Category Archives: Health Communications Articles
SEX WORKERS IN JAMAICA – ‘The Dangers, The Thrills’ – MALE & FEMALE Sex Workers Speak About the Dangers & Challenges of the Trade
Sex work in Jamaica is taboo. Selling sex – prostitution, is illegal. There have been ongoing lobby from a human rights perspective for the repeal of the 18th century laws that make prostitution (selling of sex) and buggery illegal. However several men and women practice the illicit trade sometimes covertly, sometimes out in plain sight. Sex workers are rarely arrested for selling sex, however, based on their own admissions, it is a dangerous business.
By: Andrea Downer, Journalist
Kingston, Jamaica. July 29, 2011- The recent 31% decline in the number of pediatric deaths in Jamaican children announced by Minister of Health, Rudyard Spencer is not a surprise to Dr. Tracy Evans-Gilbert, a pediatrician with considerable experience in the care of HIV positive children and their mothers in Jamaica.
Dr. Evans-Gilbert, who is based at the Cornwall Regional Hospital in Montego Bay, Jamaica, says the current overall decline is the result of sustained efforts by persons involved in the HIV fight in Jamaica from as early as the 1990s. She also credits the increased availability and reduced cost of anti-retrovirals for treatment of HIV in children for the positive development.
“It’s a decline we have been seeing since the early days at Bustamante Hospital children when antiretrovirals first became available to those who could afford it,” she stated.
“As the drug became universally accessible across the island we saw at first a decline in hospital stay then fewer admissions. The children’s nutrition improved, they didn’t miss school and less and less children died. Even those who had advanced HIV that affected their brain and slowed their development started walking!” she told Panos Caribbean.
Mr. Spencer made the announcement recently at the launch of Regional HIV/AIDS Testing Day 2011 in Kingston, Jamaica.
According to Dr. Evans-Gilbert, when she began her medical career at the Kingston Bustamante Hospital in Kingston in the 1990s, HIV treatment and care of children was done in a very ad hoc way. Although anti-retrovirals for the treatment of HIV had become available by then, very few persons in Jamaica could afford the drug which was very expensive.
“In those days there was no HIV medication available in Jamaica to give to babies born HIV positive. The most we could do for the babies was treat the infections brought on by the HIV virus, manage their nutrition and try to make them as comfortable as we could,” she explained.
“But there was really nothing we could do and we would tell this to the parents – although not immediately. At that time, those HIV positive babies would not live beyond one year. We referred to them as ‘rapid progressers’ who would develop AIDS very quickly and die shortly after being diagnosed with HIV.”
“Back then, HIV testing was not a part of ante-natal care and so we would only find out that the mothers were HIV positive when they would take their sick babies in for treatment and the babies were diagnosed with HIV,” she stated.
“All of the early challenges in pediatric HIV care and subsequent progress that have been made have been captured in publications over the years by a team of pediatricians across the island, which I am a part of,” Dr. Evans-Gilbert disclosed.
“In the early days of HIV pediatric care in Jamaica, myself and the other doctors who are part of the now island wide team, shared the same frustration with the challenges we faced and had the same passion to see the children survive,” she explained
“We formed the Jamaica Paediatric Perinatal and Adolescents HIV/AIDS Group headed by Professor Celia Christie. The group now leads about eleven paediatric HIV clinics across the island, which were initially launched as outreach clinics in 2003 but are now stand alone clinics. We all still interact with each other as a group and share experiences and best practices. The success of that model, based on research, resulted in an island-wide establishment of standardised care for mothers and their children,” she continued.
“In a study on deaths at Cornwall regional hospital due to HIV in children we found antiretroviral was the only factor that determined survival in children who were orphaned, had AIDS or had a rapid progression of the disease,” she continued.
According to Dr. Evans-Gilbert, the Ministry of Health has an aggressive Prevention of Mother to Child Transmission programme that has been yielding significant results.
“Over the last five years at The Cornwall Regional Hospital in Western Jamaica, of 75 HIV infected children, only seven have died and those who survived were more likely to have an improved immune system and suppression of the virus due to antiretrovirals according to lab studies,” she said.
