Peru climate talks

Indi Mclymont Lafayette (right), regional coordinator for Panos Caribbean, in discussion with Clifford Mahlung, coordinator for capacity building with the Alliance of Small Island States, at the Peru climate talks on Wednesday. (Photo: Petre Williams-Raynor)

Panos Caribbean\'s Regional Director shares lens time with Amerindians from Lima,Peru

Panos Caribbean\'s Regional Director shares lens time with Amerindians from Lima,Peru. Panos is one of the civil society organisations attending the United Nations Climate talks in Peru. The talks end on December 12.

 

Category Archives: 2002

SOME REHABILITATED STREET GIRLS ARE TALKING ABOUT THEIR PAST

SOME REHABILITATED STREET GIRLS ARE TALKING ABOUT THEIR PAST

 By Nicole Siméon, Journalist.

Léone, Danise, Nadine, Carline and Nadège are young ladies today.  They try to regain a normal life after they have lined for several years in the street.  Thanks to the intervention of CAFA (Centre d’Action Familiale) founded in July 1996 by Madam Kettlie Marseille, they said goodbye to this way of life.

As best they can, they have been taken into care by the programmes of CAFA. But, how long will we be there, they wonder? For adults and, mothers for two ( 2 ) of them, they no longer can be dependent on the scanty budget of CAFA. Divided between the relief  to leave the street and the apprehension about a future which is not quite certain, these five (5) young ladies talk about  their past in the street, the reasons why they lived there and also they talk about their hope.

Léone is eighteen (18) years old now : I found myself in the street because I accepted to be convainced by a friend of mine when I was ten ( 10 ) years old at that time.

I used to sell small sachets packeging in the street with my mother before that period.

When I met this girl, I made friend with her, the she proposed me to come with her. She had taken me to Delmas V around “L’Eglise Saint Yves” (Saint Yves Church. Then, I had to wander from “Avenue Haïlé Selassié” (commonly called “Carrefour de l’aéroport”) through Delmas II  and then finally at Champ de Mars. I could never sniff thinner but smoked  cracks and other hard drugs.

At Champ de Mars, I found Maguy, a social worker who had taken me to CAFA. I had quit going to school very  early and I have had a child  who died fifteen (15 ) months later.Now, thanks to CAFA, I have returned to school (evening classes) at Saint François d’Assise. I am in grade one now. Today my mother has died. My father lives in Artibonite  but I don’t know him. I have a boyfriend who doesn’t live in the street”.

Nadège is eighteen ( 18 ) years old :” I used  to leave at Cité Soleil, I have been taken to  the street because of  the situation of conflict which was rampant in this area, what we call gangs war. The events surpassed me.  I new some young girls who were raped just because they lived in a certain neighborhood or because they refused the advances of a  “Chimè” (Nickname given to the armed political activists who claim to be the followers of Lavalas Power ).

“For fear of being victimized, I also left the quarter and I found myself back in the street where after all I found a certain peace of mind. It’s clear, in the street as soon as one of us  is the girlfriend of one of the boys, we feel easy in mind. At the beginning, when we arrive, we must be kind, if not, we are beaten, sometimes raped. In that case the protector, of course, becomes the boyfriend “.

Danise tells her life story : “ I used to live also in Cité Soleil  with my sister and the father of my child and I was always very fear, too many conflicts, too many murders. I left then because I could not put up with the situation.

I decided to go to the town while I didn’t know anybody there. I met there a young girl who took me along with her into the life in the street, from a neighborhood to another one.  Some of us give ourselves to the prostitution. I met a man at Champ de Mars who used to live in the street also, we have got a child together. Then I met Nadine who already attended CAFA and took me there.

Now, I would no longer want to return to the life in the street. All the more reason it is no more the same thing. Most of our friends got killed there by invisible hands or they were missing. The street becomes very dangerous.

Nadine, at her return, tells her life story : “ I lived at an aunt of mine . We had a little difference of opinion, I came out of the house. At first I worked as a baby – sitter at a lady’s house. But after the lady has left the country, I found myself again out of job. Then a friend of mine advised me the street. After a while, Claudette a social worker took me  to CAFA; I have been there for five ( 5 ) years.

“ One thing is certain, we would never like to see our children undergo the same lot as we did.  In the past I didn’t attach any importance to the fact that I slept in the street. Now I would be ashamed of it, and it’s a miracle if I managed to get out of it definitively. In spite of the efforts of CAFA, some of us returned there”.

It’s true that we are no longer as independent as before, she adds, by specifying “But this new life style is better than that we have known up to the present day.  Sunday, for example, used to be an awful day.  We virtually found nothing to eat.

Carline remains the most marked of the street life: “The greatest problem of the street is insecurity, the untimely police raids.  Some times, we are arrested and beaten.  And they don’t show any consideration for the fact that we are girls.  They give us blows anywhere  in our bodies.  But, in general, they let us go after”.

Some times, they come to search for one of the boys and when they don’t find him, they arrest the girls.  I was in prison several times, but we must say that there were some police officers who were nice towards us and they defended us towards their colleagues when some of them brutally hit us”.

Living in street is not easy.  The interviewee frequently had sexual intercourse with different partners.  They confess that they haven’t always used the condom, or even not at all.  Thanks to the intervention of the social workers of the reception centers who make them aware of the use of the condoms and the danger to be infected by HIV and SIT, they come there to ask for the use to their partners’ great displeasure.

“Once rehabilitated, the people in charge of the center initiate us into cooking, flower arranging, into pastry, dressmaking and some times we give a hand to CAFA’s laundry in return for a bit of money”, they say.

“Now, our life is more restrictive than we are in the center.  Confronted with the reality, we try to hang on to what little we have.  We content ourselves with what little fruits of our works which provide us a meagre but honest subsistence”, they say.

On top of all that, we are much better considerate in the public’s eyes.  For example, when there is a wedding, a graduation, they appeal to us to make the decoration and that generates us a bit of money.  Now, we no longer need to be supported by a man”, they indicate.

“The boys used to give us money.  In the street, we learned to live in solidarity, to make friends.  We have lost some of them during the campaign “zéro tolérance” (tolerance zero).  It was a very painful experience for us”, they estimate

THE RIGHT TO LIFE FOR PEOPLE LIVING WITH HIV/AIDS IN HAITI

 

Briefing on Haiti, No 6, July 2002

THE RIGHT TO LIFE FOR PEOPLE LIVING WITH HIV/AIDS IN HAITI

By: Roosevelt Jean-François, Journalist and member of the Centre for Communication on AIDS (CECOSIDA)

The provision of care, including access to medical care, is a serious challenge for people living with HIV/AIDS (PLWHA) in Haiti.  The reasons for this are particularly related to the economic situation of the country, which suffers from acute unemployment and effects of the contraction of the global economy during the recent years, according to trends and figures published by the Haitian Institute of Statistics and Informatics.

However, in addition to medicines and the provision of direct care, several experts think that the best assistance lies in the social reintegration of the infected person.

It is unanimously recognized that an infected person is often not accepted at home because he/she becomes an extra burden for the family.  He or she doesn’t contribute.  That is the reason why, it is said, it should be avoided to leave such person totally dependent on others, but have the Government do more for him/her.

“You don’t need to have a lot of money.  What is important is human assistance, especially when one feels physically and mentally weak: it is good to know that you have someone on whom you can count,” Adeline Benoit says, a professional pastry cook, who had to stop her profession after learning about her infection, in order not to be ostracized.

 “Being infected by HIV isn’t the end of life. I don’t want to compare the United States to Haiti, but access to medical care is not a gift in this country.  It is the fruit of the constant work of all the people and organizations which bring together people living with HIV/AIDS (PLWHA).  It is a battle for having the right to life.”

This is the lesson that the seropositive Saurel Beaujour draws of his participation (in October 2001) in a programme of international visits to the United States, where infected people benefit from a specific budget for their access to health care and medicines, and where the private firms are heavily involved in the battle against HIV/AIDS.

43 years old, electrician by training, Beaujour has been for several years the leader of the Association for National Solidarity with people infected and affected by HIV/AIDS (ASON), which has about fifty active members.

According to him, in addition to the need of being involved in a constant institutional battle, following the example of several other countries, PLWHA have an important role to play in activities which aim to stop the spread of the virus and to promote the access of infected people and affected families to care.

“When an infected person meets another infected person like himself, dialogue and empathy take off easily.  One has nothing to hide.  For, we are in the same situation,” he says.

Saurel Beaujour is very active in activities against HIV/AIDS at the Caribbean level.  He has participated in several meetings in Trinidad and Tobago concerning PLWHA, where there is an annual meeting of Caribbean PLWHA.  “For 3 years now, we have been present at this meeting organized by the Caribbean Regional Network, which gives us the opportunity to exchange information with our Caribbean colleagues,” he explains.

“My presence in these meeting has been very useful because of the fact that I could observe infected people like me involved in the fight in other Caribbean countries, which share the same mores and customs as Haiti,” he says during an interview.

A not-very-welcoming environment

The solidarity among people living with HIV/AIDS is all the more necessary as they generally have to function in an environment which is not very favourable.

The Caravan of Youth and Artists against AIDS in Haiti, May-October 2000. 

The Caravan was a Haitian initiative of several governmental, non-governmental and international organizations. The Caravan passed the towns of Jacmel, Saint-Marc, Gonaives, Port-de-Paix, Miragoane, les Cayes and Jeremie, using means of communication which are culturally adapted to the youth, and also events and rallies (public debates, walks, music and other entertainment).  The traveling Caravan was a great moment in promoting less risky sexual behaviour, through the creation of a social environment which validates protected sexual intercourse,mutual fidelity and the acceptation of people living with HIV/AIDS.

“Living with AIDS in Haiti is very difficult. Even the street is a nightmare, with all its detritus which weakens our immunological system even more,” Adeline Benoit explains.

Adeline Benoit confides that the socio-economic environment traumatizes her: an overflow of stress when she waits for a tap-tap (public bus) and subsequently when she has to make great efforts to find a place to sit down; the long waiting time for PLWHA at the doctor’s; the discrimination of which PLWHA are the object in general society; and so on.

Esther Boucicault, another Haitian seropositive, thinks that the private commercial sector can help directly by granting scholarships to children of PLWHA.

“When one has personal frustrations, such as not having a place to live, or not being able to send his or her children to school, how can you honestly ask that person to commit him/herself to saving other people?” Mrs. Boucicault wonders, pointing out that the environment is difficult and that the education of the population has not been done as yet.

She remembers the case of a young man in Saint-Marc (about 96 kilometers North of Port-au-Prince) who, following the Caravan of Artists and Youth against AIDS in the year 2000, declared himself infected.  He was booed, avoided in his neighbourhood and very nearly lynched.  Also, as he was accused of transmitting his AIDS to people around, he was forced to leave the neighbourhood.

“I do not want that, only after my death, people are going to talk about the great efforts of the Esther Boucicault Foundation and about the great courage of this little lady.  While I’m alive, I want to see this Foundation bloom by helping others, as my daughter Michele told me: ‘Mom, while saving other people, you will be saved’.”

Advocacy

For the people living with HIV/AIDS, solidarity groups constitute an ideal discussion platform to help with specific questions, such as access to care, treatment of opportunistic infections, the support and training of the family, of friends and other priority needs, such as food, medicines and work.

Very well informed and very useful in the activities of the « Fondation promoteurs de l’objectif Zero-SIDA (POZ) »[Promoters of the Objective Zero-AIDS Foundation] where she works, Adeline Benoit pleads tirelessly for the full access of PLWHA to the labour market.

Reduction of the price of medicines against AIDS for Caribbean countries

 In July 2002, six large international pharmaceutical laboratories formally concluded an agreement with Caribbean countries,  to obtain price reductions on anti-AIDS medicines. 

GlaxoSmithKline, Hoffman-La Roche, Boehringer Ingelheim, Bristol-Myers Squibb Co., Merck & Co and Abbott committed to reductions ranging from 70 to 90%, for the countries gathered under the banner of CARICOM, the Prime Minister of St Kitts and Nevis announced during a CARICOM summit in Georgetown.

 “They accepted to negotiate with us as a region.  The medicines will become affordable and the Caribbean can prepare for generalized treatment,” Leslie Ramsammy, the Health Minister of Guyana, said.

 The agreement, which was negotiated during meetings in Jamaica and at the Headquarters of the World Health Organization in Geneva in  May 2002, was signed during the Conference on AIDS held in Barcelona from 7-11 July 2002.

 Statistics, newly published in the scope of this Barcelona Conference, state that the number of 40 million people who currently live with the HIV virus will increase to 100 million by the year 2012. At the end of 2001, there were about 420,000 HIV infected people in the Caribbean region, against 1.5 million in Latin America, according to the United Nations.

“If I tell you that I am ill, you should have special consideration towards me.  More precisely, PLWHA should have special buses at their disposal, or at least priority in public places.”

Numerous countrymen, who during the military coup d’etat (September 1991 – September1994) requested political asylum in the United States had to face the shock of discovering their sero-positive status through the tests which were carried out.

This was the case with Saurel Beaujour who was a community development worker at the « Centrale Autonome des Travailleurs Haitiens (CATH) [Autonomous Union of Haitian Workers], a job which sent him to several geographical departments of the country in order to create and train trade union peasant groups.  In order to escape the political persecution of supporters of the defacto Government, he opted for political asylum in the United States, he explains.

“My greatest problem was to announce to my wife that I was HIV positive.  I was forced to tell her the truth, because she knew about the various steps undertaken to obtain political asylum in the United States.  It was very sad in the family.  And it was there that the battle started,” Beaujour says.

“It was a shock for me to learn that my test was positive.  I could not believe my eyes.  I redid the test five (5) times before accepting the result,” he tells, looking at the ceiling.

Psychologists later advised all the people infected by HIV assemble themselves within an association.  This was later created under the name of ASON.

A most-important event

On 21-23 April 1999, in Petion-ville, the Foundation POZ in partnership with Plan Haiti and the Panos Institute organized a large event aimed at encouraging people living with HIV/AIDS to break the silence, to come out of obscurity and accept their sero-positivity without fear for their human dignity.

Health professionals, journalists, religious and political leaders, and others who participated in the forum, publicly expressed their desire to “draw the attention of the entire Haitian society towards the needs of the people living with HIV/AIDS in terms of care, support and consideration.”

Putting the emphasis on the situation of exclusion and discrimination of which people living with HIV/AIDS are victims, they called on public authorities to create a climate of justice and equity which promotes their well-being.  They also urged authorities involved in the battle against AIDS to make use of the experience of PLWHA in the fields of education, information and support.

The final declaration of that first forum of solidarity with PLWHA invites, indeed, the PLWHA to stop considering themselves as victims, but rather to adopt positive and responsible attitudes, in order to take control of their lives.

Results

Following this assembly in 1999, several networks were created, among which the Centre for Communication on AIDS (CECOSIDA), composed of journalists.  The forum marked a crucial turning-point in the battle against AIDS in Haiti, according to Dr. Eddy Genece, the Director of the Foundation POZ.

“The sensitizing of decision-makers started there.  The National Strategic Plan has a component which grants a rather important place to aspects of care and support.  Now we have many more people living with HIV/AIDS who have publicly declared their status.”

The Strategic Plan of the Ministry of Public Health and Population grants also an important place to the voluntary testing, for which there are several centres available throughout Haiti.  Several institutions, such as the POZ Foundation, have established support and counseling units for PLWHA, in order to accelerate the testing work.

“We carry out tests.  In the case where the tested person is tested negative, we will with his/her collaboration provide some follow-up: that person leaves our office with a lot of information and we invite him/her to send us his parents and friends.  In case where the result of the tested person is positive, we invite him/her to participate in support groups, called by us ‘community mutual aid groups’,” Dr. Génécé points out.

 Declaration resulting from the First Forum on Solidarity with People Living With HIV/AIDS (PLWHA), 21-23 April 1999

We, representatives of organizations and individual participants, assembled at the Ritz  Kinam II Hotel in Petion-Ville, the 21st, 22nd and 23rd of April 1999, in the scope of the First National Forum on Solidarity with the Victims of AIDS in Haiti, aware of the situation of exclusion and discrimination of which the people living with HIV/AIDS (PLWHA) are victim; desiring  to draw the attention of the entire Haitian society to the needs and terms of care, support and recognition of the PLWHA in Haiti; desiring, especially, to encourage the PLWHA to break their silence and to come out of the shadows; choose this historic event to declare the following: 

  1. PLWHA must recognize their status of seropositivity and assert themselves in all circumstances, without prejudice and without any harm to their human dignity;
  2. Public authorities must create a climate of justice and equity, promoting the well-being of PLWHA;
  3. Agencies involved in the struggle against AIDS must use the experience of PLWHA, in particular in the areas of education, information and support;
  4. PLWHA must cease to consider themselves as victims, but rather adopt positive and responsible attitudes in order to retake control of their lives;
  5. Civil society in all its components must assist the Government in its efforts for solidarity with PLWHA, through appropriate and effective support.

