Several times each hour on prime- time television, the Brazilian govem- ment's latest and flashiest AIDS adver- tisement punctuates the commercials between telenovelas, rock videos and news programs. "Use condoms with unknown partners, from beginning to end," counsels singer Caetano Veloso in a quick, tight close-up. "There's no medicine for AIDS, but it can be com- batted through prevention," adds a well- known soap opera star. And in its final seconds, the government delivers the real message to those who hope the Sarney administration might do some- thing about AIDS besides run commer- cials. "Don't wait for the authorities to act!" warns Jo Soares, a late night talk- show host, "The solution depends on us alone." In the last two years, a growing number of activists have taken such advice to heart. Nearly 40 new organi- zations have sprung up in response to the AIDS epidemic. "With AIDS, it's become clear that [this government has] no real commitment to the health of the Brazilian people," says sociologist Herbert de Souza, the founder of the country's most prominent non-govem- mental organization which deals with the disease. '"This is apolitical issue for which all of us must take responsibil- ity." For some, taking responsibility means providing services to the sick; for others, defending their civil rights. But most conclude it means pushing the government to act. As a country, Brazil has the third highest incidence of AIDS cases world- wide. Although official statistics place the number of people with AIDS at around 7,000, doctors, academics and activists say the figure is at least twice that high and may be doubling every ten months. Perhaps 500,000 Brazilians carry the HIV virus. When AIDS first appeared here in 1983, most Brazilians with the disease were young, gay, educated, white men from the big city. Many tried to dismiss it as a doenga do desviado da Zona Sul, an affliction that would only befall "queers" from the affluent and tour- isty southern neighborhoods of Rio de Janeiro. But today more and more heterosexuals, women, poor people, drug users, small-town residents and children are joining the ranks of those who are ill or dying from the disease. According to Dr. Mauro Schechter, who heads AIDS research at the Fed- eral University of Rio de Janeiro, in 1985 the ratio of men to women with AIDS in Brazil was thirty to one; three years later, it was eight to one. Schech- ter also says that around 70% of Brazil- ians with AIDS in 1985 held university degrees; now, the figure is closer to 30%. In 1985, 72% of the country's AIDS cases lived in Rio de Janeiro and Sio Paulo; last year it was just under half. The number of Brazilians with the disease suddenly skyrocketed in 1986. In that year Herbert de Souza, a hemo- philiac, founded the Brazilian Inter- Disciplinary AIDS Association REPORT ON THE AMERICAS Elizabeth Station is a writer and translator living in Rio de Janeiro. 8(ABIA). ABIA's early "safe sex" materials targeted middle-class gays, and were reminiscent of literature which circulates on the streets of New York or San Francisco. Now, ABIA produces frank, explicit videotapes for use with street kids and construction workers, and distributes pamphlets equipped with free condoms to sailors and dock work- ers. The group also sends speakers to Rio de Janeiro slums, schools and workplaces. Alarmed at the fact that 10%-20% of AIDS cases originate from contami- nated blood transfusions, ABIA activ- ists also lobbied hard to insert a clause in the country's new constitution pro- hibiting the commercialization of blood and its derivatives. They were success- ful, but most blood still comes from unscrupulous private banks that do not screen for malaria, Chagas' disease, syphilis, hepatitis or AIDS. Activists complain that only wealthy patients can get a pure transfusion, yet nothing guarantees purity. De Souza himself is HIV-positive; two of his brothers, also hemophiliacs, died of AIDS in 1988. Varig's Surprise "People with AIDS are the best means to disseminate correct informa- tion about AIDS," says Herbert Daniel, a writer, gay activist and ex-guerrilla leader who, like de Souza, spent most of the 1970s in exile. He discovered he had AIDS earlier this year, and has since joined with ABIA to found "Pela VIDDA" (For the Valorization, Inte- gration and Dignity of People with AIDS)-the only group in Latin Amer- ica which organizes people who have the disease to demand their civil rights. Pela VIDDA held its first public demonstration in August, picketing the downtown Rio de Janeiro offices of Varig airlines for administering AIDS tests to prospective employees without the applicants' knowledge or consent. Worse