“Over that same five-year period about 400 babies were born to mothers with HIV but only about 3 percent of those babies became HIV infected. Those who died had rapidly progressing disease in infancy and were started on antiretrovirals late. But that doesn’t happen anymore. Now that mothers are identified in pregnancy, more babies have a chance of survival when they are enrolled in the prevention of mother to child transmission programme and receive preventative treatment,” she explained.
“It is uncommon for new born babies to be infected and when this happens it is usually because part of the preventative programme has been compromised. As soon as babies are identified in early infancy as positive, life saving antiretroviral agents are started when they are still healthy preventing any progression of the disease,” she continued.
“Compared to the early days of the epidemic when I watched children die due to lack of treatment the mothers and families now have hope. Our team is encouraged to keep pushing until we have less and less newly infected babies and a healthy childhood and longer survival for those who are already infected along with their infected parents.” (End29/07/2011)
Jamaican HIV+ Prisoners Appeal for Help – Panos Study on HIV Treatment, Prevention & Care in Jamaican Prisons Support Their Claims
By: Andrea Downer - Three years ago, Panos Caribbean broke the silence surrounding sex among male prisoners in Jamaica and the associated sexual and reproductive health issues in an investigative study that was researched and written by Panos Caribbean‘s journalist and consultant Andrea Downer.
The book: No Sex or Condoms Here: HIV Prevention, Treatment & Care in Jamaican Prisons won several awards including the first place in print in the United Nations Population Fund’s (UNFPA) regional media awards as well as first place in the Pan-American Health organisation’s (PAHO) national and regional awards in 2008.
In May 2011 Panos Caribbean awarded a media fellowship to Advanced Media Productions for them to produce a short video based on the issues explored in the book. The idea was to re-ignite public debate on the very relevant issue and hopefully spark action by the relevant authorities.
On Sunday, July 15, 2011 an article written by Janice Budd published in the Jamaica Observer screamed: “Left to die – HIV-positive inmates say they are neglected in prison” The burning issue was once again front and centre. According to Janice, inmates from the Tower Street Corrections facility in downtown Kingston had contacted her newsroom and begged them to get word out about their plight.
“I am living with HIV, you understand, but I don’t want to die inside here,” was the impassioned plea from an inmate to the Sunday Observer from behind the massive masonry that constitutes the walls of the maximum-security St Catherine Adult Correctional Centre in Spanish Town, the country’s old capital.
“I did not bring this disease on myself and now I have to live wid it. I don’t want to die as yet,” The inmate was quoted as saying, with more than a hint of desperation resonating in his soft voice.
“Prisoner living with HIV hopes is just from the hospital, to the morgue, to their grave,” he said, adding that it’s easy to feel that there is no point to living.
“Quite often, when you si dem drive in di ambulance, drive in and drive out, is a prisoner who is HIV-positive or have full-blown AIDS they taking to hospital, and by time dem tek dem out there, dem dead, because they not paying us no attention at all,” the inmate continued.
The 2008 Panos study was quoted extensively in the article. Two media houses contacted Panos Caribbean and invited a representative to speak on the matter. Online Content Manager, Andrea Downer was interviewed by Jamaican radio station Bess FM and local television station, TVJ on it’s morning programme: Smile Jamaica.
Panos Videos on Street Boys and their Vulnerability to Contracting HIV to be Aired on CVM Television
“A work mi a work fi my money enno! You see this?” he asked in reference to the old wind shield wiper he was gripping in his hand, “It better than even work! Cause when you a work, you haffi wait pon a pay day. Everyday me get pay when me have this inna mi han’!” 16 year old Kemar declared as he sat on the concrete median that divides the busy dual roadway at Portia Simpson Miller Square in Kingston, Jamaica.
Holding the tattered windshield wiper tightly he looked intently into the camera, his tone firm and defiant. “Yuh see how this old!? Mi naah dash it whey! It can make me earn one million dollar before the week done a juss me fi save the money!” he continued.
His loose hair processed and shaved at the hairline. The hardened youth from the tough innercity community of Tivoli Gardens in Western Kingston spoke with the authority of someone who has seen and experienced too much at such a tender age.
Kemar is one of several young boys who were interviewed by CVM Television’s anchor and journalist, Kalilah Enriquez during a three-month media fellowship which examined the issue of HIV and Human Rights and focused on the streets boys and their vulnerability to contracting HIV and other sexually transmitted infections.