 Done at Petion-ville, Haiti, Friday 23 April 1999.

 AOPS * APROSIFA * ASON * ASPHA * BIREBS * CARE HAITI * CDS * CECPH * CEPROMEC * CONAHDE * CPFO * FANM YO LA * FEPLS * FNUAP * FOSREF * GHESKIO * GRASADIS * HELP * HTN * INSHAC * JHM * MAISON ARC‑EN‑CIEL * MSPP * MSPP‑IDA * NPFS * ONUSIDA * OPS/OMS * PANOS INSTITUTE * PLAN HAITI * PNUD * POLICY PROJECT * POZ * PREVENCION IDS * PSI HAITI * RADIO CARAIBES * RADIO GALAXIE * RADIO GUINEN * RADIO KISKEYA * RADIO MEGA STAR * RADIO PHARE * RADIO PLUS * RADIO ST. LUCIA * REDOVIH+ * SHP * SIGNAL FM * UNASCAD * USAID * VDH * WORLD VISION * ZANMI LASANTE

Prevention kits are given to the members of community mutual aid groups, each group averaging about fifteen.  These kits contain 7 or 8 articles of daily use such as: tooth past, tooth brushes, razors, vitamins, condoms, and bactrin (an antibiotic).

Already since 1998, even before the Forum was held, the POZ Foundation created support groups named “GIPA” (Greatest Involvement of People Living with AIDS), which in particular were involved in advocacy, in view of the limited resources.

The “Blue telephone” was created during the same year.  This permits thousands of people, in majority young people from the capital and the main provincial towns of Haiti, to inform themselves, in anonymity and without a need to travel, about HIV infection, sexuality and family planning.

“The POZ Foundation toys with the idea of making this service available 24 hours a day, in order to have people who are busy in the morning or who have no telephone benefit from it also,” Magalie Cherenfant, the person in charge of this programme, says.

Responsibility and discipline

Esther Boucicault is the infected woman most openly involved in the battle against the spread of the epidemic and for the provision of care for infected and affected people in Haiti.  She regrets that not all people can have access to medicines, although she underlines that the way medicines are taken requires a very strict discipline.

“It would be good if everybody could have access to medicines,” Boucicault says, but, according to her, a “continuous education campaign” is necessary.  “The infected person must be taught to measure out the doses of medicines well, to take them on time, to know his/her body and, above all, to face the secondary effects.  In most cases, the infected person needs a social worker to support him/her, to follow the development of his/her health, secondary effects, to control the tests like CD-4, viral charge.  A regular general check-up is necessary,” she adds.

“I have never stopped taking medicines.  Over time, I developed a certain resistance to some medicines.  I had to travel to do a check-up and the doctors gave me new medication. Now I am taking Ziagene, Viracept and Sostivan.  I swallow 7 pills in the morning and 10 at night. It takes a strict discipline to take these medicines.  For example, I know that I cannot take Sostivan after  a meal, because, in order to dissolve in the body  this medication must not meet fat,” Esther Boucicault underlines, mother of two daughters of which one is HIV positive.

“These medicines develop secondary effects.  I have cramps in my feet.  I suffer from cholesterol, diabetes and I have high blood pressure.  I take my insulin twice a day: 35 milliliters in the morning and 15 milliliters at night.  And I eat lots of salads and fruits.  I eat neither beef nor pork.  I eat local chicken, but no imported chicken which contains too much hormones,” she pursues.

Unlike Esther Boucicault, Saurel Beaujour chooses not to take the anti-retroviral medicines.

“I take vitamins.  I learned to know my body.  I know that as soon as an infection comes up I must go to a doctor.  And I do much to prevent against tuberculosis,” he indicates.

“The most important thing is to know that you are important.  And that life goes on.  Also to have a responsible sexual behaviour.  You can be re-infected and die faster.  One has to be positive.  I would very much like to see my three children grow up,” the chief of ASON concludes.

Negotiating generic medicines against AIDS

 In July 2002, the 14th International Conference on AIDS opened in Barcelona with a call for the availability of generic medicines at low cost  for the poorest countries, in order to arrest the AIDS epidemic which rages throughout the world.  While the meeting was being held, more than 500 activists demonstrated in the streets of the Catalonian capital, calling for giving two million inhabitants of the poorest countries access to anti-retroviral treatment by the beginning of 2004. 

Peter Piot, the Executive Director of UNAIDS, denied that it would be technically impossible to carry advanced medicines to millions of people in the poorest countries of the planet.

“Without doing anything, the world has looked at Sub-Saharan Africa being submerged.  That never again!” Piot declared in front of the 15,000 people gathered for the opening ceremony of the one-week conference.“We cannot stay just passive observers, while history is being repeated on other continents, and we must not desert Africa at this time,” he added.

 “Treatment is technically available in each part of the world  (¼).  It is not knowledge which constitutes a barrier, it is political will,” the Chief of UNAIDS pursued.

 According to the UN Agency, the epidemic is only at its beginning and could kill 70 million  people in the next 20 years, while the virus continues its spread in Asia and in Eastern Europe.  Today, HIV affects 40 million patients all over the world.  Sub-Saharan Africa counts 28.5 million of them and only 30,000 benefit from an appropriate treatment.

 A  sickening answer from donors

In view of these figures, experts estimate that 10 billion dollars a year are needed to launch an effective programme of prevention and treatment with generic medicines.  For the moment, only a third of this sum has been raised.

 “The answer by donors has been disgusting, (while the sum) corresponds only to four days of global military expenditure,” Mogha Smith, a member of the British NGO OXFAM, said.

Over the past two years, the price of the antiretroviral treatment in Africa has decreased by at least 90% under the pressure of militants.  However, they still stay out of reach of millions of seropositives who are completely dependent on programmes which are financed by the international community. 

 For Morten Rostrup, President of Doctors without Borders, the absence of real political will is the only cause.“Don’t tell me that we don’t have the resources for that.  We have learned from the 11 September events that it is possible to mobilize a large coalition and billions of dollars within several weeks to mitigate a common threat.” “This inertia is a crime against humanity, nothing else,” he said.

 

A new promising medication against AIDS 

An experimental medication which attacks the AIDS virus in a different way then existing treatments, has produced positive results during the first experiments on humans.  The tests now have been widened, according to the laboratory which invented this new medicine. 

This medicine, S-1360, also called GW810781, is being developed by the British group GlaxoSmithKline (GSK) in association with Shionogi of Japan.  The group specified that the medicine had been administered to 24 healthy volunteers, without entailing any important undesirable effects. This product is the most advanced of a new family of anti-AIDS medicines known under the name of integrase inhibitors which prevent the HIV virus from inserting its genes into the normal DNA of a cell.

 “It (the S-1360) has been tolerated very well and there are only very few people who had to stop the therapy,” Dr. Michelle Berrey said, of GlaxoSmithKline, specifying that the undesirable effects were limited to itching and several cases of headache.

 Consequently, last month, GSK launched “Phase II” tests.  About one hundred patients in the United States infected by HIV will participate in these tests.  The results of these tests should be known at the beginning of next year and, if all goes well, the medication could arrive on the market by 2006. The integrase inhibitors are the second category of new medicines made public during the fourteenth international conference on AIDS in Barcelona.  This shows that the pharmaceutical research continues to develop even while the poorest countries of the planet still have no real access to the first generation treatment.

 Earlier the Swiss laboratory Roche and the American Society for Bio-technologies Trimeris announced that tests had shown that their new “fusion inhibitor” T-20 could reduce the amount of virus in the blood of those patients who are not sensitive to common treatment. The development phase of this medicine should come to an end soon, and it could arrive on the market during the first quarter of the next year.

Providing care

“Sometimes, even the Doctor traumatizes you.  It is better to keep silent and tell nothing about your seropositivity if that is not necessary,”  Adeline Benoit says.

Fortunately for her, a group of women of her church helped her to get back on her feet, to fight against the sadness which could be read on her face, and to become a member of the Consultative Council (CAB) of GHESKIO Centres (Haitian Group for the Study of the Karposi Syndrome and of Opportunistic Infections) where she has found care and regular medication.

“Each time when I have to go to GHESKIO Centres,  it is like a blessing from heaven.  GHESKIO helps numerous people to live with the illness by relieving them of opportunistic infections.  But the environment is very difficult with hundreds of patients every day.  You receive medicines in small sachets which are not always well packed.”

Since 1980, CARE has been a militant in the field of HIV/AIDS in several regions of Haiti.  This American NGO actively takes part in prevention programmes, as well as in an integrated programme of care for PLWHA.  In 1999, it started a pilot training project in the Grand’Anse  (South-West of Haiti), in partnership with the Ministry of Social Affairs, in order to directly amplify the voices of communities, through the Community Health Units (UCS).

On the other hand however, Esther  Boucicault notes that most hospitals do not accept to keep PLWHA.  As soon as the hospital finds out that a patient is HIV positive, it orders its staff to send him/her out immediately.

“Here is a big responsibility.  You very well know that the person is infected, and the person knows it also, and you let him/her go out without listening to your conscience.  This person is going to continue to live and infect other people,” she states.

ASON is involved in a programme of home care for PLWHA in a poor area adjoining an affluent residential zone in the hills of Port-au-Prince (Freres).  For almost a year, the organization Plan Haiti has run this initiative in Freres where constant domiciliary visits are paid to the PLWHA.  During those visits, the infected people receive a kit of medicines and some products of first need.  But, the most important thing is the ability for ASON councilors to be with the infected person in the presence of his/her family and in this way to reinforce social bonds.

Tritherapy : limited availability

“Today  we are able to offer the tritherapy to the volunteers taking part in the vaccine trials, even when this method is not the standard of care in Haiti or in the region,” Dr. William Pape declares, Director-General of GHESKIO Centres, the main institution of research and care for PLWHA.

Dr. Pape doesn’t conceal his apprehension regarding these volunteers, who in light of availability of treatment, could expose themselves more to an HIV infection by adopting risky behaviours, as  has been documented in the United States.

“The tritherapy doesn’t begin immediately after an infection by HIV has been documented.  For many reasons, among which the shortening of the observance period on the taking of medicines and problems related to medicinal resistance, the tritherapy is only administered at an advanced stage of the disease.  A patient needs to remember that receiving this dose doesn’t bring healing, AIDS still remains an incurable disease.  For this the need to adopt safe behaviours,” the Director-General of GHESKIO Centres recommends.

More private clientele

Although the cost of medicines has passed from US$1,250.00 to US$150.00 per month, depending on what is available on the local market, the great majority of Haitians living with HIV cannot afford to buy the medicines.  An estimated budget of around three (3) million United States dollars is needed to allow a wider circulation of antiretroviral medicines in the country.

“We are very late regarding this subject.  The national programme is particularly focused on prevention and the agreed activities for providing care and support date back only two years.  Until now, sponsors have not listed care and support in their financing priorities,” Dr. Eddy Genece of the POZ Foundation, notices.

Having no experience in the domain of providing antiretroviral medicines, which requires a particular expertise, POZ doesn’t intend to involve itself, except for having a partnership programme with other institutions working in this field.

However, “the dissemination of information and the downturn of the price of medicines are among the factors which explain a constant rise in the number of PLWHA visiting private clinics.  There are patients with financial means who can pay for private services related to their seropositive status,” Dr. Damocles Patrice Severe of GHESKIO Centres reveals.  He is a specialist of infectious diseases and the provision of care regarding STI/AIDS.

Some doctors who prefer not to reveal their identities declare themselves in favour of the establishment of facilities for the production and sale of generic medicines, following the example of several countries such as Brazil and Argentina.  In professional circles related to the health sector, « the interest » for manufacturing generic medicines by several pharmaceutical firms and Haitian laboratories is known.

Houngans (voodoo priests) and natural medicine

“During recent years, people in Saint-Marc have seen me very ill, as well as recovered.  I have a strong impact on them, because there are some taboos that we have brought out,” Esther Boucicault, who leads a Centre bearing her name, declares.

The Esther Boucicault Foundation works with houngans and very often participates in training courses for medical personnel of the Saint-Marc Hospital, with the assistance of several institutions such as POZ and Family Health International (FHI/IMPACT).

Esther Boucicault considers it necessary to seriously involve the voodoo priests in the battle against AIDS.  Often, doctors do not feel able to inform patients of the results of tests who, according to their belief, think that they are the prey to « evil spirits ».

A person who has shingles can believe that he/she is affected by a « mort petit bébé » (the spirit of a dead little baby) evoked on him/her.  In his/her mind, whenever the baby tosses and turns, the shingles extend further on the skin.  In such cases, it’s preferable to make the houngans aware of the situation so that they can recognize the illness and talk openly about it, all the more as there are risky practices in these circles, Mrs. Boucicault specifies.

“Until now, a great part of the population does not go to the doctor for ordinary diseases, let alone for AIDS which remains an enigma even for the scientists,” Jacob Pierre, 54 years old, indicates.  He has a peristyle (voodoo temple) in Carrefour-Feuilles (a suburb in the South-east of the Haitian capital) and is very active in an association of houngans.

Jacob Pierre doesn’t pretend to treat AIDS, but he says that as soon as a person feeling sick comes to see him for consultation, he « throws water » (expression used in Haiti in the practice of invoking the spirits) to see what the person is suffering from.

Voodoo priest Pierre speaks  in favour of natural medicine and of the virtue of plants, as well as the relationship of the human being with his environment.

“Everything is in nature, you just need some knowledge to ask mother nature to solve certain problems, including AIDS.”

Asked about the costs of treatment in his peristyle, he says that his work has no price and it is up to the treated person to give what he has got.  Most patients want to hear the opinion of the voodoo priest whom they trust more than the doctor, Jacob Pierre adds.

Perspectives

The authorities grant a great priority to the battle against HIV/AIDS.  “We are very aware of the situation, and with restricted means we do the best we can to control and limit the spread of HIV/AIDS in the country, in partnership with Haitian civil society organizations and with the assistance of international institutions,” Dr. Henri Claude Voltaire, the Minister of the Public Health, declares in an interview.

“We are in a country where everything is a priority,” he says, continuing with: “the battle against HIV/AIDS is the affair of the whole country and not only the government, because poverty, the high rate of illiteracy and unemployment are among the factors which make the population much more vulnerable to this virus, which kills numerous people everyday and leave a lot of families in mourning and disarray.”

“We are asked to combine our strengths and join the efforts of the national and international scientific community in order to find appropriate solutions to the disease, which has serious social economic consequences,” the Minister Henri Claude Voltaire pursues.

It remains to be determined which mechanisms should be established to ensure the appropriate follow-up to the national strategic plan on AIDS, notably regarding the issue of providing care and the access of PLWHA to medical treatment.

Even although the price of medicines has been lowered substantially after agreement was reached with pharmaceutical laboratories, the access to financial resources for assisting PLWHA remains a problem not to be neglected.  For, not only must the funds available for anti-AIDS programmes have been utilized within several years, moreover the existing amount can only provide care for very few PLWHA, with difficulty.

Nevertheless, in general PLWHA can nurture a lot of hope because of the already effected decrease in cost of medicines on the market.  The vaccine trials, which started in Haiti in 2001, have begun to bear fruit and appear to have much more promising results than those obtained in the same trials in Trinidad and in Brazil, according to attested information.  Additionally, the rate of vertical transmission seems to have decreased a lot in Haiti, based on the efforts extended by certain institutions working with PLWHA.

Within this context, it is important to note that ASON intends to organize advocacy activities with jurists in Port-au-Prince, in order to establish legislation to protect the rights of people living with HIV/AIDS, according to Saurel Beaujour.