yet, charged Pela VIDDA, when those who test positive return to see if they will be hired, they are told they have the AIDS virus-and no job. A Varig spokesman admitted the allega- tions were true, and insisted that the testing would continue. Though illegal, it is common for public and private hospitals to deny treatment to AIDS patients, alleging lack of space and specialization to deal with the disease. Even when an emer- gency AIDS patient is admitted, staff members may refuse to go anywhere near him. Insurance companies have summarily bumped clients when it is revealed they have AIDS. People with AIDS or the HIV virus are frequently fired from their jobs and are often aban- doned by their families. One objective of the Varig protest was to fight the notion that aideticos-as people with AIDS are often called in Brazil-are social deviants or outcasts on the verge of an inevitable, gruesome and somehow deserved death. "Ever since I found out I had AIDS, I repeat constantly that I am alive and I'm a citizen. I have no deficiency that immu- nizes me against my civil rights," says Daniel, who rejects the term aidctico as dehumanizing. Zeca Nogueira, a found- ing member of Pela VIDDA who re- cently lost his lover to the disease, agrees. "We aren't people dying of AIDS; we aren't victims of AIDS," Nogueira explains, "We're people liv- ing with AIDS. This is really a political problem and we have to fight it politi- cally." Private Initiative Not all activists see political struggle as an appropriate response to the AIDS crisis. Three years ago, Ubiratan da Costa e Silva began to take strangers with AIDS who had nowhere else to go into his Sdo Paulo home. He now manages a group of 27 volunteers who make house-calls to over 80 patients throughout the city. "It's not easy to keep this work up," admits the interior decorator-turned-activist, pointing to the tall metal shelf in his dining room which is piled with bottles of antibiot- ics, AIDS education materials, food and medical books. "Until yesterday, there was a piano there." (He sold it to Beijo da Rua activists talk to transvestites on Rio's Rua Augusta VOLUME XXIII, NO. 4 (NOVEMBER/DECEMBER 1989) I ABIA's Ranulfo Cardoso teaches street kids about AIDS 9Herbert Daniels of Pela VIDDA raise money for the project.) Raffles, book sales, donations and Costa e Silva's own savings have underwritten most of the AIDS work he coordinates. "The responsibility is ours, too; it's not only up to the government," he says. Transvestite Brenda Lee is the owner of a house in an Italian district of Sdo Paulo known as "The Palace of Prin- cesses," where for years transvestites shared expenses and household tasks while they weren't out on the streets. The city's press discovered the house in 1984 after a group of thugs, probably police, went on a shooting spree that left several transvestite prostitutes dead. Brenda then told reporters from a popu- lar TV news program that she would take in any prostitute or transvestite who needed protection-including those who had AIDS. "I said having AIDS isn't any worse than getting gunned down in the street," Brenda recalls. Within days, she had opened her doors to several patients whose families refused to care for them. The house has been a full-fledged AIDS clinic since October 1988, when the Sdo Paulo state secretary of health, in an unusual collaboration, agreed to cover most of the expenses that Brenda previously struggled to pay on her own. The house now provides food, medi- cine and shelter for transvestites, home- less gays and anyone else with AIDS referred by the state health department. Nurses, maids and most of the 24 pa- tients under Brenda Lee's roof usually go about their daily routine in drag. "When a family won't accept them because of prejudice, they come here," says Veronesa, a transvestite nurse's assistant who has worked at the house for about a year. "These people are abandoned," adds Brenda. "It's terrible-we don't have room for all the patients." Brenda Lee and Costa e Silva are quick to distance themselves from "leftists who blame the government for everything." They believe that private initiatives are the best hope for stop- ping AIDS in Brazil. "I'm different from everyone," shrugs Brenda, "I hear everyone complaining about the gov- ernment, [but] I've learned that in gen- eral, the community is never satisfied with the government. If they all worked as hard as I did, there wouldn't be any problem," she says. One of Many Disasters Herbert Daniel is one of the few gay activists working on AIDS to openly, and proudly, admit his homosexuality. The gay rights movement was tiny and fragmented before AIDS hit the coun- try, and