Since the January 12, 2010 earthquake, the Haitian Group for Studies in Karposi’s Sarcoma and Opportunistic Infections (GHESKIO) in addition to supporting a field surgical hospital and a refugee camp for thousands of earthquake victims, it is providing humanitarian assistance and emergency care to those affected by the disaster as well as life saving medications to Persons Living with HIV and AIDS (PLHA) and tuberculosis.
Even in the chaos left by the earthquake, hundreds of people make their monthly visits to Port-au-Prince’s GHESKIO clinic for AIDS treatment. Located in the centre of the city, GHESKIO, despite being damaged and surrounded by rubble, cries of desperation and chaos, it continues dispensing AIDS treatment to the thousands of lives that depend on it.
“It is a real pleasure for us health workers to see our patients come here despite what has befallen them” said nurse Naomi Jean-Charles as she renewed prescriptions and handed out pills to dozens of nervous people waiting in line.
“I’m surprised they are still coming in. But one learns to work in situations of poverty caused by hurricanes and political unrest” said Dr. Jean William Pape, Director of GHESKIO who has moved the clinic’s operations to a wing of the building that survived the earthquake intact.
Dr. Patrice Severe, one of GHIESKIO’s senior physicians announced: “GHIESKIO is fully operational – providing both relief to refugees and continued medical care to those who have counted on us for years.”
Dr. Ken Hover, Prof. of Engineering at Cornell University continues to evaluate the safety of the medical buildings at GHESKIO. He had initially thought that the new building had been too damaged to be safely used, but he said that seeing the blueprints he may help him find a way to reinforce the building instead of tearing it down.
Writing to his office in the United States, Dr. Hover described the scene to his colleagues: “The main clinic downtown sounds overwhelming for the doctors and patients. It is next to a soccer field where about 5,000 people are camped out waiting to be seen by doctors or hoping for food. Several times a day a helicopter comes in with injured people, and the army sends out a squad to push back the people to make a circle for the chopper to land. They carry in the stretchers, the helicopter takes off, and the people fill in the area again”.
Dr. Hover continued: “Yesterday, our driver took us on a short tour around some parts of the city to show them the damage. They went by the Presidential Palace, Cathedral and other government buildings so they could see for themselves and take quick pictures. In these areas, there are still bodies in the ruble, and the smell and desperate crowds are unbelievable. The Haitian people are hoping all these visitors will take their stories back home and spread the word about their needs.“
Dr. Hover is also very inspired by Dr. Pape whom he said is not only dealing with the critical immediate needs, but also trying to handle the short and long term planning at the same time: “Such awful stress on top of what they have been through. But perhaps envisioning the future is the only way to get through the present.”
Supplied with medications by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the US President’s Emergency Fund for AIDS Relief (PEPFAR) and the Merieux Institute; thanks to whom the clinic has never suffered an interruption in its stocks of antiretroviral drugs.
In an interview with Haitian RadioCaraibes, Dr. Pape who also teaches at Cornell University said “The patients visit us each month and as a precaution we always give them a month and a half’s treatment so they won’t run short. What worries me more is not our usual patients but this horrible emergency situation, offering care to people who come in from all over with horrible injuries.”
Hundreds of injured Haitians have converged on the clinic in the nearly two weeks since the earthquake, along with some 5,000 homeless people who have taken refuge on the land next to it. A military hospital with a surgical unit has set up shop in a rear courtyard of the clinic, with the help from the US Health Department and American volunteer surgeons.
The 28 GHESKIO centres in Haiti care for half of all Haitians receiving anti-retroviral treatment, or about 12,000 patients, approximately 6,000 of them in the capital. About 300 people, including 18 doctors, work in the centre Port-au-Prince. After the earthquake, the centre broadcast reminders by radio to AIDS patients that their treatments were waiting for them in the capital or in the provinces, and it organized car pool to bring them from their neighbourhoods. “The war against AIDS, we are going to win it. The prevalence of HIV continues to fall in Haiti” Dr. Pape said. It has fallen from 7.2% of the population in urban areas in the 1990s to 2.2% in 2009 with fewer than 150,000 people infected. Nurse Jean-Charles said: “The treatments are working. Children who were born with HIV and who are today 30 years old come in regularly for their medications. It is an achievement”.
GHESKIO is the acronym, in Creole, for the Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections. Because it had been illegal to say the word AIDS — or later HIV — the name stuck. In the early 1980s, a group of Haitian clinicians noticed a growing number of patients dying from Kaposi’s sarcoma and unusual opportunistic infections. In 1982, they founded the Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO). In 1983, GHESKIO published their experiences in The New England Journal of Medicine, documenting the first cases of AIDS in a developing country. In 1987, GHESKIO was recognized as an official independent non-governmental organization by the Haitian Government. In 2000, the Haitian government designated GHESKIO a “Public Utility” a status reserved for institutions “essential to the welfare of the Haitian people” such as the Red Cross. For more than twenty years, GHESKIO has served as the Haitian Government’s research and training center for HIV and AIDS, and it is now an internationally recognized center of excellence.
The Haitian doctors who run the organization could have long ago gotten good jobs in the USA or elsewhere, but they stayed because they love their country. Now they need all the help they can get to help their neighbors survive. “We have no choice. They need food. They need water. They need security. This is basic. We are all optimistic. That is why we stayed in this country. I am very optimistic that with support from all over the world, with good Haitian management, we can get there” said Dr. Pape.
Dr. Jean Pape has been the Director of GHESKIO since its inception, and many of GHESKIO’s staff have been with the center for more than twenty years. Dr. Pape and the Board of Directors work with the Community Advisory Board, the Weill Cornell Medical College and other universities, and the Fondation Rodolphe Mérieux to coordinate the core sections of the center, including the clinics, counseling, pharmacy, laboratory, finance, and administration.
GHIESKIO centre in Port-au-Prince, Haiti was the first institution in the world dedicated to the fight against HIV and AIDS. These centres have provided continuous medical care in Haiti since 1982, never once shutting its doors or charging fees. GHESKIO’s commitment to service, research, and training has led to the expansion of many GHESKIO models to the national level. GHESKIO has expanded models for HIV care and prevention, treatment of sexually transmitted infections, care for diarrheal diseases, blood safety, AIDS treatment, and the prevention of congenital syphilis. Through the development of national programs to address major health issues, GHESKIO plays a catalytic role in improving public health in Haiti.
When the organization began, Haitians were suffering intense discrimination around the world because of AIDS. Under the Duvalier government in Haiti, it was literally a crime to mention AIDS. But these doctors carried on and, recently, they have been giving out life-saving HIV therapy to tens of thousands of Haitians. Amazingly, immediately after the earthquake they were able to resume giving medications to about 80% of those patients, probably close to the number who survived the quake, on top of all the other challenges they faced.
Allison S. Ali
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