Some reference institutions

Association for National Solidarity (ASON)

16, rue Malval, Turgeau

Port-au-Prince, Haiti

Tel: (509) 555-2219

Email: ason@mediacom-ht.com

Haitian Medical Association (AMH)

33, 1ère Avenue du Travail

Port‑au‑Prince, Haiti

Email: amh@haitiworld.com

CARE

92, Rue Grégroire

Pétion-ville, Haiti

Tel: (509) 257-1571/5358/5389

Fax: (509) 257-6785

Web site: www.care.org

Centre for Communication on AIDS (CECOSIDA)

c/o POZ

2, rue Tertulien Guilbaud, Bourdon

Port-au-Prince, Haiti

Centres GHESKIO

(Groupe Haïtien d’Étude du Sarcome de Karposi et des Infections Opportunistes)

33, Bicentenaire

Port-au-Prince, Haiti

Tel: (509) 222-0031/2241

Fax: (509) 223-9044

Web site: www.gheskio.org

Catholic Relief Services (CRS)

1, Delmas 81

B.P. 1118

Port‑au‑Prince, Haiti

Tel: (509) 249‑1992/ 510‑4586

 

Family Health International/IMPACT

83, rue Lambert/Rigaud

Pétion-ville, Haiti

Tel: (509) 257-9100 

 

Foundation Esther Boucicault Stanislas (FEBS)

24, Rue Bonnet

St. Marc, Haiti 

Tel: (509) 279-9144/9165 

 

Foundation Promoters of the Goal No-AIDS (POZ)

22, Rue Carlstrom

Port-au-Prince, Haiti 

Tel: (509) 245-2308/244-4024 

 

Haitian Institute for Childhood (IHE)

41, Rue Borno

B.P. 15606

Pétion-ville, Haiti

Tel: (509) 257-3101/ 1508/ 510-8438

Maison Arc-en-Ciel (Rainbow House)

Rue Beaulieu, Boutilliers

Pétion-ville, Haiti

Tel: (509) 246-5596 / 557-2948

E-mail: arcenciel@acn2.net

Ministry of Public Health and Population (MSPP)

Palais des Ministères

Champ de Mars

Port‑au‑Prince, Haiti

United Nations Children Fund (UNICEF)

17 rue Armand Holly, Debussy

B.P. 1363

Port-au-Prince, Haiti

Tel: (509) 245-1404/1424

Fax: (509) 245-1877

Pan American Health Organization / World Health Organization (PAHO/WHO)

295 Ave John Brown/Lalue

B.P. 1330

Port‑au‑Prince, Haiti

Tel: (509) 245‑0764 /8666/ 8695

Fax: (509) 245‑1732

Plan Haiti

Impasse Lily No. 3, Rue Stephen

Delmas 60

Port-au-Prince, Haiti

Tel/Fax: (509) 256-1438 / 4229

Email:  comhti@planinternational‑ht.org

Haiti : Violence – a bad legacy bequeathed to kids

 

Haiti : Violence – a bad legacy bequeathed to kids

By: Hugo Merveille,

Editorial Staff, Le Nouvelliste

In Haiti, the violence exerted on children seems quite a normal thing. Children, as a category of the  population, are the first to suffer the consequences of everyday-violence in society.  Being dependent and fragile, kids bear the brunt of all kinds of frustrations at the level of the community as well as the family.

In recent years, several initiatives have been launched to sensitize public opinion on an issue of which the immediate consequences are not felt, but which has serious repercussions on those who will make up tomorrow’s society.

 Under Haitian law, children are defined under the term of minor.  Article 392 of the Civil Code defines the minor as every person who has not reached the age of 18 years.  According to Haitian law, a child cannot be brought before court.  This prerogative belongs to the parents or guardians who represent the child.  These conditions make the child very dependent on adults, even though he or she may receive direct help from the Citizens Protector.  As a consequence, a child can be seriously exposed to violence in a society where this is tolerated, because there is no legal framework to prevent or punish it.

Several people have raised their voice in the past years to condemn violence exerted on children in Haiti and to sensitize people on new educational approaches which exclude the physical punishment and other forms of abuse practised on children.

Table I: Population per Department and per age group as estimated in 2002

Department Population 0-14 years 15-64 years 65 years +
West 3.071.306 1.042.931 1.931.726 96,649
South-East 490.350 199.340 266.596 24.414
North 852.488 374.013 446.786 31.689
North East 272.502 116.889 144.220 11.393
Artibonite 1.152.876 491.906 615.411 45.559
Centre 552.405 242.313 288.003 22.089
South 714.802 299.095 384.685 31.022
Grand Anse 707.802 295.661 380.525 31.616
North West 489.531 223.619 242.751 23,161
Total 8.304.062 3.285.767 4.700.703 317,592

Source: Institut Haïtien de Statistique et d’Informatique (IHSI)

The forum “Childhood and violence” organized in 1996 and the law voted into force in September 2001 by the Haitian parliament, put under scrutiny an evil which eats Haitian society away and especially its kids. In November 2001, Haiti hosted the first regional meeting on violence within the family.  Many sectors of the society took advantage of that meeting to complete a survey of the problem of violence in general, and in particular that exerted on children, and to envisage solutions.

Dr. Legrand Bijoux, psychiatrist at the “Centre d’Education Speciale” (CES – Centre for Special Education), defines violence as each situation which hurts a person in his / her body or in his / her personality.  Psychologist Vania Berrouet, who lectured at the forum on childhood and violence in 1996, points out that there is violence when, in an interaction with an individual, a constraint is exercised which lifts certain personal rights, attacks his / her moral or physical integrity, or limits or lifts his / her decision-making rights[1].

Children in Haiti face these situations everyday. No matter if it is at school, within the family, in the street or in their relations with the State, violence pursues children and is part of their everyday life.

To learn under the threat of the whip

Physical punishment at school has been prohibited since 1843 under the government of Jean Pierre Boyer (President of Haiti from 1816 to 1843).  In 2002 however, most schools in the country still continue this practice in one or another form.  The “Rigwaz” (Cow skin – dried and stretched), “matinet” (small whip), and the wooden ruler belong to the teachers’ implements, especially at primary school, to “encourage” the pupils.  In certain schools there is systematic use of the whip, while in others the teachers may decide on its use, without any form of direct intervention by relevant associations or the Government.

Other forms of physical punishment are also administered: teachers put pupils on their knees in the sun, pinch them with their finger nails, pull their ears, and so on.

Verbal violence is also very much practiced in classrooms. Children are often designated “moron” or called silly when they don’t manage to understand a lesson given by the teacher.  Vania Berrouet, now collaborating with the Haitian Foundation for Private Education (FONHEP), determines forms of cultural violence.

“It is a fact that schools are unaware of the reality of the children’s life style.  They are told that what they have is no good, that what they are going to be taught is the truth, because their truth is not good[2],” Mrs Berrouet said.

However, based on several training seminars for teachers on the question of violence at school which she organized, it can be concluded that the infractions reported by those teachers were minor ones.

“In Haiti we don’t have the worst cases, where there is attack on the integrity of the other, as we see nowadays in the United States, where kids are obliged to pass a firearm or knives detector[3],” she noticed.

Although laws forbid corporal punishment, no supervisory structure has been put into place.  Mrs Berrouet made clear that during the period from 1986 to 1996, only three complaints provoked the dismissal of teachers.  In these cases, there were fractured fingers or fore-arms of a child.

Two children encountered in a bus, Henry (7 years) and Albert (9) told that they were beaten at their school.  Their mother, who was present in the bus, said that it this had to happen because her children are very boisterous.

“I know they can get to the end of their unruly spirit at that school; that’s why I enrolled them there,” she said.

As such, parents are accomplices in the violence exerted on school children.  Besides, violence is even omnipresent within the family.  A survey under various levels of society, carried out in August 2002 by a group of 20 kids trained by Plan Haiti in the city of Jacmel, revealed that teachers form the second category of people who do not respect the Rights of the Child.  The category “illiterate people” came in first place.

The family : First responsible

The family circle, where the child should feel itself secure, is the first place where he/she encounters violence.  Whether carried out against him/her or against family members, the child grows up in an environment punctuated by brutal scenes.  Even the most humiliating punishments are considered to be means to provide the child with a good personality. [4]

About nine women and nine men out of ten think that it is normal to slap the children in their face once-in-awhile or to smack their bottoms in order to make them obey, according to a survey on mortality, morbidity and the use of services (EMMUS III) carried out by the Haitian Ministry of Public Health and Population in 2000.  Additionally, 15% of women and 23% of men think that it is normal to give physical punishment to children.

87% of women and 74% of men admitted to have given, sometimes or often, slaps to children in their face or on their bottoms to make them obey.  Moreover, 39% of men said to have given corporal punishment to children[5].

These figures indicate a state of mind which puts the child in a situation of inferiority, with regard to adults.  Dr. Bijoux summarizes this fact through two Haitian proverbs: “Timoun se ti bet” (Children are little animals) and “Ti neg se baton ki fe l mache” (It is the whip which makes the little guy walk).

Parents who were polled think that they have the rigtht, even the obligation, to correct their children. “Children are so boisterous, disobedient and disrespectful that they well-deserve the stick,” Elvie said, a merchant of fried food.  Patrick, her son, doesn’t like it when his mother beats him.  He said that sometimes he is beaten without even knowing why.

Table II: Domestic violence and ill-treatment of children

  Conjunto Area metropólitana

Area Urbana

Conjunto Urbano

Rural

Mujeres afectadas por la violencia física  desde la edad de 15 años (%) 35 34 41 35 35
Mujeres de 15-49 años afectadas por la violencia física durante el embarazo (%) 7 6 7 7 7
Mujeres/hombres  que piensan que  es  normal infligir castigos corporales a los niños(%) 15/23 13/16 16/28 14/20 17/25

  

  

 

 

 

 

 

 

 

 

 

Source : EMMUS III

Why do, in Haiti, women come out on top of the statistics dealing with violence exerted on children?  A story told by psychologist Edwige Millien during the forum “Childhood and violence” can enlighten us on this:

“Jeannette is a little girl who was beaten often by her mother.  Jeannette’s mother was beaten as a  child.  She was first of all beaten by her father, and to escape from his ill-treatment, she married when she was very young.  Her husband was a drunkard and kept on beating her.”[6]

This shows that violence is a chain and the weakest ones are those who are going to be the greatest victims.  In Haiti, women are much victimized by violence. The results of EMMUS III reveal that in the geographical regions where violence towards women is the highest, equally violence exerted on children tends to be more important.  Thus, the EMMUS III inquiry reveals that the women who approve of beating children most frequently, are those living in Grande Anse (21%), the North-West and the Artibonite[7].  Those departments are characterized by the highest rate of domestic violence.

“Violence results of our incapacity to resolve our conflicts in a peaceful manner.  This requires communication, negotiation and critical reflection.  These techniques are not taught in schools.  People should know that children can be disciplined without the use of a stick,” Mrs. Stefanie Conrad said, Officer in charge of communication at Plan Haiti, a non-governmental organisation which places children in the centre of all its activities.

Several specialists admit that the consequences on a child are more serious when it has been eyewitness to violent scenes than when it has been subjected to them.  Dr. Bijoux asserts that research done in Canada demonstrates that the effects of violence are deeper when a child is a direct witness of the violence or that violence is carried out against a person that he/she loves.

A survey by the Inter-American Development Bank (IDB) in Nicaragua very well illustrates the effects that violence can have, especially with regard to the education of children.  According to this study, 63 % of children coming from families where women suffer domestic violence repeat a school year, and, on average leave school when they are nine years old, while that age is 12 years for children whose mothers are not victims of serious ill-treatment.[8]

“Domestic violence is a problem which concerns health, law, economy, education,  development, and before all, human rights,” Merhr Khan said, during the year 2000 Research Director of “Innocenti” (a UNICEF publication).

Children in domestic service: the most ill-treated

Although Haitian legislation on child labour is very restrictive, domestic service is a  widespread  phenomenon in Haiti.  Aged from 5 to 18 years, thousands of children are torn from their families to go to work free of charge or in return for assistance such as access to school.

Even as the Labour Code authorizes the placement of children in domestic service at age 12, the Institute for Social Well-Being (IBSR), which is charged with providing advise, categorically opposes it.

On the other hand, the minimum age for paid labour is fixed at fifteen (15) years, with the authorization of the Labour Directorate.

If the majority of Haiti’s children is not being spared from violence, les restavèk, the name given to children in domestic service (from “staying with”), are those who experience most brutality.  According to the first results based on data collected during an inquiry in 2001 by the International Labour Organisation (ILO) through its “International Programme for the Elimination of the worst forms of Child Labour (IPEC),” the number of children in domestic servitude in Haiti ranges between 90,000 and 120,000 of which 75% are girls from 7 to 15 years old.

Attorney-at-law Betty Casty who works with UNICEF and was speaker at a regional meeting on violence within the family (November 2001), said that many children carry out domestic tasks which are above their physical capacity.  Often, they have no access to health care, education and leisure.  Worse, they are victims of sexual abuse.

Table III: Children in domestic service in the Caribbean and Central America

Country Child population Children in domestic service %
El Salvador 447782 21508 4,8
Dominican Rep. 428720 48017 11,2
Honduras 336136 20764 6,2
Nicaragua 311464 17694 5,7
Costa Rica 147087 12498 8,5
Panama 67247 9300 13,8

Source: ILO/IPEC

60% of the children in domestic service who were questioned in the scope of an inquiry carried out by the Psycho-Social Family Institute in 1998 told that they have been punished by the head of the household.  Moreover, they are continually insulted, which reinforces the never-ending humiliation they are subjected to.

Until now, only about forty countries in the world have adopted specific legislation concerning domestic violence, among which are 13 countries of Latin America.

Dieuseul (12 years old), interviewed within the context of this briefing, tells that he was severely beaten by a lady with whom he came to Port-au-Prince at age 8.  The lady honoured certain promises made to his mother, such as sending him to school.  But the domestic tasks he had to do did not leave him time to study.  He had to spend the entire day to do his tasks well and not be reprimanded by her.  “After three years, I was worn out.  One day I ran away.”

The International Labour Organisation (ILO) organized on 27-28 May 2002 a seminar for journalists with purpose to make them more aware on the subject of child labour in Haiti, in particular related to domestic servants.  The judge for children, Mr Emmanuel Lacroix, had detected contradictions in the Haitian legislation relative to child labour, pointing out that Haiti as yet has not ratified Convention 182 on the elimination of the worst forms of child labour and Convention 138 on the minimum age of children to be employed.  The journalists who attended that seminar expressed their will to raise awareness among the population in order to eradicate the worst forms of child labour.

16 % of children in Latin America and the Caribbean are mistreated when adults judge that their behaviour is wrong.  Verbal insults represent 13 %, against 16 % for corporal punishment.  Haiti is the country in the region with the highest rate of beaten children (40%), followed by Guyana (23 %) and the Dominican Republic (20%).

Street children : left to themselves

Street children are those who haven’t got any place else to live but the street.  Other children spend their day in the street but at night they have a place to sleep: those children are called children in the street.  The number of street children is about 2,000 according to figures provided by father Attillo Stra, in charge of a home for street children named Lakay (situated in La Saline, Port-au-Prince).

Street children experience violence from day to day.  Left to their own devices, they undergo violence and they use it to survive. “Subject to a general insecurity and deprived of everything, the street child lives on violence to survive,” Mrs Casty said.

In the street, the child is initiated to violence and sees it every day.  These children are very exposed to violence in its most brutal forms.

“Generally, drug-addicted or not, the street child of Port-au-Prince lives in an early familiarity with death and in an abnormal promiscuity with its most violent and revolting forms, such as murder and lynching.  Actually rare among these youth are those who didn’t experience the useless death of someone more or less close, sometimes a comrade of the same base (group), of another group or of a well-known adult.  Few are those who have not seen in the early hours of the day a body corpse covered with blood left along the roadside, and often left to rot in the sun for several hours, “ Frantz Lofficial explains[9].

“Some among them have even witnessed lynchings and other revolting forms of violent death.  The fact that violence is a feature of every day life for street children and that there is a depreciation of human life, should be kept in mind when considering certain atrocities committed by some street kids.  When considering death as child’s play, they only replicate an established model, without worrying of the consequences, for the life of others nor their own seem to have value,” he adds.

Prey for themselves and for other children on the streets, street children often are also the victims of police violence, and see their rights trampled underfoot.  Most of the incarcerated children are street children.  For mere offences or fines, they are incarcerated, although the law concerning minors prioritizes rehabilitation and education.

The judge for minors, Mr. Emmanuel Lacroix, declared that the incarceration of minors is illegal according to the law of 7 September 1961.  Even in the case of criminal sentencing, a minor should be placed in the reception centre Duval-Duvalier.  Children who commit offences are presently incarcerated in Fort National.  For Mr. Lacroix this situation is a non-respect of children’s rights.

Harmonising communication between children and the police force

At the other hand, in order to improve the relations between police authorities and children in difficulty, in particular street children, the National Police of Haiti in cooperation with UNICEF organized from 21-23 February 2001 a training workshop on communication techniques with children, in which  twenty police instructors took part.

For the organizers, this event “responded to the necessity to heighten the respect for child rights and especially to develop knowledge on the situation of children in difficulty, and social care for vulnerable children.”[10]

The workshop was centred on the need of the police to start listening to children, and to establish a specialized detachment to deal with the cases of minors and of more police specialisation in the protection of children.

The instructors learned to establish the difference between justice for children, aiming at the protection and rehabilitation of the delinquent minor, and justice for adults, which aims to repress the offender.