it is hard to tell whether the disease has helped or hurt its growth, As in the United States and Europe, in Brazil a few gay leaders have been able to win mainstream recognition and respect for their activities on behalf of people with the illness. But only one gay organization, located in the poor northwest suburbs of Rio de Janeiro, is openly attempting to address AIDS from a gay perspective. The group, "Atoba," distributes 6,000 condoms a month in plazas and gay bars, along with flyers which read "Homosexual- ity is not an illness! It's not a crime, it's not a sin, nor a punishment! Find out about and defend your rights." By most estimates, Brazil is at least five years behind the United States and Europe in terms of its response to AIDS. Only a few AIDS groups have secured funding from foreign foundations or national agencies. Volunteer organiza- tions like the Support Group for the Prevention of AIDS (GAPA), which has chapters in 12 Brazilian cities, run hospices, distribute food and medicine, make hospital visits and provide pa- tients and their families with coun- selling services. Members of Protes- tant and Catholic churches also visit and provide material aid to the sick, although the Catholic rank-and-file complain that the church hierarchy has been slow in responding to the crisis. A Rio de Janeiro-based group, Religious Support Against AIDS (ARCA), is at- tempting to form an ecumenical front which includes Catholic, Protestant and Brenda Lee [I.] takes AIDS patients into her Sio Paulo home REPORT ON THE AMERICAS i 10In a Sio Paulo hospice: Many people with AIDS are abandoned by their families Jewish volunteers, as well as practi- tioners of the Afro-Brazilian religions Candomble and Umbanda. Meanwhile, financially strapped public hospitals, which treat 80%-90% of AIDS cases, bear most of the burden. Available beds fall far short of the total needed; drugs like AZT are either un- available or prohibitively expensive. Federal funds for AIDS research and lab equipment were drastically slashed last year as part of a general cut in spending on health and social services, and training programs for hospital per- sonnel are still inadequate. "I'm abso- lutely certain that if I were a construc- tion worker," says Herbert Daniel, "I'd already be dead." Dealing with AIDS on a day-to-day basis has led doctors, nurses, social workers and hospital administrators to join the movement to demand a more vigorous government response to the epidemic. According to Dr. Ranulfo Cardoso, the director of ABIA's health education program, "It doesn't matter how many hospices we open-the AIDS issue is one for the government to face." Though he urges individuals to join the fight, Cardoso points out that civil society can't clean up blood banks, import AZT and create public hospital beds unless these are also official pri- orities. Health professionals also point out that, while serious, the AIDS epidemic is only one of many disasters resulting from Brazil's failure to invest in public health over the years. One in three people has no access to health services, and public hospitals suffer chronic short- ages of funds, beds, drugs, ambulance services, lab equipment and staff. Ministry of Health statistics show that preventable and treatable illnesses like malaria, yellow fever and dengue still run rampant. Over 2,000 Brazilians die of syphilis and gonorrhea each year, making these diseases bigger killers than AIDS. Activists and doctors agree that the situation will not improve until the Sarney administration leaves office in early 1990. "President Sarney hasn't opened his mouth to say the word AIDS," complains one organizer, "It's as if he were afraid of getting contami- nated." None of the front-runners in the race for this month's presidential elections has made concrete proposals for dealing with AIDS or reforming the public health system. The tiny Brazil- ian Green Party, which has no chance of winning the election, nearly chose Herbert Daniel as its presidential candi- date hoping he could draw attention to the minority rights issues the Greens have championed. AIDS activists have picked up on the Green Party slogan, "All Brazil is a high-risk group," from rubber tappers to homosexuals to people attempting to live on the minimum wage. According to Herbert Daniel, people with AIDS must join forces with those fighting to obtain housing, education, decent wages and human rights. As Daniel wrote earlier this year, "My problem, like thousands of other people with this disease, is not to ask for easier condi- tions for death but to demand a better quality of life. A problem, by the way, which is common to almost all Brazil- ians."