Wife of Jamaican Prime Minister – Lorna Golding addresses UN on the Elimination of new HIV Infections in Children
Civil Society not Impressed
Patricia Watson, journalist
Panos Caribbean: June 16, 2011: Lorna Golding, wife of Prime Minister Bruce Golding, was among thirty First Ladies from Africa, Asia, Latin America and the Caribbean who gathered at a special event in New York to mobilize support around achieving the Joint United Nations Programme on HIV/AIDS’ (UNAIDS) vision of Zero new HIV infections among children by 2015. The event was held on the opening day of the United Nations (UN) High Level Meeting on AIDS which took place in New York June 8 – 10.
Mrs. Golding and her counterparts participated in a session entitled, “First Spouses for the Elimination of New HIV Infections in Children”. In her brief presentation Mrs. Golding informed that Jamaica has successfully reduced HIV transmission from mother to child since the inception of its Prevention of Mother-to-Child Transmission (PMTCT) programme in 2004.
“The number of HIV positive pregnant women receiving antiretroviral medication has increased significantly from 47 per cent in 2004 to 83 per cent in 2009. This has led to a dramatic reduction in mother-to-child transmission of HIV from 25 per cent in 2002 to below five per cent since,” she said.
Mrs. Golding further noted that stigma associated with HIV and AIDS is one of the reasons pregnant women opt out of testing or don’t access public health services until very late in their pregnancies.
“All of us as first spouses, many of us being mothers, can help shatter the misconceptions around HIV by lending our voices to the movement and encouraging women to get tested early,” she noted.
She further noted that she will work to ensure that there is an end to the stigma and discrimination impeding Jamaica’s HIV response.
Civil society representatives who were in attendance at the event felt Mrs. Golding’s presentation was disappointing and lacked clarity in what her plans are as it relates to eliminating vertical transmission of HIV.
“I’m disappointed that there were no specific commitments made by the First Spouse on this very critical issue. She only quoted from our national prayer that ‘under God’ Jamaica will play her part in advancing the welfare of the whole human race. I’m surprised she didn’t seize the opportunity to seek specific assistance from the international community to support prevention of vertical transmission in Jamaica,” Legal Advisor, Marginalized Groups AIDS-Free World, Maurice Tomlinson said.
“She gave no indication as to what she or the Government plans to do. This makes it palpably clear she and the Government fail to understand the issue of vertical transmission which is not going away but is festering and threatens to explode in our high-sex and multiple/concurrent partners’ context.”
Director of Programmes and Training at Eve for Life, Joy Crawford had similar views.
“I found that the contribution lacked specifics or any clear action plan, strategies or projects to be undertaken by the first lady. In her promise to play her part in upholding the national pledge “Before God and all mankind … we anticipate she will develop clear advocacy and interventions that will reduce the current societal, familial and moral stigma and discrimination faced by the young pregnant adolescent female especially those identified as HIV positive,” Mrs. Crawford said.
Also addressing the session was first lady from Haiti, Sophia Martelly. Mrs. Martelly committed to working to increase the involvement of men in the Prevention of Mother-to-child transmission in Haiti; improve sex education for adolescent and to supporting programmes that integrate the empowerment of women and improvement in their economic status.
UNAIDS note that an estimated 1,000 babies are infected with HIV every day, 90 per cent of whom are in countries in sub-Saharan Africa. HIV is also the leading cause of maternal deaths in developing countries. The First Ladies in general agreed to advocate for comprehensive and integrated access to maternal and child health services. They also advocated for an end to gender inequality, gender violence, discrimination and inequitable laws that prevent pregnant women from accessing HIV testing and counselling, prevention, treatment and support services.
On return to their respective countries, some of the First Ladies agreed to advance key action steps to ensure that children are born free from HIV and to promote lifesaving HIV services for women and children. Some of the actions put forward include supporting efforts to: increase the number of centres providing free maternal, newborn and child health services, including treatment to prevent the transmission of HIV from mothers to children; strengthen sexual and reproductive health programmes for adolescents living with HIV and ensure meaningful engagement of people living with HIV.