Perspectives in Health Magazine
The Magazine of the Pan American Health Organization
Volume 7, Number 1, 2002

Facing the Music

(Photo ©ODECO)

Compounding this human tragedy is the fact the victims are, as Stansbury puts it, "those who can least afford its consequences." The $180 per month that Yolani X. spent for single-drug therapy for her mother put a great strain on her family. But even that limited treatment is out of reach for most Garífuna, whose total household income falls short of its cost. The preferred "triple therapy" now recommended would run in excess of $1,000 a month and is simply not an option for the vast majority of Garífuna on the north coast. Instead, the best available treatment is simply compassion from the family while they watch a loved one die.

"Right now, most of the Garífuna with AIDS who receive treatment get it from family members who are living in the United States," says Sierra. "Usually they come from different sources, donations from people who probably died from HIV or through illegal activities. What really concerns us is that most of them don't receive an adequate schedule of drugs. They just take it until they run out, and they go without medicine. And then several months later, they receive another drug. Their situation is dramatic now."

Alone at the end The Garífuna are not the only Hondurans suffering from AIDS. Indeed, the country as a whole has the highest incidence of HIV/AIDS in Central America. Yet misunderstanding about the disease and its means of transmission is widespread. Dr. Nestor Salavarría, of the Buen Pastor Clinic in Olancho province, describes a visit to a mestizo woman dying of AIDS: (Photo ©Nestor Salavarría) "Wanting to orient a colleague who was a recent medical graduate, we explored a community asking if there were any AIDS cases, and they told us 'yes.' We decided to walk toward the house, and when we arrived we found the door half-open and this woman lying on the bed. There was some food-beans and coffee-on the floor beside her. She told us that a nephew would come, leave the food, and run away. The woman was so weak she could not feed herself. Our colleague felt great compassion and placed a 100-lempira bill in the woman's hand, pressing her fingers around it. Two days later she died, and we went back to meet her family. Possibly they were hiding; we didn't find them. The neighbors told us they had buried her quickly and burned all her belongings. We found her bed burned, her clothing and even the 100-lempira bill partly burned."

Colón established a relationship with ODECO, a grassroots women's organization in Honduras, and began raising funds to provide drugs for AIDS patients there. Together the two organizations are able to provide medication for a group of 40 Garífuna patients, but the need remains great.

Doctors Without Borders has also recently begun providing care for AIDS patients in northern Honduras, but education and prevention is still seen as the key to curbing the epidemic. More than 100 volunteers in the communities of Limón and Santa Fé have helped spread the word. Vicente Loredo, a health volunteer and head coach of the local AIDS awareness soccer team, believes they have had an impact. "Since this program first began," he said, "men in the fields have started talking about AIDS. The fear and respect for the disease is starting to sink in."

But the task remains, in many ways, an overwhelming one that has reached beyond individual health to the social structure of Garífuna communities. In one school Sierra visited, one out of four children had lost at least one parent to the virus.

As the Garífuna begin to face the truth about HIV/AIDS, observers note that their epidemic is reaching levels previously only seen in Sub-Saharan Africa. Meanwhile, Sierra and Salavarría are having to search for new funding sources to support their efforts. "The possibility exists to reduce this epidemic," says Salavarría. "But of course we need support to be able to continue this valuable project."

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