Criminal law and childrenThe age of criminal majority is laid down at about 16 years.  Children from 13 to 16 years old who commit crimes and offences are brought before the tribunal for children.  Only the sixteen-year old minors are liable to the Court for minors.Criminal responsibility and measures which deprive freedom (detention) are strictly speaking not relevant to children.  The judge for children decides here, according to the nature of the crime or offence committed by the minor, on protective measures to adopt in the greatest interest of the child.  In one or another case, this measure is limited to placing children in a reception centre in order to protect them from the crowding of the prison for adults, and only concerns children among thirteen (13) and sixteen (16) years (law of 7 September 1961 on the protection of stray minors or those in physical or mental danger).

The minor under 13 years old benefits from the principle of criminal irresponsibility.  Only  measures of assistance, protection, monitoring and education can be pronounced against them. In the case of offense, the Tribunal of police is competent, but against minors over thirteen (13) years, it can only pronounce an admonition or a fine.

Report of follow-up on the application of the Convention on the Right of the Child, November 2000, pages 11-12.

 

SOS Timoun (SOS Child): Coming to the assistance of ill-treated children

Because of the numerous cases which have been submitted to it over recent years, in 2000 the Institute for Social Well-being  and Research (IBESR), a governmental organism under control of the Ministry of Social Affairs, opened a service called SOS Timoun (SOS Child).  This service puts a phone number at the disposal of children who are victim of or witness to violence: 133.  It receives calls from Monday to Friday from 6 A.M to 6 P.M.  The SOS Timoun service was launched on the National Day of the Child, the second Sunday of June 2000.

“Its creation forms a response to certain problems linked to violence towards children within the families, the children in domestic service and street children, for whom the Institute for Social Well-being is constantly approached,” the Principal of Social Protection at IBESR, Marie Carmelle Déjean, noticed.

She said that the service of which she is in charge often receives severely  beaten children, brought in by the police or by someone near to the child.  Those children sometimes have very serious injuries, she emphasized.

Table IV: Distribution of the children received, by age group and sex (October 2000 – September 2001)

Age group Male Female Total
6-10 7 15 22
11-15 23 9 32
Total 30 24 54

Source : IBESR

Table V: Number of calls with their origin (October 2000 – September 2001)

Calls Child victims Parents Neighbours Others
725 350 24 276 75

Source : IBESR

Table VI: Cases treated according to sex and status (October 2000 – September 2001)

  Male Female Total
Abandoned children 2 6 8
Lost children 2 4 6
Incarcerated children 8 4 12
Children in domestic service 34 98 132
Total 46 112 158

Source : IBESR

“The majority of those attacks are committed within the family, especially towards the children in domestic service,” she pointed out.

When a child is brought in or requests the intervention of SOS Timoun, the Service for the Protection of Minors at IBESR makes an inquiry.  The parents may be invited in order to convince them of the danger of violent practices.  In the past, seminars for teachers were organized in primary and secondary schools.  The lack of logistic means hampers the assistance of the Service in treating urgent cases, Mrs. Déjean explained.

Children are sometimes placed in another family or in a partner institution of IBESR, like ESCALE, a non-governmental institution which cares for ill-treated children in domestic service.  However, such a solution is an exception, for it is always better that the child remains with its family, she added.

Economic reasons are the first cause of violence towards children in Haiti, Marie Carmelle Déjean stated.

“When the lady of the house wakes up and doesn’t know how she is going to feed the family, she takes it out on the children,” she said.

Although SOS Timoun is a good initiative, it suffers from the lack of telephone lines in Haiti.  Moreover, a taboo reigns on an external intervention to solve a family problem.

For Jimmy (8 years old) residing at Carrefour-Feuilles, “it is out of the question to call the police” regarding his parents (Jimmy compares SOS Timoun to the police).  “Even if they beat me, I put up with it. One day I will be adult and they will not be able to beat me anymore.”

A man (of about forty years old) interviewed on the street and questioned on the subject, told that if he would beat a child for its own benefit and the child would call the police to arrest him, he would abandon that child.

Kathia (13 years) is a domestic.  She doesn’t know SOS Timoun.  “When they beat me, I call a neighbour for help.  If I knew that there was a phone number to call for help I would already have done so.  But if people in the house would overhear me on the phone, I would be severely beaten,” she told.

A phone call is not a condition for an intervention by IBESR within the context of its service SOS Timoun.  A person can directly go to the institution to inform it about a case of violence towards a child.  However, IBESR has only three offices throughout the country (Port-au-Prince, Gonaives and Cap-Haitien).

It appears that many cases do not reach the ears of the authorities or of organizations working in the field of the protection of children’s rights.  In Port-au-Prince, the Directorate for the Protection of Minors has only one car.  Very often, even for a case of moving someone, the victim is obliged to wait.

Elaborating one sole registration of cases of violence

Statistical data on violence in general and that towards children in particular are rare in Haiti.  This can be explained, on the one hand, by the fact that victims hesitate to lodge a complaint, and on the other hand, by the fact that there isn’t a uniform method to register the information in this domain.

In view of this, the Centre for Intervention, Rehabilitation, Research and Expertise for Victims of Violence (CIRREV), a non-governmental organization working against violence towards women and children, has proposed to several institutions active in this field to elaborate a sole registration sheet for cases of violence.

“It is very difficult to make a complete report of the status of violence in Haiti and to draw the necessary lessons in order to modify activities for the different types of violence,” Marjorie Joseph, a medical doctor at CIRREV, said.

“This new instrument (which is in an experimental phase) will permit the preparation of better prevention and public awareness programmes on the phenomenon,” according to Mrs. Joseph.  She facilitates also the preparation of proposals to the public authorities, which could assist to adapt policies and to develop laws in relation to the realities observed.

Miguelina Rousse, a social worker with CIRREV, revealed a relatively high rate of rape of young girls.  Over a month, about twenty rape cases are registered at “Hopital de l’Université d’Etat d’Haiti” (State University Hospital of Haiti).  Most of them are between 8 and 12 years old.

About a hundred cases of violence have been reported to CIRREV since January 2001, 25% of which concern children (under 18 years of age).  Mrs. Rousse said that the children in centres for children in difficulty are often violent, because they have been themselves victim of violence.

Having a say in the matter

The media have a part to play in the struggle against violence in society, Mrs. Rousse believes. Several radio and television stations have put their aerials at the disposal of CIRREV and have carried out broadcasts aiming at educating the population on non-violence.  Several broadcasts have been done on the waves of Radio Planète Creole, Radio Guinen and the National Television of Haiti (TNH).

Mrs. Rousse indicated that broadcasts concerning sexual attacks have been re-broadcast.  They inform listeners on how to implement a judicial appeal in the case of a rape, for example.

In Haiti, about 7 out of 10 teenagers think that they are little or not informed about their rights, according to a survey by UNICEF, entitled “The Voice of Children”[11], published in 2000.  The survey measures the knowledge of Latin-American and Caribbean children on their rights.

Children from urban areas and from a more-or-less high socio-economic level are better informed about their rights than other children.  It should be underlined that “to be informed” doesn’t mean that the children are completely aware of their rights.  The rights which are the most spontaneously mentioned by them are: education (59%), health (38%), leisure (25%), the freedom to speak (23%)  and the right not to be ill-treated (16%).  Concerning the latter right, this rate is 37% in the Dominican Republic and 41% in Jamaica.

The Haitian child remains deeply embarrassed by expressing its opinions and feelings.  The report “The Voice of Children” specifies that half of the children and adolescents polled pointed out that they have difficulties to express their opinion at home and at school.  The reason most often given is a lack of courage to take the floor (52%).

In Haiti, this figure is 41%, in the Dominican Republic 57% and in Jamaica 10%.  The percentage of children who answered that teachers don’t listen is 9% (Haiti), 19% (Dominican Republic) and 16% (Jamaica).  80% of those polled declare that they rarely experience feelings of well-being at school.

The absence of information presents itself even in very important areas, such as sexuality.  Two (2) children out of three (3) are little or not informed in the matter of sexual education, the inquiry of UNICEF reveals.

“Most of the data from Haiti are different from those from other countries in the region (a better knowledge of rights, stronger feeling of well-being, appreciation of the school environment, rejection of domestic violence),” Mrs. Rousse mentioned.

Over recent years, several initiatives in the media have helped children to gain access to information or to work for the change of bad aspects in the relations between children and adults.  The newspaper “Le Nouvelliste,” reserves a weekly supplement, “Le p’tit Nouvelliste” (the little Nouvelliste) for young readers.  The subjects covered aim to give children responsibility.

In the scope of that supplement, the paper collaborates with some organizations which work to improve the children’s lot.  For example since January 2002, together with the Panos Institute and Plan Haiti, there is a series covering the experiences, in various regions of the country, with the training of child journalists.  These child journalists regularly write short texts which are published by the P’tit Nouvelliste.  In the North-east of Haiti, the child journalists conceptualize and produce their own radio programme, which is broadcasted on Radio Gamma in Fort Liberte and on Radio Hispaniola in Trou-du-Nord.

In Haiti, one radio and one television station have been created with the core part of their programming intended for children.  Mr. Eddy Trofort, Director of Radio Timoun (Children’s Radio) told that most of the broadcasts deal with issues related to the situation of children.  Radio Timoun also grants an important place to educating parents.  According to him, the ill-treatment of children in the country is due to the lack of education of parents.

Creating new parents – children relationships

Stephanie Conrad, in charge of communication at Plan Haiti, informed about the work accomplished by her institution for the improvement of children-parents relationships.  The programme ”Children and media” is an example of the activities undertaken by Plan Haiti for that purpose.

The children’s broadcasts show to parents that children can be responsible beings. “This instills the parents’ respect and confidence.  They have the possibility to see their kids express themselves and show their capacities,” she pursued.

Mrs. Nicole Pierre-Louis, person in charge of Child Rights at Plan Haiti, emphasized the rights of children but also their duties.  According to her, it is very important to make the children aware of their responsibilities.  This contributes to the growth of respect between adults and children.

She signalled that within the “quality school programme,” a joint project between  FONHEP and Plan Haiti, carried out by different institutions active in the educational field, the issue of violence at school was broached to teachers.  They were shown how an environment where a child feels secure favours a greater output on the academic level.

On the other hand, since April 2001, a group of national and international organizations have undertaken a series of awareness activities in other to promote the enforcement of child rights.

This mobilisation is done in the scope of an international campaign: “Global Movement for Children.” One of the rallying cries is the arrest of the ill-treatment and exploitation of children.

The Haitian Coalition for the Defence of the Rights of the Child (COHADDE) is one of the organizations which participates in the Global Movement for Children.  Since 1991, this organization, which associates nearly forty institutions working for the protection of child rights, promotes the development of children on the ground.  At present, COHADDE organizes training sessions for children from various regions of the country in order to allow them to take part in the promotion of their own rights.

According to Mr Emmanuel Lacroix, President of COHADDE, about a hundred children will have been trained at the close of that programme.  Their task will be to train other children in order to create regional networks for the protection of child rights throughout the country, within the framework of the Global Movement for Children.

Corporal punishment is henceforth forbidden

On 6 September 2001, the Haitian Government through the intervention of the parliament formally forbid corporal punishment exerted on children.  In Article 1, the legislators say: “Inhuman treatment of whatever nature, including corporal punishment against children, is forbidden.”

“By inhuman treatment is meant every act which provokes a child with a corporal or emotional shock, such as striking or jostling a child, inflicting a punishment which attacks his/her personality, by or without the use of an object or a weapon or the use of force,” Article 2 specifies.

This law envisages a series of clauses concerning corporal punishments which are still being inflicted at school. Sanctions are provided against all those who refuse to respect this law.

However, several experts in the field of the protection of child rights bring forward that a law cannot change mentalities; and  that structures should be conceived of to facilitate the application of the legal norms.

Almost in the same street where the Institute for Social Well-being is located (Rue des Marguerites), there are schools which still use the whip.  A teacher questioned about this, answered that Haitian children are not ready as yet to learn without the whip.  “We obtain better results with the whip,” he said.

Long before this law was adopted, some schools had already forbidden use of the whip.  However, in many schools, teachers who are reluctant to lay down the whip are tolerated.

Parliamentarian delegate Wilner Content thinks that follow-up clauses must be formulated, as foreseen in the adopted law.  Mr Content realizes that many points in this law will not be applied automatically.  He thinks that especially the Ministries of Social Affairs and National Education must be “very watchful” in the preparation of a framework for application.

“There are many laws in the country but that doesn’t prevent us from noticing gaps every day. Whether it is at home or at school, corporal punishment is still being practised.  These follow-up clauses are needed to monitor this law and apply the provided sentences,” he declared.

To work for the elimination of abuse exerted on children will be very difficult because of the mentality of parents who think that the whip can improve children’s behaviour, according to Mr. Content.

“The difficulty can also be explained by the fact that the Department of Justice will have to take the reality into account. That’s why the Ministry of Social Affairs must set up programmes to make parents aware of this legislation, to make them understand that their job is to watch over the full development of their children,” he added.

The law adopted by the Haitian Parliament is a step towards the harmonization of Haitian legislation with the Convention on the Rights of the Child, ratified by Haiti in 1994.  During the Special Session of the United Nations on Children, which took place from 8-10 May 2002, the Haitian government presented the adopted measures, which are to make the rights acknowledge by that Convention effective in Haiti.

Article 19.1 of the Convention of the United Nations on the Rights of the Child: The signatory States take all the appropriate legislative, administrative, social and educational measures appropriate to protect the child against all forms of violence, physical and mental attacks or brutality, abandonment or negligence, ill-treatment or exploitation, including sexual violence, while he/she is under the guardianship of parents or one of them, the legal representative(s) or any other person to whom he/she has been entrusted..

Teaching for non-violence

Several people met in the scope of the preparation of this briefing, expressed their anxiety about the phenomenon of violence in the country.  Dr. Bijoux emphasized the risk of a perpetuation of violence by the “complex of reproduction,” which leads the victim to identify himself / herself with the agressor.

According to Dr. Bijoux it is difficult to build a society founded on violence.  “Although the history of the country, full of violence, can explain the extent of the phenomenon in the minds of people, after two centuries it is time to break with this.  These practices have brought nothing positive to our society.”  Dr. Bijoux thinks that after several generations an education for non-violence can bear fruit.

That was also the appeal of several Haitian-American elected representatives on visit to Haiti in January 2002.  While speaking at the office of public affairs of the United States Embassy in Haiti, on 18 January 2002, Mr. Ossman Désir, a member of the municipal council of Miami North (United States), pointed out that since Independence, the Haitian people often have resorted to violence.

The mayor of the city of Miami North, Joseph Celestin, also criticized the fact that violence is omnipresent in the Haitian mentality.

“We have sufficiently tried violence.  Now, it is time to explore other alternatives to see results, founded on principles of non-violence,” Marc Villain said, Chair of the Committee for Haitian-American political actions.

Some reference institutions

Escale

Drouilard près de la fontaine Duvivier

Port-au-Prince

Contact : Nadine Burdet

Timkatec ( Timoun k ap teke Chans)

59, Rue Derenoncourt

Pétion-Ville

Tel : (509) 557-2410, 257-1397

Contact : Père Joseph M. Simon

Lakay

Boul. Jean Jacques Dessalines # 10

Port-au-Prince

Tel : (509) 510-7137 , 556-8203

Contact : Père Attilo Stra

Foyer Maurice Sixto

Brochette 97-99, Rue Saint Louis# 90

Port-au-Prince

Tel : (509) 510-4766, 222-7464

SOFA

Nazon, Rue Monplasir, 1ère ruelle à gauche, # 1 bis

Port-au-Prince

Tel : (509) 245-4460

Contact : Marie-Frantz Joachim

PEJEFE (Programme d’encadrement des jeunes Femmes et des Enfants)

Rue Becassine # 61

Port-au-Prince

Tel : (509) 221-3485

Contact : Erlande Merceron

CIRREV (Centre d’intervention, de réhabilitation, de recherche et d’expertise pour les victimes de violences)

Rue M # 4, Turgeau

Port-au-Prince

Tel : (509) 245-1869

Contact : Marie Desmousseaux

IBESR ( Institut du Bien-Être Social et de Recherches)

Rue des marguerites # 13

Port-au-Prince

Tel : (509) 245-1346, 245-0271, 245-6485

Contact : Marie Carmelle Déjean

Tribunal pour enfants

Rue Pétion #16

Port-au-Prince

Tel : (509) 556-3083

Contact : Juge Norah Amilcar Jean-François

Service social de l’Hôpital de l’Université d’Etat d’Haïti (HUEH)

Rue Mgr Guilloux

Port-au-Prince

Tel : (509) 222-3247, 222-3249, 223-9131, 222-4253

Contact : Jeannette

Plan-Haïti

3, impasse Lily, Rue Stephen, Delmas 60

Port-au-Prince

Tel : (509) 510-9471

Contact : Stefanie Conrad, Nicole Pierre-Louis

Centre d’Education Spéciale (CES)

73 , Rue de l’Enterrement, Port-au-Prince

Tel : (509) 223-6167/ 222-2154/ 222-5544

Contact : Legrand Bijoux

COHADDE

23, 3ème Rue du Travail

Port-au-Prince

Tel: (509) 245-5014

Contact: Emmanuel Lacroix


 Forum enfance et violence, Haiti, 1996, page 10

2 Forum Childhood and Violence, Haiti, 1996

[3] idem

[4]  idem,  page 13

5  Haïti : Enquête Mortalité, Morbidité et Utilisation des services 2000, ministère de la Santé publique et de la Population (MSPP), USA, June 2001

7 Forum Childhood and violence, Haiti, 1996, page 22

8 Haïti : Enquête Mortalité, Morbidité et Utilisation des services 2000, ministère de la Santé publique et de la Population (MSPP), USA, June 2001, page 304

[8] La violence domestique à l’égard des femmes et des filles, UNICEF Digest Innocenti, No 6, juin 2000, page 13

11 Frantz Lofficial, Lakay :Un foyer pour les enfants des rues, UNICEF, 1998

[10] La lettre des Nations-Unis en Haïti, numéro 11, la police et les techniques de communication avec les enfants

13 La lettre des Nations-Unis en Haïti, July-September 2000, no 9, page 6

THE SITUATION OF HAITI’S STREET CHILDREN 1:DIAGNOSIS OF A LARGE- SCALE PROBLEM

 

Briefing on Haiti, No 8, December 2002

THE SITUATION OF HAITI’S STREET CHILDREN 1:DIAGNOSIS OF A LARGE- SCALE PROBLEM

By: Nicole Siméon, Journalist

They are about 100 million throughout the world, among whom at least 40 million in Latin America.  In Haiti, the phenomenon of street children forms a real social challenge.  Seen initially in the second half of 1980s, the present magnitude of the issue brings up many questions.  From the few street children noticed during the 1970s, their number has gone up considerably.

