephew’s HIV status and it was up to him to inform the child. But he didn’t. After Emile was released from hospital he was given a patient card, medication and a follow-up appointment. But his uncle never took him back, and soon after that Emile was adopted by a neighbour, Jean-Louis [Elie] Joseph, who is now one of the main organizers of the Chanjem Leson movement at the Camp Acra.

When I met Emile he had again become ill with fever and night coughs. It was at this point that the uncle, who also lives in the camp, finally told Elie that Emile’s family had all died of AIDS-related illnesses. Emile told us he had spent a year in GHESKIO hospital so it made sense for him to return there and continue his treatment. However, the hospital had no record of him ever having been a patient.

The confusion was understandable: how was a six- or eight-year-old child supposed to know which hospital he had attended, how long he had stayed or what medication he was given? The uncle, perhaps not wanting people to know about his nephew’s status, was not forthcoming with information. Despite the decrease in HIV/AIDS cases in Haiti, and the increase in awareness and prevention, there remains a high level of stigma around the illness. Eventually, Emile’s guardians found out he had been in a hospital run by nuns in Delmas 18, but the uncle could not remember the name.

By this time, four weeks had passed and Emile’s health was deteriorating rapidly. I received a text message from my interpreter, Serge Supre, saying he was going to Delmas 18 to try to find out the name of the hospital and to collect Emile’s records so they could treat him again or refer him to the Hôpital l’Université d’Etat d’Haïti.

The hospital, run by the Sisters of Mercy (of Mother Theresa fame) refused to see Emile, because ‘his uncle gave trouble’. Serge tried to appeal to their ‘mercy’ but in vain:

‘They said they will do something for the poor but they cannot help Emile because his uncle brought trouble. I would like to know who the poor are – are we not poor, is Emile not poor and sick and a child? Something must be done for him. At night he is crying and I don’t know what to do. On Monday I will return to GHESKIO and hope they will help.’

Emile didn’t get to GHESKIO. Through a ‘friend of a friend’ he is now waiting for an appointment at Dikini hospital in Kafou where they receive HIV+ patients. I hope he finally gets the treatment he needs.

This is a shortened version of a previously published piece on Black Looks: Haiti: Missing healthcare on the frontline of HIV

* Not his real name

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