Stemming the tide
April 24, 2004
Apathy is lethal, is the name of a website sponsored by the United Nations Foundation. It provides statistics which estimate that worldwide every 14 seconds, AIDS turns a child into an orphan. The number of AIDS orphans is 14 million and counting. And AIDS kills 1,600 children every day. These statistics refer mainly to countries on the African continent, some of which have the largest number of HIV and AIDS cases in the world. However, the apathy of successive governments, not only to HIV, but to the fact that our public health system was a disaster has proved lethal for Guyana. Per capita, Guyana now has the second highest number of HIV and AIDS cases in the region.
Over a number of years, there have been moves to change this, which have gained momentum with the ever-growing accessibility to international and US funding targeted specifically to fighting this disease. There is no denying the fact that the non-government sector revolutionised the response to HIV and forced the government into action, but involving the private health sector has been a major struggle. Media practitioners, and in fact anyone who sought HIV/AIDS statistics from the National AIDS Programme, became used to hearing: 'These figures only represent the public health sector. The private health sector does not provide reports', or words to that effect. This is about to change.
Leading the way is St Joseph Mercy Hospital, with its 'Stemming the Tide' programme, which offers voluntary counselling and testing for HIV free of charge. And not only that, its holistic approach includes free anti-retroviral drug therapy and free hospitalisation, should the need for this arise. It also operates a mobile clinic, which offers on-the-spot testing. The programme, which began last September, has already seen some 200 people and is currently treating 16; people who, perhaps, may never have sought HIV testing at public hospitals, people who may have slipped through the cracks.
Despite the valiant efforts of many, it appears that the Genito-Urinary Medicine Clinic at the Georgetown Hospital, which is the main HIV treatment facility in the government sector is still stigmatised. Long before HIV, when it was still known as the venereal diseases (VD) clinic and before it moved to its current location, visitors to the clinic were forced to queue up on the stairs to await its opening. Many covered their heads and hid their faces so as not to be seen by passersby on Middle Street or in the hospital compound. This awful, demeaning practice enforced by those who ran the clinic guaranteed a lack of confidentiality, kept alive the spectre of shame associated with pre- and extra-marital sex and made what ought to have been a discreet service an ordeal. This in turn gave birth to the stigma that is still alive today.
St Joseph Hospital has never had a VD clinic and has over the years, except in a few instances, maintained a reputation for offering efficient and compassionate medical services. This alone would ensure the success of its HIV programme, even if it were not free. Fortunately, the Dominican Republic-based Catholic Relief Services funds Mercy's programme and the availability of free drugs through the Ministry of Health helps. This is the sort of involvement that Guyana needs to beat back HIV and it must be advocated.
Other private hospitals can certainly take a leaf out of St Joseph Mercy's book. While the Davis Memorial Hospital is the only other church-based entity, the others perhaps have links with organisations or can seek to form them, with a view to accessing funding for what can no doubt be an expensive programme. There also may be international agencies willing to finance such efforts, to which proposals can be written. The Minister of Health has given an undertaking, publicly, to providing free anti-retrovirals to any and all Guyanese who need them. If health-care volunteers can be found to provide counselling and care at these hospitals, funding proposals would only be needed to cover the cost of testing and the odd hospitalisation, which would include other medical incidentals.
This would free the Ministry of Health and NGOs to concentrate more on health education and risk reduction for those most vulnerable to HIV - youth and women. This must be maintained for as long as HIV remains a threat. National involvement is what is needed to curb HIV; it has worked in other countries. It is time to end the torpor.