People who work for the reintegration of street children agree that the reasons that street children are nowadays so massively present, are complex. 

 “The worsening of socioeconomic conditions, the increasing pauperization of the country and the unremitting rural exodus are the main factors causing an increase in the number of street children,” the Report on the follow up to the application of the Convention on Child Rights, published by the Ministry of Social Affairs in November 2000, indicates.

The number of street children: a Gordian knot for social workers

In the absence of a real census and reliable statistics, in order to estimate the population of street children, we must refer to either invalid inquiries, contradictory figures, or catastrophic projections.

According to a study carried out by the Research Centre for Human Resources (Centre de Recherche des Ressources Humaines -CDRH) in 1991 under the auspices of UNICEF and the Institute for Social Well-being and Research (Institut du Bien-Etre Social et de Recherches -IBESR), the figures for street children were about one hundred for the towns of Cap-Haitian and Cayes and two thousand for Port-au-Prince.  The projections of CDRH for the year 2000 show an increase to about 50,000 taking into account the over-all deterioration of the country.

In a survey carried out in 1998, Martine Bernier and Dr Françoise Ponticq admit the impact of poverty on the street children phenomenon and estimate the population of street children to be about 8,000 souls.

In 1996 in a survey on the consequences of the embargo, the former Minister of Social Affairs, Ms. Mathilde Flambert, estimates that number to be 10,000.  Frantz Lofficial of the street kids centre Lakay on the other hand expresses his reserve on these figures.  He thinks that in reality none of these estimates and projections are accurate.

Following a survey carried out in 1998[2], M Lofficial asserts that the number of street children for the metropolitan area is not more than 1,000.  He strongly refutes the figures which are currently used.

Thus, are we dealing with farfetched numbers which have nothing to do with reality?  Can we believe a possible regression of this number in spite of the deterioration of socio-political and economic factors?  Should we ask ourselves whether the work done by street children reception centres have born fruit on this scale, in spite of their numerous financial difficulties?  There are many questions and only an immediate inquiry on this can provide responses.

Street boys and girls

Social workers specialized in street child issues, particularly Frantz Lofficial, notice a fundamental difference between two groups of children in the street.  The first group, entitled “street children,” is composed of children who have their household in the street, in short who live there.  They find food and shelter on the street and do not keep in touch with their families.  They sleep in the street at night, in public places, in front of churches, in front of stores and lottery shops, on markets, and so on.

The second group, called “children in the streets” is larger than the first one.  This group consists of children who spend their days in the street, working there like the first group, but as night falls, more or less regularly they go home.  More often than not they live with a family and they contribute their day’s earnings to this family to assist in its economic survival.

Generally, street children are boys; girls have always been in the minority.  However, social workers say that they notice a perceptible increase of this minority.

In their report, Françoise Ponticq and Martine Bernier estimate the number of street girls at eighteen percent (18%) of the number of street children in the metropolitan area[3], while the big provincial towns practically lack them.  Only some were seen in Cayes, a town in the South of Haiti.  In Cap-Haitien in the North, they notice about a dozen and in Jacmel in the South-East, none are seen.

Other published reports on street children are practically silent on the subject of girls, except for saying that this is a very complex group.  Nevertheless, the Centre of Family Assistance (Centre d’Appui Familial -CAFA), a NGO which exclusively works on street girl issues, in 1996 estimated the number of street girls in Port-au-Prince at 150.  Upto now, this estimate is the only existing reference.  A survey is to be set up shortly by CAFA on  the actual situation of street girls, we have learnt.

The number of street girls in Cap-Haitian varies from one time to another, based on economic opportunities.  So, during parish or rural festivals there are many more girls in the streets than usual, according to social workers.  Without doubt, this situation distorts any validation of their real number.

“Generally, the girls in the streets are brought there by their precarious economic situation, and the country feasts offer them the possibility to find more people to beg from, taking advantage of the generosity of people desiring to repent.  Many of them go home after these days of work.  These are the ones who do not live exclusively on the street, as is the case for many boys.  Nevertheless, others stay there,” Margarette Joseph explained, a social worker with Project Pierre Toussaint in Cap-Haitian .

According to Ms. Joseph, the few girls who make the street their home, are for security reasons very mobile.  It is difficult to impose themselves into a “boys environment,” and they are often beaten and raped.

Definition and source of the problem

In the course of numerous activities, governmental, religious, non-governmental, charitable, local as well as international organizations, intergovernmental coalitions and other independent professionals working in the struggle for children rights in Haiti, classified a category of childhood under the suggestive concept: “Children in Specially Difficult Circumstances.”

The IBESR/UNICEF definition
 The child in an especially difficult situation is a minor (girl or boy) who lives in particular conditions on the fringe of norms generally known and accepted by the society, and who is exposed to all sorts of physical or emotional violence, which can harm his psychosomatic development and even create, in certain cases, some attitudes and antisocial behaviours.

Street children figure prominently in this category.  The period when a street child was considered to be an isolated element, independent from all socio-economic systems, has passed.

Nowadays, children take to the streets to find a way of survival, an escape to poverty and humiliation.

“Girls or boys, they run away from violent intra- or extra-family situations.  They also take to the street because their parents cannot provide for their needs, or because they have become orphans, among other things orphans of AIDS,” Ms. Maryse Guimond of Save the Children – Canada, states.

Many of them living in the streets, particularly girls, have run away.  Such a decision requires courage, in view of the fact that “the child which runs away is afraid of street life as much as it is afraid of its immediate situation, but it ventures to change it,” Dr. Nadine Burdet tells, a child-psychiatrist at “Escale”, a reception, training and rehabilitation centre for abused children and those in domestic servitude.

These children have abandoned their host families to flee from the psychological, physical and sexual abuse of which they are a continuous victim; or even the area where they live, to get away from the violence.  They are attracted by the freedom which street life offers them.

Danise (22 years old) tells that she lived in Cité Soleil (a shanty town in the North-West of Port-au-Prince, the capital of Haiti, well known for murderous confrontations).  “There were always inter-gang armed fights there, the young girls who lived in this or that part were often raped by the men of the opposing gang, as a way of reprisals.  Several of my friends were taken.  I didn’t want to be subjected to that, so I went to town”.

That’s how this girl, which today is being “reintegrated” by the Centre for Family Assistance (CAFA), became a street girl.  She spent a number of years on the street before benefiting from care.

Other children become street child of their own free will because they let themselves be attracted by city life and by the euphoria of their friends who are already in the streets, Ms. Guimond pointed out.  This is the case for Léonne (18 years), another girl at CAFA.  “I went to the street because a friend of mine, who lived there, convinced me.  Before that, I used to sell in street with my mother.  But when Mamoune proposed me to follow her, I quickly accepted.  That’s how my first street experience started.”

As the report 2000 of UNFPA remarks : “Many Haitians leave the countryside to seek a better future in the towns, especially in the capital.”  But: “Not much official data document this internal migration.  However, the rapid growth of shanty towns gives the impression that the urbanization of the country goes quickly and anarchically,” this same report pursues.

An increase which worsens an already difficult situation and changes the magnitude of the problem in general.

Arrival in street: a long process 

“Poverty combined with lack of privacy is one of the main factors which can encourage children to take to the street,” Dr. Legrand Bijoux, a neuro-psychiatrist, says.

According to this practitioner, the lack of space, a main characteristic of shanty towns, harms the moral, physical and intellectual development of the child.  Responding to the natural need for development at this stage of growth, the child begins to run away from the confining space.  It will follow a long process before being definitively on the street.

“In the first phase, you will find him more often at the neighbour’s who has a greater space, and when that is not enough, he will go to the street,” Dr. Bijoux explains.  “At this stage, only space interests him.  Therefore, he is on the street to play, to make friends.  He spends his days there.  He may return home from time to time to sleep and to eat.  Subsequently, he begins to spend more time on the street, he finds there all kind of attractions.

“Generally living in a one-room house with numerous brothers and sisters, they make him sleep on the floor, under the bed or the table.  Sleeping for him is very difficult.

“He decides to join his day-friends who describe the benefits of sleeping under the stars to him.  Now he comes home just to eat.  But the truth is that the more than precarious economic situation may mean that he will not find anything.  He will go back to the street then, not really wanting it but being ‘obliged.’  Sometimes he may even find himself in a situation of economic independence which gives him the possibility to feed the rest of the family,” Doctor Bijoux indicates.

The case of the girls is often different.  As they grow up, they demand more attention, more care, and more money must be spent on them.  Around them, they are indirectly encouraged to prostitute themselves.  “If what I give you is not sufficient, then, manage on your own,” words which they hear repeatedly.

There are not enough free schools to attend and parents cannot afford to pay the education of many children.  This is another significant factor to take into account for explaining that so many children find themselves in streets, Dr. Bijoux pursues.

In 70% of the cases at “Escale”, the family of origin of the children counts more than 4 kids, and all are from rural areas or shanty towns.  According to data provided by the International Labour Organization (ILO), within the context of its International Programme for the Extermination of Child labour (BIT/IPEC) in Haiti, more than 500,000 children from 5 to 12 years old are not registered at school.  What are those children doing?

Domesticity : a factory producing street children

In 1984 the population of children living as domestic servants was estimated at 109,000 children.  Estimates fluctuate around 300,000 in 1998[4], which is an increase of nearly 200% in less than 20 years.  75% of these children are girls between 4 and 18 years old.  Nevertheless, we unofficially learnt that a study carried out by IPEC in collaboration with UNDP and UNICEF, in 2002 estimates the number of these children between 90,000 and 120,000.

The children in domesticity “lack care and are psychologically mistreated : humiliation, injustice, bullying, punishments, no consolation at all, no calm, little rest and leisure, a very small or a non-existent personal place, anxiety.  They experience the abuse of verbal and physical violence as well as sexual abuse,” Dr. Chantal Jörg, a Canadian ethno-psychologist, summarizes in a pilot-project of assistance to adolescents in difficult situations in Haiti, entitled “la Marelle.”

Most of the time, the host family doesn’t enjoy a comfortable level of life because of their low income.  The book “Analyse de la situation sanitaire (Analysis of the health situation) :  Haiti 1998″ states that most of these families have an income under 1200 Gourdes per month, the equivalent of $45 American dollars[5].  The result is that domestic children are the most often ill-fed and they rarely benefit from any medical attention.

Running away is the most common used manner of children to escape from situations of exploitation and violence.  Freeing themselves of the neo-slavery of the householder and often of violence and sexual abuse by the head of the family, hundreds of psychologically and physically deprived children find themselves one day or another in the street.

“As long as a child is victim to unequal treatment with relation to the householder’s own child, regarding eating, sleeping and dressing ¼ the child in domestic servitude endures it.  But when it is ill-treated, beaten and even raped, it ends up running away.  Usually not able on its own to find the parents, he or she remains in the street,” Dr. Bijoux has actually noticed.

To some extent, the flight causes a snowball effect with children in the same situation, because the one who left will praise the freedom that the street offers to the children still living in domestic servitude.  According to Ms. Marline Mondésir, the person in charge of the Support Centre for Development (CAD), a comprehensive reception centre for street children situated at Carrefour-Feuilles, the majority of the 24 girls hosted at the centre previously lived in domestic servitude, before finding themselves on the street.

Many children tell that they ran away after a beating.  At average, 4 children out of 5 testify that they were beaten.  They turn out to weigh less than they are supposed to and they are undersized for their age,  Dr. Nadine Burdet of Escale states.

Prostitution : an inevitable passage for girls

Within the category of street children, girls form a particularly vulnerable group.  Most of them turn directly to prostitution,” Ms. Jessie Mathurin tells, one of the directors of the Popular Education Centre (Centre d’Education Populaire -CEP), an organization in Carrefour-Feuilles which works with street children.

Prostitution is caused by “the normalness of sexual intercourse and its earliness.”  Most of the time, social workers report cases of children who get deeply involved in  sexual practice even before their puberty.

To compensate for their particularly precarious socioeconomic situation or encouraged by the promiscuous environment, girls enter commercial sex with their friends of the streets and/or with older men, who do not necessarily display secure behaviour.

According to Ms. Kettlie Marseille, founder and leader of CAFA, “most of girls we welcome here, lead the life of a prostitute.  If one does not take this factor into account, every type of assistance is doomed to fail.  That’s why we have developed support methodologies adapted to their situation, their personality and their sex,” she explains.

However, we must admit that “the reasons which push children into streets are not the same now as it was in 1996,” Ms. Marseille tells.  “Now, we have children who do not have the problems inherent to children in difficult situations.  There are those among them with a normal family life and who attend school.  They go into the streets to prostitute themselves and after that they go back home,” she says, adding that the number of girls sleeping in the streets has gone up.

This is also the point of view of Ms. Jessie Mathurin of the Popular Education Centre (CEP), based in the community of Saint-Gerard, who adds: “We could say without any risk of being mistaken that now we have a population of street children in Haiti.”

She upholds that “The street children are not the same today.  They have much greater ambitions.  Ill-intentioned people take advantage of them and lead them to perpetrate reprehensible acts serving their horrific plans.” She indicates that “it is a reason to believe that the data have really changed; this must be taken into account in intervention programmes.”

According to an internal study carried out on a sample of 20 street girls surveyed by CAFA, prostitution networks expand in Port-au-Prince.   Thus the street girls are victims of pimps and paedophiles.  Though cases of boys who prostitute themselves are known too, there are no data which establish a figure or confirm that they depend on such networks.

“The prostitution by street girls expands in proportion to their increasing number,” the CAFA report specifies.

Victims of the inequality of gender and belittled in their values, girls cannot practise some of the street activities which are restricted to boys, such as polishing shoes, cleaning cars, loading the public transport buses, etc.  Apart from begging, they have not much alternative than to prostitute themselves.

Psychological portrait of a beginning street child

Street children are between 4 and 18 years old and in majority live in the metropolitan area of Port-au-Prince.  The first characteristic of a street child, according to Dr. Bijoux, is that generally speaking more than others, it is branded as a disadvantaged child.  Everybody (the public bus driver, the motorist, the passer-by, the merchant, the policeman and so on), makes him feel that he is “inferior,” and depreciates him.  He feels therefore unloved and not respected.  He is psychologically belittled.

The second characteristic, Dr. Bijoux pursues, is that the child is dismayed by a feeling of insecurity.  An insecurity which shows itself in all its forms.  He cannot eat when he is hungry and when he eats none of the hygienic conditions is respected, thus his health is endangered.  When he is sick, no one  will take care of him, no mechanism which permits him to benefit from free care in the hospitals.  He sleeps in the streets, at everybody’s mercy.  He is not protected in sexual intercourse.

In this regard we should notice the praiseworthy efforts of organizations and people who carry out relevant programmes, but their activities cannot take charge of all street children.

A third characteristic is despair.  The street child is hopeless, Dr. Bijoux explains.  This despair expresses itself through resignation.  He resigns himself, saying that nothing good will ever happen to him.  And in this state, anybody can take advantage of him.

“It is no coincidence that we find so many armed teenagers, who have become “zenglendo.” [6]  He tells himself that he has nothing to loose, the neuro-psychiatrist says.

