Haiti: The AIDS Stigma

September 25, 2007

AIDS. Everybody has heard of it, everybody is scared of it, and no- body knows just what it is. Dubbed "Acquired Immune Deficiency Syn- drome," AIDS has already claimed hundreds of lives, with its inci- dence reportedly accelerating at an alarming rate. Most AIDS vic- tims fall into one of the syndrome's alleged "high-risk groups": homo- sexuals, intravenous drug (e.g. heroin) users, hemophiliacs and- last but not least in notoriety-- Haitians. AIDS' popular nickname, "the 4-H disease," derives from these four groups. The very use of such a sobri- quet is an eloquent sign of the American public's need to ostra- cize victims of this frightening ill- ness. For Haitians, both in the United States and at home, the implications of being pigeonholed in this way have been particularly devastating. Already in the politi- cal limelight because of the huge influx of "boat people" in recent years and the subsequent contro- versy over their legal status in the United States, Haitians now find themselves the object of further unwanted attention as possible purveyors of a deadly new plague. In much of the American press, bizarre speculation about the "Hai- tian AIDS connection" has fostered a climate of suspicion which Hai- tians have had trouble dispelling. Initially, even voodoo-the tradi- tional Haitian religion involving Martha Cooley is a free-lance writer based in Cambridge, Massachusetts. She has recently returned from a visit to Haiti. dance, music and occasional ani- mal sacrifice-was invoked by the media as an explanation for AIDS' appearance in the Haitian community. Distortion of physi- cians' statements stoked the fires: The New York Daily News cited one American researcher, Dr. Jeffrey Viera of Downstate Medi- cal Center in Brooklyn, as draw- ing a potential voodoo-AIDS link. Dr. Viera sent a letter to the Daily News denying he had ever made such a suggestion; only one month later did the Daily News see fit to print his refutation. In another glaring piece of sen- sationalism, the Boston Globe (April 29, 1983) ran the headline "Researcher Links AIDS, Swine Fever," citing a Harvard School of Public Health researcher who con- jectured that AIDS "may have origi- nated with one Haitian homosexual who ate infected pork" and then spread the disease to vacationing American homosexuals in Haiti. (No scientific corroboration was offered by the Globe; indeed, two U.S. scientific groups have since stated that no data exists to sup- port the notion.) Haitian doctors are angry at such cavalier handling of the topic, A worker erects a new barricade at Miami's Krome Avenue Detention Center in 1981. Sept/Oct 1983 47update * update update * update and have largely opted to respond with silence or extreme reticence out of fear of being misquoted. One American doctor studying AIDS at Atlanta's Center for Dis- ease Control (CDC) feels that the annoyance of his Haitian counter- parts is understandable: "They're struggling just like we are. And their secrecy isn't unique to Haiti- it's the way scientists work." He claims that CDC is encouraging collaboration with Haiti and that there is mutual respect between medical researchers in both coun- tries. "Pointing fingers doesn't strengthen anybody's position." Dr. Warren Johnson of Cornell's College of Medicine, who attended a symposium on AIDS in Haiti sponsored by the Haitian Medical Association, feels similarly about the issue of caution. "The Haitians are doing an excellent job," he confirms, "and they want to de- vote their time to working, not talk- ing. The press hasn't dealt fairly with Haiti. They have a reason to be silent." Racist Overtones Few Haitian researchers have been willing to break this silence. As a consequence, U.S. doctors have often ended up as spokes- persons for the Haitians, a situa- tion that disturbs Dr. Jean-Claude Desgranges, a Haitian physician affiliated with Downstate. Articu- late and angry, Dr. Desgranges claims that sensationalism and racism have severely impacted Haitians in the United States. "Haitians were prematurely des- ignated a 'high-risk factor'," says Desgranges. "There have been no serious epidemiological studies in any of the Haitian communities of the diaspora. Haitians with AIDS represent only about 2.5% of the entire victim population in this 48 country. People have jumped to conclusions about the Haitians." Dr. Desgranges is presently in- volved in an epidemiological/im- munological case control study in New York's Haitian community. The study uses two groups--a random sample of about 150 Hai- tians and a control group of Haitian AIDS victims and their families-- living under similar socioeconomic conditions. Dr. Desgranges insists. that no study can be successfully undertaken without the participa- tion of Haitian doctors. "In Miami they're trying to do one without us. The language barrier makes it im- possible. They try to speak French to Haitians, but most of us under- stand only Creole. It won't work." Dr. Desg ranges has harsh words for U.S. press coverage of the Haitian connection. "The New York Times has never sought out Hai- tians for their point of view. They only want to talk to American doc- tors, it seems. And two weeks ago, I gave an interview to the Daily News, telling them about what we're doing here and in Haiti. What did they report? That I was asking for help! That wasn't at all what I said. It makes us look feeble." A Small, Black Scapegoat Like most experts inside Haiti, the AIDS Research Group in Port- au-Prince is far more reticent than Dr. Desgranges. The group's mem- bers, who are among Haiti's most prestigious physicians, insisted on written questions before they would grant a brief interview re- cently. One inveighed strongly against the American press: "They come in here with big cameras and already I'm repulsed. We've refused to give out any informa- tion thus far. We assume that any- thing we say will be misquoted or misinterpreted by the press." Slapping his palms with his fingers in a characteristic Haitian gesture of vexation and resignation, he added, "Because the United States is rich, white and big, it thinks it can make a bouc emissaire-a scapegoat--of us. Haiti is poor and black and small. If our reputa- tion is maligned, what can we do? Sue the United States!?" According to Dr. Desgranges, Haitians in the United States are already suffering the ill effects of being maligned. "People are los- ing their jobs. A Haitian girl I know of was recently fired from her job as a maid because her employer thought she might have AIDS--and she was working for an American doctor!" Dr. Desgranges also wor- ries about discrimination against Haitians seeking work, as well as prejudice against Haitian school children. "Kids are refusing to sit next to Haitian students, even in kindergarten. It's a real problem." In the busy streets of Port-au- Prince, few foreigners are in evi- dence. When asked why tourism has declined, Haitians cluck their tongues and murmur "Quatre-H" in ironic tones. They are upset not only by the loss of desperately needed income, but by the politi- cal ramifications of AIDS' presence among Haitians at home and abroad. During the past two years, both the Haitian and U.S. authori- ties have made strenuous efforts to curtail the flow of Haitian refu- gees to the north; the AIDS scare will put an extra damper on the hopes of emigres. A young man in the Champs-de-Mars, the capital's central park, put it succinctly: "You Americans think we're stupid, don't you? We know you don't want us coming to your country any more. This 4-H thing is just one more way to keep us out."

Tags: Haiti, AIDS, racism

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