The last characteristic is violence.  Still according to Dr. Bijoux, “violence is a pathology characterized by the conscious or unconscious wish to make others suffer what one suffered oneself.  A second variant of this violence is the complex of identifying with the attacker: the person who suffered the attack nourishes hope for taking vengeance one day and it is not important whoever is the victim.

The street child is more exposed to delinquency than anybody else.  His moral consciousness little by little crumbles.  A street child confides “I have no one telling me what I can do or not.”

These children have no models.  Delinquency expresses itself little by little; in the beginning it is only thefts, then they start to sniff “thinner”[7]  until this is no more sufficient.  The moment for hard drugs can come and for armed attacks.

“Violence calls up more violence; it is not surprizing that street children turn out violent,” Dr. Bijoux points out.

A not very reassuring environment

The only shelter of street children is the streets.  They are alone, homeless and without relations.  Some of them even don’t know where they come from, others don’t know their names.

Turning their back to their zone often to run away from a situation that they judge unbearable, these children no longer want to have relations and prefer to say that they have got no family or to admit that they don’t want to go back there.

“I was 2 years old when my father died,” little Jean says, a 12 year-old.  “I have henceforth been living in street.  My mother couldn’t afford to care for me, so I left the house.  I know that she has now another man in her life.  I no longer want to go back to their house, I am OK where I am.”

However in street, they are deprived of everything and live day to day, through developing protection and survival strategies which oscillate between distrust and violence.  They organize themselves, often in little groups (“cartels or bases”) and establish internal rules which everybody has to respect.

For example, the one who betrays a friend will in most cases be beaten, be ignored or in serious cases be expelled, Rony (17 years) tells.  He experienced this once when he incriminated a boy from his base for an attack on another base.  “I didn’t want to do that, but the other had threatened to kill me and I was afraid.”

In Port-au-Prince, from “La Saline” through boulevard Harry Truman (Bicentenaire), from the Iron Market to “Portail Léogâne,” street children are part of the daily scenery.  Although most live in little groups, others prefer to go it alone.  They use their time to wash or to wipe cars, to load public transport, to beg, to handle stolen goods or commit thefts in order to earn money.

The day’s earnings provide them with a meagre and often unhealthy sustenance.  At night in certain quarters (La Saline, road of Delmas, near Delmas 33, near Port-au-Prince’s cemetery, and so on), some of them take to prostitution.  These conditions added to lack of hygiene make them vulnerable to different types of viral and infectious diseases, and/or sexually transmittable infections.

Some children are abandoned and find themselves in the street because “their families cannot afford to feed them or meet their general needs,” Father Jean Claude Louisimond of the “Fondation Timoun se Lespwa” (Children is Hope Foundation), points out.  He also confides that some of the children at this Foundation were directly left with him by members of their families who cared for them in absence of their biological parents.

Poverty, a considerable springboard

“More than 100 million children in the world do not go to school because of poverty (¼)  Children are most harshly affected by poverty; they will bear the psychological and physical effects with them all their life,” the world report 2002 of UNICEF specifies.

In Guatemala, most of the children do not attend school for long periods, or not at all, because they have to work to help their families survive, the Casa Alianza web site states.  This level of poverty leads children to a street life to practice little jobs or offer their services for remuneration, which will enable them to survive.

In Haiti, the case of Davidson (8 years old) is a good example of this problem.  He sells a kit of razors on Boulevard Jean-Jacques Dessalines (Grand-Rue) near “rue des Miracles.”  He tells that he has to work.  His mother is constantly in financial difficulties.  He does this job since his father started having other partners, and abandoned them during the summer vacation of 2001.

The bitter experience of the street
 Immacula (14 years old) left her house when she was 11 years old.  She points out that she could no longer put up with the sexual abuse which she suffered from the owner of the house and from the son of the lady of the house.  “What is more, I didn’t see why I worked so hard,” she said.  “I was always tired.”

 

“Since I was placed in this family  living at Delmas 2, I have not slept well,” she confides. “I did everything in the house, but it was never good and I always had to suffer the anger of the lady.”

 

Nowadays, she begs for a living around the Cathedral of Port-au-Prince, but sometimes, she does services for people in exchange for some money or a hot meal.  She tells that life isn’t easy for her.  “I am constantly harassed by others”, she says.

 

Immacula, who comes from Miragoane, tells that she regrets leaving her native town.  All the euphoria when arriving in Port-au-Prince disappeared, and she has lost all contact with her parents.  Often she thinks about returning to Miragoane, but she wonders if she will be able to find her family.

With the money of the razors, his mother takes part in a “sòl.”[8]   With three daughters, his mother lives at a friend’s in “Cité de l’Eternel.”  They had to leave their house because the owner had taken the roof away because of lateness in payment.  Davidson hopes that his mother will be able to rent another house with the money from the “sòl.”

The compulsory work of children is not limited to a physical exploitation which is sometimes beyond their capacity, but there is also sexual exploitation, most importantly paedophilia and pimping.  As far Haiti is concerned, although some organizations working on child labour or human rights mention it, there are no figures to prove that this practice is linked to poverty.

The need of survival obliges street children to accept anything to earn money.  Ill-intentioned people take advantage of these children, they give them weapons and they ask them to use these weapons for a little sum.  No one can forget the spectacular arrests of gangsters by the National Police of Haiti within the context of a zero tolerance policy.  Among them were children from 12 to 17 years old.

In a press release of 10 December 2002 in the scope of the commemoration of the 54th anniversary of the Human Rights Declaration, Ms. Justine Colas of the organization “Justice and Peace” tells that 7 street children under 18 years old had been executed in Port-au-Prince.  Additionally, in Cite Soleil, more than 50 others were injured by bullets in the same year.  She castigates the police institution for not having presented a report on these human rights violations.

Street children and STI/AIDS

One problem leads to another: “Young prostitutes are particularly exposed to viral and infectious diseases and to sexually transmitted infections (STI), but moreover to very early and repetitive pregnancies.”  Young girls, who constitute between 60 to 80% of children living as domestic servants, are also exposed to HIV/AIDS because of rapes committed by the men in the house.

To some extent, this increases the number of the children infected by HIV/AIDS in Haiti.  Consequently they become non-negligible propagators of this infection.  “Specific prevention programmes must target and train these vulnerable groups, and help them to adopt less risky behaviour,” a 1998 study on the impact of AIDS recommends.[9]

No well-known authority such as the GHESKIO Centres or the Haitian Institute of Childhood (IHE) could communicate figures to us regarding the prevalence of HIV among street children.

Out of the twenty girls at CAFA, who all had been tested, only three girls were HIV positive, and at present, the Centre has still not registered any new case, Ms. Marseille confides, adding that the reputation of people living with HIV/AIDS given to street children is not entirely founded.  However, she admits the incompatibility of this finding with the risky behaviour of these children.

On the contrary, the cases of syphilis, anaemia and vaginal infections are more common in both sexes.  Also in this case, a study at a national scale is a must.

The prison environment : witness of the disrespect of child rights

Dozens of children from 10 to 17 years old are rotting in the country’s prison centres in most degrading situations.  In defiance of Haitian legislation which forbids to keep a minor behind bars, children taken in for questioning because of minor or serious offences, do not always have the opportunity to see a judge able to decide their case.

Some children, taken to prison during police raids, are ill-treated and beaten by police officers.  Almost half the girls at CAFA, interviewed during the study, asserted that they have been incarcerated and two of them said that they were subjected to police violence.

In April 2002, the management of the prison authorities of the civil prison for women and minors (“Fort National”) had registered a total of 31 minors from 13 to 17, among which three (3) girls.

According to Ms. Joseph Marymagg Gracieux, Director of the prison, the majority of boys are street children.  They are there for armed robbery, rape and thefts.  “Since 1999, we haven’t had any sentenced person, and the children don’t know for how long they are there.  We find minors here who are accused of minor offences and have been here for at least 3 years, without any judgment, in spite of interventions by our legal assistants,” she says.

The children’s judge Emmanuel Lacroix acknowledges that he doesn’t know all the cases of incarcerated children and all unlawful acts haven’t been referred to the court for children.

During the judicial year 2000 – 2001, the court for children registered 20 cases of incarcerated children.  However, cases in provincial towns are not mentioned.

“As a rule, there is no law authorizing the incarceration of a child,” Judge Emmanuel Lacroix asserts.  He indicates that the law gives priority to the protection of minors in criminal cases and makes provision for free detention places for children on probation.  But between paper and reality, the gap is still enormous “because there are no specific facilities for children of this category,” Judge Lacroix says.

The law man indicates that during Duvalier’s regime, it was customary to take an arrested and judged child to the Reception Centre Duval Duvalier.  But this establishment no longer exists and has been replaced by Fort National or by police stations.

“Sometimes, I wonder whether children have really committed the crimes of which they are accused,” Ms. Gracieux confides, “since these children look so vulnerable!  Is prison the appropriate place to rehabilitate these kids?” she wonders.  For reasons of which we are not aware, a visit to the cells was forbidden to us and we couldn’t interview the children.

Reception Centres : not enough means

In the year 2000, the Institute of Social Well-being and Research (IBESR) communicated that they had registered more than 30 orphanages and reception centres throughout the country.  Meanwhile, some have been created and others have disappeared for lack of means, it is said.  Among the most well-known centres, there are: Foyer Lakay, Projet Pierre Toussaint (Cap-Haitian), Lafanmi se lavi, Timkatèk, CEP, CAFA, Escale, CAD, Timoun se Lespwa, etc.

Several people in charge of the reception centres bring up the problem of lack of funds: “We do not have sufficient resources to respond to the needs of the children,” they emphasize.  Centres still exist mostly thanks to rare grants from few non-governmental international organizations and irregular gifts from their benefactors.  An efficient financial support by the Haitian government is awaited.  “There is a great institutional void, while collaboration is essential for the survival of the reception centres and of more children,” a director of a reception centre states.

The centres cannot assume the heavy responsibility of rehabilitating all street children without a general policy headed by the government through which their activities will be reinforced.  If not, the phenomenon will only at a small-scale be lightened, never solved.

Some examples of interventions by reception centres

The reception and accommodation centres are charged with restoring the childhood to street children and assist them in becoming useful citizens in society.  Their aims are articulated around certain parameters in the field of social rehabilitation, schooling, professional training and the shaping of the personality.

We tried to put ourselves in their skin in order to understand them better.  Our way of working with them has considerably changed the population’s attitude toward them,” Foyer Pierre Toussaint.

According to several people in charge of the reception centres, training is envisaged around personal development interventions.  But more programmes which demand the personal contribution of the children should be set up in their interest and for the success of the interventions.

Following in Saint Jean Bosco’s footsteps, Father Atilo Stra founded Lakay in 1998, a centre which helps street children of both sexes to return to a normal life and to take their place in society.

While applying new intervention methodologies, Father Stra set up activities through which more than 400 street youth between 10 and 18 benefit from 5 projects dedicated to them.  Professional training in electricity, plumbing and cooling technology, in beauty care and dressmaking is given to the young people of the Lakou and Lakay centres.

The Development Support Centre (CAD), located in the quarter of Carrefour-Feuilles, works with about 150 children, among which 61 participate in the regular social reintegration programme.  Founded 9 years ago, CAD supports children with education, health care and a set of integrated activities which ensure their survival and development.  While not being able to assure their full professional education, they participate in informal education.

The “Timoun k’ap teke chans” (Timkatec) Centre (Children who try their luck to survive) in Petionville, managed by the Salesian priest Father Joseph Simon, counts about 80 boys, of which 40 live on the compound.  Since 6 years ago, children have been coming in from the streets.

Before, when they were between 12 and 16 years old, most of these children had fire arms, and they knew how to use them for “protecting themselves”, they said to the priest.  The working methodology of Timkatec is based on two pillars: education and professional training.  In this way, the child learns to be aware of his talents, his personality, nature’s beauty and of his real limits.

It’s with pride that Father Simon tells that 30 of his kids are placed in four garages where they learn auto mechanics.  Others, after obtaining their certificate for successfully finalizing primary school, are sent to the Salesian Brothers in downtown Port-au-Prince.

“It is fundamental to show children that one loves them and that one really wants to help them.  The rest goes automatically,” Father Simon of Timkatec.

 

Foyer Pierre Toussaint, located in Cap-Haitian, counts about 80 street boys of which 24 are in regular boarding.  Managed by two young Americans and a team of Haitian social workers, this centre first of all plays the role of guide for street children.

“Banishing every moralizing attitude, we accept the boys as they arrive, and little by little they tell about their situation, by assessing themselves (starting from instructions which are established in advance).  If no change takes place in them, they cannot develop in our structure,” Andrew Schulteis explains, one of the people in charge of this centre.

These children have the possibility to learn to read quickly thanks to an adaptation to the Montessori method based on their situation.  They have their football team and like other children, the most advanced ones attend the best schools in town.  Moreover, those who show inclination to renew their family ties, are strongly encouraged to do that.

Odney (22 years) has attended the Centre Lakay for 2 years.  Being found too old by the educator, he has not benefited from the complete care provided by the centre, as it does at present for 86 kids.  Nevertheless, in Lakou’s workshop at boulevard Harry Truman (Bicentenaire), he has learned to be an electrician.

In 1997, he left his house because of the bad treatment given to him by one of his uncles.  His father and mother are dead.  From fourth grade on, he never had a chance to continue his studies. 

On the street, he cleaned cars.  He is happy to attend Centre Lakay and to have learned a profession enabling him to earn a living.  Nevertheless, he laments the lack of follow-up to this.  “I sporadically work for private individuals.  After that it is unemployment.  I would very much like to find a workshop where I could work constantly,”  he says.

Throughout the Caribbean and Latin American region, there are similar activities assisting street children.  These ensure that there are alternatives to delinquency, to HIV/AIDS, to crime and death.  Casa Alianza is one of the most famous ones for having brought Guatemalan police officers before the courts for the murder of a twelve-year-old street boy.

The role of the Government is still ill-defined

“Investing in children simply is the best investment that a government can do,” the 2002 UNICEF world report states.

A lot of legislation to guarantee the respect of child rights is foreseen, and new arrangements are to be adopted envisaging the provision of care to children in difficult situations and the respect of the rights of every child without discrimination.  With great fanfare the government welcomed the Global Movement for Children in April 2001, but unfortunately many of the promised programmes are still lying in the desk drawers.

Providing care to street children is essentially ensured by non-governmental organizations (NGO) and private institutions.  Although the government has outlined a wish to act on children’s issues (it forwarded to parliament legislation against physical punishment of children, as well as appointed three judges for children in 2001), the only public reception centre of the country no longer exists and nothing has been done as yet on street children issues.  This situation is criticized in the Alternative Report on Child Rights, coordinated by the Haitian Coalition for the Protection of Child Rights (COHADDE), a grouping of about 30 organizations working for the respect of child rights in Haiti.

How do children see the activities of the centres?

The open and/or restricted social rehabilitation centres, as well as the orphanages provide children on a more or less regular basis with food, education, primary health care, professional training and in many cases lodging.  The children who were interviewed say that they appreciate the work done for them by these centres.  Some of them say goodbye to their roaming lifestyle while others prefer to enjoy a centre’s assistance in day-time but to return to their street life at night.

“I am too old for the care provided by child centres, but if it weren’t for Lakay’s assistance, I would still be in the street.  The managers have rented a house in “Cité de l’Eternel” (a populous quarter of Martissant) where other children in difficulty and I live,” Odney, met at Father Stra’s project, recognizes.

“Because of the fact that I attend the centre, I take more care of my body”, Hervé (17 years) declares.  He lives on the street.  He is a car washer, but came to the Popular Education Centre (CEP) in 1994.  He doesn’t want to leave the street because he earns a great deal of money there.  Thanks to CEP, he also works with a “bòs metal” (craftsman in iron or in wrought iron) since several months.  He appreciates that he has learnt a profession, but he is not ready to leave the street.  He asserts that the street is dangerous but it offers compensations.

Nolis is 13 years old.  He is in third grade and lives at the Foundation “Timoun se Lespwa” (Children are hope) of Father Louisimond.  He wants to become a mechanic.  He does not want to go back to the street because he feels in security where he is: “I do not have to defend myself against older boys.”

Nadine is 22 years and she wonders what would have become of her if CAFA hadn’t assisted her for a while and convinced her to abandon the street.  Now, she encounters the problem that CAFA will have to drop her in future in order to make place for other street girls.

What future for street children ?

“The future does not bode well for street children, especially if the political crisis and the lack of social services continue, for they worsen the social and economical impasse which arises for children who are already in the street as well as for the ones, much more numerous, who are not in the street,” Dr. Françoise Ponticq states.

The child arriving in the street runs away from a situation of poverty and seeks an alternative.  When his rights to education, to health and to leisure, three fundamental rights, are really respected, he has no pretext to go to the street.  “It’s this basic problem that needs to be solved urgently,” Father Simon of Timkatec says.

While broaching the question with children, they show themselves to be very pessimistic with regard to their future.

Stigmatization and indifference constitute the deadliest weapons that can be used against street children.  By many considered to be the dregs of society, they have often developed a good-for-nothing complex.

Rony has many dreams in his head, such as driving one of the high-speed race cars that he watches on the TVs in the department stores downtown.  But well, “It is time to face reality and say to myself that I will never have this chance,” he says.

Ms. Stefanie Conrad, Public Relations Officer of Plan Haiti, states that her organization established in December 2002 a partnership with Save the Children through the project : “An immediate Response to the issue of street boys and girls,” in order to contribute to public awareness on street children, to strengthen the institutions working with children, to provide social services to them, to conduct advocacy activities and to put forward sustainable solutions with regard to their situation.

“Many street children take charge of their life from a very young age onwards.  They are creative in developing techniques to protect themselves and to survive, and very often also take care of the survival of the family.  These are the strengths and potentials which we should highlight in each of our interventions,” Stefanie Conrad of Plan Haiti emphasizes

 

Leaders of the reception centres talk about follow-up to the activities which were already carried out.  Therefore, they would like to have funds for training the youth who they have rehabilitated and sent back to their original families, so that they will not fall in the same mess again.

These efforts and many others have been carried out for a number of years in Haiti.  Nevertheless, public powers as well as private individuals still have much to do to eradicate the problem.

Because “if we want peace, we must practice justice” should not remain mere words.  It is social justice which all should render to street children.

Some reference institutions

Aide à l’Enfance Canada (Save the Children Canada)

8 Imp Baron, Ave Jn Paul II, Turgeau

Port-au-Prince, Haiti

Tel: (509) 245-2101/0243

E-mail: aecanada@haitiworld.com

Casa Alianza

Bureau pour l’Amérique Centrale

Apartado 1734-2050

San Pedro, Costa Rica

Tel: (506) 253-5439

Fax: (506) 224-5689

Email: info@casa-alianza.org

Site web: www.casa-alianza.org

Resp. Bruce Harris

Centre d’Appui pour le développement (CAD)

14, rue Bredy, Carrefour-Feuilles

Port-au-Prince, Haiti

Resp. Mme Marline Mondésir

Centre d’Appui Familial (CAFA)

Rue Mgr Guilloux, Morne Lélio 1, rue Cangé. Port-au-Prince, Haiti

Tel: (509) 222-1005

Centre d’éducation populaire (CEP)

10, rue Saint- Gérard

Carrefour-feuilles

Port-au-Prince, Haiti

Resp :Jean-Robert Chéry

Coalition Haïtienne pour la défense des droits de l’Enfant (COHADDE)

23, 3ème Avenue du travail

Port-au-Prince, Haiti

L’Escale Fontaine Duvivier

Drouillard

P.O Box:495

Port-au-Prince, Haiti

Tel. : (509) 238-3820

Resp. Dr. Nadine Burdet

Fondation Timoun se Lespwa

24, Bergeau, Delmas

Port-au-Prince, Haiti

Resp. Frère Jean Cefenor Louisimond

Tel: (509) 245-0251

Foyer Pierre Toussaint, Cap-Haïtien

Rue 13

Cap Haïtien, Haiti

Resp. Douglas Perlitz/Andrews Schulteis

Lakay

1, rue des Salesiens, la Saline

Port-au-Prince, Haiti

Tel. (509) 510-7137

LASAF, Jacmel

Resp. Pierre Antoine Jean (Familus)

Place Louverture à l’int. No 47,

Jacmel, Haiti

Village d’enfants SOS (fermé depuis)

Santo 19, Croix-des-Bouquets, Haiti

Tel. (509) 238-1134

Resp. Pierre Michel André


[1] This concept also takes the adolescents into account.

[2] Frantz Lofficial, “Lakay” – a centre for street children, UNICEF, March 1998.

[3] This is 1,440 girls on 8,000 children counted.

[4] See: La domesticité juvénile en Haïti-IPSOFA, 1999.

[5] At the time of publishing this text.

[6] Expression used for gangsters in Haiti.

[7] A solvent which can cause mental troubles and violent behaviour.

[8] A type of periodic contribution to a group where each member, in turn, will receive the totality of the contributed money.

[9] By: Eric M.Gaillard, E. Génécé, B. Liautaud, L. Eustache and J.W. Pape

The Right to Life for People Living with HIV/AIDS in Haiti

The Right to Life for People Living with HIV/AIDS in Haiti
July 2002

by: Roosevelt Jean-François, Journalist and member of the Centre for Communication on AIDS (CECOSIDA)

This briefing has been produced with the collaboration and financial support of the Fogarty Center – National Institutes of Health (NIH) of the U.S.A. and the Centres GHESKIO of Haiti in the scope of the project “Building Capacity of Journalists in the Caribbean and Central America to Report on HIV/AIDS: a focus on Haiti.” The project is carried out by the Centre for Communication on AIDS (CECOSIDA) and the Panos Institute.

The provision of care, including access to medical care, is a serious challenge for people living with HIV/AIDS (PLWHA) in Haiti. The reasons for this are particularly related to the economic situation of the country, which suffers from acute unemployment and effects of the contraction of the global economy during the recent years, according to trends and figures published by the Haitian Institute of Statistics and Informatics.

However, in addition to medicines and the provision of direct care, several experts think that the best assistance lies in the social reintegration of the infected person.

It is unanimously recognized that an infected person is often not accepted at home because he/she becomes an extra burden for the family. He or she doesn’t contribute. That is the reason why, it is said, it should be avoided to leave such person totally dependent on others, but have the Government do more for him/her.

“You don’t need to have a lot of money. What is important is human assistance, especially when one feels physically and mentally weak: it is good to know that you have someone on whom you can count,” Adeline Benoit says, a professional pastry cook, who had to stop her profession after learning about her infection, in order not to be ostracized.

“Being infected by HIV isn’t the end of life. I don’t want to compare the United States to Haiti, but access to medical care is not a gift in this country. It is the fruit of the constant work of all the people and organizations which bring together people living with HIV/AIDS (PLWHA). It is a battle for having the right to life.”

This is the lesson that the seropositive Saurel Beaujour draws of his participation (in October 2001) in a programme of international visits to the United States, where infected people benefit from a specific budget for their access to health care and medicines, and where the private firms are heavily involved in the battle against HIV/AIDS.

43 years old, electrician by training, Beaujour has been for several years the leader of the Association for National Solidarity with people infected and affected by HIV/AIDS (ASON), which has about fifty active members.

According to him, in addition to the need of being involved in a constant institutional battle, following the example of several other countries, PLWHA have an important role to play in activities which aim to stop the spread of the virus and to promote the access of infected people and affected families to care.

“When an infected person meets another infected person like himself, dialogue and empathy take off easily. One has nothing to hide. For, we are in the same situation,” he says.

Saurel Beaujour is very active in activities against HIV/AIDS at the Caribbean level. He has participated in several meetings in Trinidad and Tobago concerning PLWHA, where there is an annual meeting of Caribbean PLWHA. “For 3 years now, we have been present at this meeting organized by the Caribbean Regional Network, which gives us the opportunity to exchange information with our Caribbean colleagues,” he explains.

“My presence in these meeting has been very useful because of the fact that I could observe infected people like me involved in the fight in other Caribbean countries, which share the same mores and customs as Haiti,” he says during an interview.

A not-very-welcoming environment

The Caravan of Youth and Artists against AIDS in Haiti, May-October 2000The Caravan was a Haitian initiative of several governmental, non-governmental and international organizations. The Caravan passed the towns of Jacmel, Saint-Marc, Gonaives, Port-de-Paix, Miragoane, les Cayes and Jeremie, using means of communication which are culturally adapted to the youth, and also events and rallies (public debates, walks, music and other entertainment). The traveling Caravan was a great moment in promoting less risky sexual behaviour, through the creation of a social environment which validates protected sexual intercourse,mutual fidelity and the acceptation of people living with HIV/AIDS.

The solidarity among people living with HIV/AIDS is all the more necessary as they generally have to function in an environment which is not very favourable.

“Living with AIDS in Haiti is very difficult. Even the street is a nightmare, with all its detritus which weakens our immunological system even more,” Adeline Benoit explains.

Adeline Benoit confides that the socio-economic environment traumatizes her: an overflow of stress when she waits for a tap-tap (public bus) and subsequently when she has to make great efforts to find a place to sit down; the long waiting time for PLWHA at the doctor’s; the discrimination of which PLWHA are the object in general society; and so on.

Esther Boucicault, another Haitian seropositive, thinks that the private commercial sector can help directly by granting scholarships to children of PLWHA.

“When one has personal frustrations, such as not having a place to live, or not being able to send his or her children to school, how can you honestly ask that person to commit him/herself to saving other people?” Mrs. Boucicault wonders, pointing out that the environment is difficult and that the education of the population has not been done as yet.

She remembers the case of a young man in Saint-Marc (about 96 kilometers North of Port-au-Prince) who, following the Caravan of Artists and Youth against AIDS in the year 2000, declared himself infected. He was booed, avoided in his neighbourhood and very nearly lynched. Also, as he was accused of transmitting his AIDS to people around, he was forced to leave the neighbourhood.

“I do not want that, only after my death, people are going to talk about the great efforts of the Esther Boucicault Foundation and about the great courage of this little lady. While I’m alive, I want to see this Foundation bloom by helping others, as my daughter Michele told me: ‘Mom, while saving other people, you will be saved’.”

Advocacy

For the people living with HIV/AIDS, solidarity groups constitute an ideal discussion platform to help with specific questions, such as access to care, treatment of opportunistic infections, the support and training of the family, of friends and other priority needs, such as food, medicines and work.

Very well informed and very useful in the activities of the « Fondation promoteurs de l’objectif Zero-SIDA (POZ) »[Promoters of the Objective Zero-AIDS Foundation] where she works, Adeline Benoit pleads tirelessly for the full access of PLWHA to the labour market.

Reduction of the price of medicines against AIDS for Caribbean countries In July 2002, six large international pharmaceutical laboratories formally concluded an agreement with Caribbean countries, to obtain price reductions on anti-AIDS medicines.

GlaxoSmithKline, Hoffman-La Roche, Boehringer Ingelheim, Bristol-Myers Squibb Co., Merck & Co and Abbott committed to reductions ranging from 70 to 90%, for the countries gathered under the banner of CARICOM, the Prime Minister of St Kitts and Nevis announced during a CARICOM summit in Georgetown.

“They accepted to negotiate with us as a region. The medicines will become affordable and the Caribbean can prepare for generalized treatment,” Leslie Ramsammy, the Health Minister of Guyana, said.

The agreement, which was negotiated during meetings in Jamaica and at the Headquarters of the World Health Organization in Geneva in May 2002, was signed during the Conference on AIDS held in Barcelona from 7-11 July 2002.

Statistics, newly published in the scope of this Barcelona Conference, state that the number of 40 million people who currently live with the HIV virus will increase to 100 million by the year 2012.

At the end of 2001, there were about 420,000 HIV infected people in the Caribbean region, against 1.5 million in Latin America, according to the United Nations.

“If I tell you that I am ill, you should have special consideration towards me. More precisely, PLWHA should have special buses at their disposal, or at least priority in public places.”

Numerous countrymen, who during the military coup d’etat (September 1991 – September 1994) requested political asylum in the United States had to face the shock of discovering their sero-positive status through the tests which were carried out.

This was the case with Saurel Beaujour who was a community development worker at the « Centrale Autonome des Travailleurs Haitiens (CATH) [Autonomous Union of Haitian Workers], a job which sent him to several geographical departments of the country in order to create and train trade union peasant groups. In order to escape the political persecution of supporters of the defacto Government, he opted for political asylum in the United States, he explains.

“My greatest problem was to announce to my wife that I was HIV positive. I was forced to tell her the truth, because she knew about the various steps undertaken to obtain political asylum in the United States. It was very sad in the family. And it was there that the battle started,” Beaujour says.

“It was a shock for me to learn that my test was positive. I could not believe my eyes. I redid the test five (5) times before accepting the result,” he tells, looking at the ceiling.

Psychologists later advised all the people infected by HIV assemble themselves within an association. This was later created under the name of ASON.

A most-important event

On 21-23 April 1999, in Petion-ville, the Foundation POZ in partnership with Plan Haiti and the Panos Institute organized a large event aimed at encouraging people living with HIV/AIDS to break the silence, to come out of obscurity and accept their sero-positivity without fear for their human dignity.

Health professionals, journalists, religious and political leaders, and others who participated in the forum, publicly expressed their desire to “draw the attention of the entire Haitian society towards the needs of the people living with HIV/AIDS in terms of care, support and consideration.”

Putting the emphasis on the situation of exclusion and discrimination of which people living with HIV/AIDS are victims, they called on public authorities to create a climate of justice and equity which promotes their well-being. They also urged authorities involved in the battle against AIDS to make use of the experience of PLWHA in the fields of education, information and support.

The final declaration of that first forum of solidarity with PLWHA invites, indeed, the PLWHA to stop considering themselves as victims, but rather to adopt positive and responsible attitudes, in order to take control of their lives.

Results

Following this assembly in 1999, several networks were created, among which the Centre for Communication on AIDS (CECOSIDA), composed of journalists. The forum marked a crucial turning-point in the battle against AIDS in Haiti, according to Dr. Eddy Genece, the Director of the Foundation POZ.

“The sensitizing of decision-makers started there. The National Strategic Plan has a component which grants a rather important place to aspects of care and support. Now we have many more people living with HIV/AIDS who have publicly declared their status.”

The Strategic Plan of the Ministry of Public Health and Population grants also an important place to the voluntary testing, for which there are several centres available throughout Haiti. Several institutions, such as the POZ Foundation, have established support and counseling units for PLWHA, in order to accelerate the testing work.

“We carry out tests. In the case where the tested person is tested negative, we will with his/her collaboration provide some follow-up: that person leaves our office with a lot of information and we invite him/her to send us his parents and friends. In case where the result of the tested person is positive, we invite him/her to participate in support groups, called by us ‘community mutual aid groups’,” Dr. Génécé points out.

Prevention kits are given to the members of community mutual aid groups, each group averaging about fifteen. These kits contain 7 or 8 articles of daily use such as: tooth past, tooth brushes, razors, vitamins, condoms, and bactrin (an antibiotic).

Already since 1998, even before the Forum was held, the POZ Foundation created support groups named “GIPA” (Greatest Involvement of People Living with AIDS), which in particular were involved in advocacy, in view of the limited resources.

The “Blue telephone” was created during the same year. This permits thousands of people, in majority young people from the capital and the main provincial towns of Haiti, to inform themselves, in anonymity and without a need to travel, about HIV infection, sexuality and family planning.

“The POZ Foundation toys with the idea of making this service available 24 hours a day, in order to have people who are busy in the morning or who have no telephone benefit from it also,” Magalie Cherenfant, the person in charge of this programme, says.

Declaration resulting from the First Forum on Solidarity with People Living With HIV/AIDS (PLWHA), 21-23 April 1999 We, representatives of organizations and individual participants, assembled at the Ritz Kinam II Hotel in Petion-Ville, the 21st, 22nd and 23rd of April 1999, in the scope of the First National Forum on Solidarity with the Victims of AIDS in Haiti, aware of the situation of exclusion and discrimination of which the people living with HIV/AIDS (PLWHA) are victim; desiring to draw the attention of the entire Haitian society to the needs and terms of care, support and recognition of the PLWHA in Haiti; desiring, especially, to encourage the PLWHA to break their silence and to come out of the shadows; choose this historic event to declare the following:

  1. PLWHA must recognize their status of seropositivity and assert themselves in all circumstances, without prejudice and without any harm to their human dignity;
  2. Public authorities must create a climate of justice and equity, promoting the well-being of PLWHA;
  3. Agencies involved in the struggle against AIDS must use the experience of PLWHA, in particular in the areas of education, information and support;
  4. PLWHA must cease to consider themselves as victims, but rather adopt positive and responsible attitudes in order to retake control of their lives;
  5. Civil society in all its components must assist the Government in its efforts for solidarity with PLWHA, through appropriate and effective support.

Done at Petion-ville, Haiti, Friday 23 April 1999.

AOPS * APROSIFA * ASON * ASPHA * BIREBS * CARE HAITI * CDS * CECPH * CEPROMEC * CONAHDE * CPFO * FANM YO LA * FEPLS * FNUAP * FOSREF * GHESKIO * GRASADIS * HELP * HTN * INSHAC * JHM * MAISON ARC-EN-CIEL * MSPP * MSPP-IDA * NPFS * ONUSIDA * OPS/OMS * PANOS INSTITUTE * PLAN HAITI * PNUD * POLICY PROJECT * POZ * PREVENCION IDS * PSI HAITI * RADIO CARAIBES * RADIO GALAXIE * RADIO GUINEN * RADIO KISKEYA * RADIO MEGA STAR * RADIO PHARE * RADIO PLUS * RADIO ST. LUCIA * REDOVIH+ * SHP * SIGNAL FM * UNASCAD * USAID * VDH * WORLD VISION * ZANMI LASANTE

Responsibility and discipline

Esther Boucicault is the infected woman most openly involved in the battle against the spread of the epidemic and for the provision of care for infected and affected people in Haiti. She regrets that not all people can have access to medicines, although she underlines that the way medicines are taken requires a very strict discipline.

“It would be good if everybody could have access to medicines,” Boucicault says, but, according to her, a “continuous education campaign” is necessary. “The infected person must be taught to measure out the doses of medicines well, to take them on time, to know his/her body and, above all, to face the secondary effects. In most cases, the infected person needs a social worker to support him/her, to follow the development of his/her health, secondary effects, to control the tests like CD-4, viral charge. A regular general check-up is necessary,” she adds.

“I have never stopped taking medicines. Over time, I developed a certain resistance to some medicines. I had to travel to do a check-up and the doctors gave me new medication. Now I am taking Ziagene, Viracept and Sostivan. I swallow 7 pills in the morning and 10 at night. It takes a strict discipline to take these medicines. For example, I know that I cannot take Sostivan after a meal, because, in order to dissolve in the body this medication must not meet fat,” Esther Boucicault underlines, mother of two daughters of which one is HIV positive.

“These medicines develop secondary effects. I have cramps in my feet. I suffer from cholesterol, diabetes and I have high blood pressure. I take my insulin twice a day: 35 milliliters in the morning and 15 milliliters at night. And I eat lots of salads and fruits. I eat neither beef nor pork. I eat local chicken, but no imported chicken which contains too much hormones,” she pursues.

Negotiating generic medicines against AIDS In July 2002, the 14th International Conference on AIDS opened in Barcelona with a call for the availability of generic medicines at low cost for the poorest countries, in order to arrest the AIDS epidemic which rages throughout the world. While the meeting was being held, more than 500 activists demonstrated in the streets of the Catalonian capital, calling for giving two million inhabitants of the poorest countries access to anti-retroviral treatment by the beginning of 2004.

Peter Piot, the Executive Director of UNAIDS, denied that it would be technically impossible to carry advanced medicines to millions of people in the poorest countries of the planet.

“Without doing anything, the world has looked at Sub-Saharan Africa being submerged. That never again!” Piot declared in front of the 15,000 people gathered for the opening ceremony of the one-week conference.

“We cannot stay just passive observers, while history is being repeated on other continents, and we must not desert Africa at this time,” he added.

“Treatment is technically available in each part of the world (…). It is not knowledge which constitutes a barrier, it is political will,” the Chief of UNAIDS pursued.

According to the UN Agency, the epidemic is only at its beginning and could kill 70 million people in the next 20 years, while the virus continues its spread in Asia and in Eastern Europe. Today, HIV affects 40 million patients all over the world. Sub-Saharan Africa counts 28.5 million of them and only 30,000 benefit from an appropriate treatment.

A sickening answer from donors

In view of these figures, experts estimate that 10 billion dollars a year are needed to launch an effective programme of prevention and treatment with generic medicines. For the moment, only a third of this sum has been raised.

“The answer by donors has been disgusting, (while the sum) corresponds only to four days of global military expenditure,” Mogha Smith, a member of the British NGO OXFAM, said.

Over the past two years, the price of the antiretroviral treatment in Africa has decreased by at least 90% under the pressure of militants. However, they still stay out of reach of millions of seropositives who are completely dependent on programmes which are financed by the international community.

For Morten Rostrup, President of Doctors without Borders, the absence of real political will is the only cause.

“Don’t tell me that we don’t have the resources for that. We have learned from the 11 September events that it is possible to mobilize a large coalition and billions of dollars within several weeks to mitigate a common threat.”

“This inertia is a crime against humanity, nothing else,” he said.

Unlike Esther Boucicault, Saurel Beaujour chooses not to take the anti-retroviral medicines.

“I take vitamins. I learned to know my body. I know that as soon as an infection comes up I must go to a doctor. And I do much to prevent against tuberculosis,” he indicates.

“The most important thing is to know that you are important. And that life goes on. Also to have a responsible sexual behaviour. You can be re-infected and die faster. One has to be positive. I would very much like to see my three children grow up,” the chief of ASON concludes.

A new promising medication against AIDSAn experimental medication which attacks the AIDS virus in a different way then existing treatments, has produced positive results during the first experiments on humans. The tests now have been widened, according to the laboratory which invented this new medicine.

This medicine, S-1360, also called GW810781, is being developed by the British group GlaxoSmithKline (GSK) in association with Shionogi of Japan. The group specified that the medicine had been administered to 24 healthy volunteers, without entailing any important undesirable effects.

This product is the most advanced of a new family of anti-AIDS medicines known under the name of integrase inhibitors which prevent the HIV virus from inserting its genes into the normal DNA of a cell.

“It (the S-1360) has been tolerated very well and there are only very few people who had to stop the therapy,” Dr. Michelle Berrey said, of GlaxoSmithKline, specifying that the undesirable effects were limited to itching and several cases of headache.

Consequently, last month, GSK launched “Phase II” tests. About one hundred patients in the United States infected by HIV will participate in these tests. The results of these tests should be known at the beginning of next year and, if all goes well, the medication could arrive on the market by 2006.

The integrase inhibitors are the second category of new medicines made public during the fourteenth international conference on AIDS in Barcelona. This shows that the pharmaceutical research continues to develop even while the poorest countries of the planet still have no real access to the first generation treatment.

Earlier the Swiss laboratory Roche and the American Society for Bio-technologies Trimeris announced that tests had shown that their new “fusion inhibitor” T-20 could reduce the amount of virus in the blood of those patients who are not sensitive to common treatment.

The development phase of this medicine should come to an end soon, and it could arrive on the market during the first quarter of the next year.

Providing care

“Sometimes, even the Doctor traumatizes you. It is better to keep silent and tell nothing about your seropositivity if that is not necessary,” Adeline Benoit says.

Fortunately for her, a group of women of her church helped her to get back on her feet, to fight against the sadness which could be read on her face, and to become a member of the Consultative Council (CAB) of GHESKIO Centres (Haitian Group for the Study of the Karposi Syndrome and of Opportunistic Infections) where she has found care and regular medication.

“Each time when I have to go to GHESKIO Centres, it is like a blessing from heaven. GHESKIO helps numerous people to live with the illness by relieving them of opportunistic infections. But the environment is very difficult with hundreds of patients every day. You receive medicines in small sachets which are not always well packed.”

Since 1980, CARE has been a militant in the field of HIV/AIDS in several regions of Haiti. This American NGO actively takes part in prevention programmes, as well as in an integrated programme of care for PLWHA. In 1999, it started a pilot training project in the Grand’Anse (South-West of Haiti), in partnership with the Ministry of Social Affairs, in order to directly amplify the voices of communities, through the Community Health Units (UCS).

On the other hand however, Esther Boucicault notes that most hospitals do not accept to keep PLWHA. As soon as the hospital finds out that a patient is HIV positive, it orders its staff to send him/her out immediately.

“Here is a big responsibility. You very well know that the person is infected, and the person knows it also, and you let him/her go out without listening to your conscience. This person is going to continue to live and infect other people,” she states.

ASON is involved in a programme of home care for PLWHA in a poor area adjoining an affluent residential zone in the hills of Port-au-Prince (Freres). For almost a year, the organization Plan Haiti has run this initiative in Freres where constant domiciliary visits are paid to the PLWHA. During those visits, the infected people receive a kit of medicines and some products of first need. But, the most important thing is the ability for ASON councilors to be with the infected person in the presence of his/her family and in this way to reinforce social bonds.

Tritherapy : limited availability

“Today we are able to offer the tritherapy to the volunteers taking part in the vaccine trials, even when this method is not the standard of care in Haiti or in the region,” Dr. William Pape declares, Director-General of GHESKIO Centres, the main institution of research and care for PLWHA.

Dr. Pape doesn’t conceal his apprehension regarding these volunteers, who in light of availability of treatment, could expose themselves more to an HIV infection by adopting risky behaviours, as has been documented in the United States.

“The tritherapy doesn’t begin immediately after an infection by HIV has been documented. For many reasons, among which the shortening of the observance period on the taking of medicines and problems related to medicinal resistance, the tritherapy is only administered at an advanced stage of the disease. A patient needs to remember that receiving this dose doesn’t bring healing, AIDS still remains an incurable disease. For this the need to adopt safe behaviours,” the Director-General of GHESKIO Centres recommends.

More private clientele

Although the cost of medicines has passed from US$1,250.00 to US$150.00 per month, depending on what is available on the local market, the great majority of Haitians living with HIV cannot afford to buy the medicines. An estimated budget of around three (3) million United States dollars is needed to allow a wider circulation of antiretroviral medicines in the country.

“We are very late regarding this subject. The national programme is particularly focused on prevention and the agreed activities for providing care and support date back only two years. Until now, sponsors have not listed care and support in their financing priorities,” Dr. Eddy Genece of the POZ Foundation, notices.

Having no experience in the domain of providing antiretroviral medicines, which requires a particular expertise, POZ doesn’t intend to involve itself, except for having a partnership programme with other institutions working in this field.

However, “the dissemination of information and the downturn of the price of medicines are among the factors which explain a constant rise in the number of PLWHA visiting private clinics. There are patients with financial means who can pay for private services related to their seropositive status,” Dr. Damocles Patrice Severe of GHESKIO Centres reveals. He is a specialist of infectious diseases and the provision of care regarding STI/AIDS.

Some doctors who prefer not to reveal their identities declare themselves in favour of the establishment of facilities for the production and sale of generic medicines, following the example of several countries such as Brazil and Argentina. In professional circles related to the health sector, « the interest » for manufacturing generic medicines by several pharmaceutical firms and Haitian laboratories is known.

Houngans (voodoo priests) and natural medicine

“During recent years, people in Saint-Marc have seen me very ill, as well as recovered. I have a strong impact on them, because there are some taboos that we have brought out,” Esther Boucicault, who leads a Centre bearing her name, declares.

The Esther Boucicault Foundation works with houngans and very often participates in training courses for medical personnel of the Saint-Marc Hospital, with the assistance of several institutions such as POZ and Family Health International (FHI/IMPACT).

Esther Boucicault considers it necessary to seriously involve the voodoo priests in the battle against AIDS. Often, doctors do not feel able to inform patients of the results of tests who, according to their belief, think that they are the prey to « evil spirits ».

A person who has shingles can believe that he/she is affected by a « mort petit bébé » (the spirit of a dead little baby) evoked on him/her. In his/her mind, whenever the baby tosses and turns, the shingles extend further on the skin. In such cases, it’s preferable to make the houngans aware of the situation so that they can recognize the illness and talk openly about it, all the more as there are risky practices in these circles, Mrs. Boucicault specifies.

“Until now, a great part of the population does not go to the doctor for ordinary diseases, let alone for AIDS which remains an enigma even for the scientists,” Jacob Pierre, 54 years old, indicates. He has a peristyle (voodoo temple) in Carrefour-Feuilles (a suburb in the South-east of the Haitian capital) and is very active in an association of houngans.

Jacob Pierre doesn’t pretend to treat AIDS, but he says that as soon as a person feeling sick comes to see him for consultation, he « throws water » (expression used in Haiti in the practice of invoking the spirits) to see what the person is suffering from.

Voodoo priest Pierre speaks in favour of natural medicine and of the virtue of plants, as well as the relationship of the human being with his environment.

“Everything is in nature, you just need some knowledge to ask mother nature to solve certain problems, including AIDS.”

Asked about the costs of treatment in his peristyle, he says that his work has no price and it is up to the treated person to give what he has got. Most patients want to hear the opinion of the voodoo priest whom they trust more than the doctor, Jacob Pierre adds.

Perspectives

The authorities grant a great priority to the battle against HIV/AIDS. “We are very aware of the situation, and with restricted means we do the best we can to control and limit the spread of HIV/AIDS in the country, in partnership with Haitian civil society organizations and with the assistance of international institutions,” Dr. Henri Claude Voltaire, the Minister of the Public Health, declares in an interview.

“We are in a country where everything is a priority,” he says, continuing with: “the battle against HIV/AIDS is the affair of the whole country and not only the government, because poverty, the high rate of illiteracy and unemployment are among the factors which make the population much more vulnerable to this virus, which kills numerous people everyday and leave a lot of families in mourning and disarray.”

“We are asked to combine our strengths and join the efforts of the national and international scientific community in order to find appropriate solutions to the disease, which has serious social economic consequences,” the Minister Henri Claude Voltaire pursues.

It remains to be determined which mechanisms should be established to ensure the appropriate follow-up to the national strategic plan on AIDS, notably regarding the issue of providing care and the access of PLWHA to medical treatment.

Even although the price of medicines has been lowered substantially after agreement was reached with pharmaceutical laboratories, the access to financial resources for assisting PLWHA remains a problem not to be neglected. For, not only must the funds available for anti-AIDS programmes have been utilized within several years, moreover the existing amount can only provide care for very few PLWHA, with difficulty.

Nevertheless, in general PLWHA can nurture a lot of hope because of the already effected decrease in cost of medicines on the market. The vaccine trials, which started in Haiti in 2001, have begun to bear fruit and appear to have much more promising results than those obtained in the same trials in Trinidad and in Brazil, according to attested information. Additionally, the rate of vertical transmission seems to have decreased a lot in Haiti, based on the efforts extended by certain institutions working with PLWHA.

Within this context, it is important to note that ASON intends to organize advocacy activities with jurists in Port-au-Prince, in order to establish legislation to protect the rights of people living with HIV/AIDS, according to Saurel Beaujour.

Some reference institutions

Association for National Solidarity (ASON)
16, rue Malval, Turgeau
Port-au-Prince, Haiti
Tel: (509) 555-2219
Email: ason@mediacom-ht.com

CARE
92, Rue Grégroire
Pétion-ville, Haiti
Tel: (509) 257-1571/5358/5389
Fax: (509) 257-6785

Catholic Relief Services (CRS)
1, Delmas 81
B.P. 1118
Port-au-Prince, Haiti
Tel: (509) 249-1992/ 510-4586

Centre for Communication on AIDS (CECOSIDA)
c/o POZ
2, rue Tertulien Guilbaud, Bourdon
Port-au-Prince, Haiti

Centres GHESKIO
(Groupe Haïtien d’Étude du Sarcome de Karposi et des Infections Opportunistes)

33, Bicentenaire
Port-au-Prince, Haiti
Tel: (509) 222-0031/2241
Fax: (509) 223-9044

Family Health International/IMPACT
83, rue Lambert/Rigaud
Pétion-ville, Haiti
Tel: (509) 257-9100

Foundation Esther Boucicault Stanislas (FEBS)
24, Rue Bonnet
St. Marc, Haiti
Tel: (509) 279-9144/9165

Foundation Promoters of the Goal No-AIDS (Fondation Promoteurs de l’Objectif Zéro-SIDA) (POZ)
22, Rue Carlstrom
Port-au-Prince, Haiti
Tel: (509) 245-2308/244-4024

Haitian Institute of Childhood (IHE)
41, Rue Borno
B.P. 15606
Pétion-ville, Haiti
Tel: (509) 257-3101/ 1508/ 510-8438

Haitian Medical Association (AMH)
33, 1ère Avenue du Travail
Port-au-Prince, Haiti
Email: amh@haitiworld.com

Ministry of Public Health and Population (MSPP)
Palais des Ministères
Champ de Mars
Port-au-Prince, Haiti

Pan-American Health Organisation / World Health Organisation (PAHO/WHO)
295 Ave John Brown/Lalue
B.P. 1330
Port-au-Prince, Haiti
Tel: (509) 245-0764 /8666/ 8695
Fax: (509) 245-1732

Plan Haiti
Impasse Lily No. 3, Rue Stephen
Delmas 60
Port-au-Prince, Haiti
Tel/Fax: (509) 256-1438 / 4229
Email: comhti@planinternational-ht.org

Rainbow House (Maison Arc-en-Ciel)
Rue Beaulieu, Boutilliers
Pétion-ville, Haiti
Tel: (509) 246-5596 / 557-2948
E-mail: arcenciel@acn2.net

United Nations Children Fund (UNICEF)
17 rue Armand Holly, Debussy
B.P. 1363
Port-au-Prince, Haiti
Tel: (509) 245-1404/1424
Fax: (509) 245-1877

Design Downloaded from Free Wordpress Themes | free website templates | Free Vector Graphics | Bateaux de Plaisance.