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Observatorio en DDHH / Proyecto Siloe
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Honduras
clinic provides treatment, care to people living with HIV, AIDS
Educational
outreach to sex workers
A woman
working in the pharmacy at Siempre Unidos in San Pedro Sula dispenses
medications to a transgender woman. Photo: Lynette Wilson/ENS
[Episcopal
News Service – San Pedro Sula, Honduras] Some years ago a woman came to the
Rev. Pascual P. Torres and said, “I am going to die.”
While she
was a patient at a public hospital, she had been tested for HIV without her
knowledge, then told the test results were positive. The staff told her: “You
are going to die because you have AIDS.” The woman left the hospital and
decided to jump off a bridge; she then remembered her 5-year-old daughter at
home.
“She
decided to kill her daughter first and then herself. But then she ran into a
nurse … and she didn’t know if it was God or whatever, ” Torres said.
The nurse
told the woman about Siempre Unidos, a ministry of the Episcopal Church
in Honduras that provides medical care and comprehensive social services to
people living with HIV and AIDS and their families.
“Ten to 15
years ago when people knew they were HIV positive, they tried to take their
lives,” said Torres. “Now with information and education, things are better but
it’s still not the best news to get.”
The woman
looked healthy, though she persisted in saying, “I am going to die,” he said.
“I told her that this [Siempre Unidos] was a place for those who want to live.
‘I can help you, I can spend all day with you, but if you have made up your
mind…’”
Eleven
years later, the woman is a technician at Siempre Unidos; her daughter is 16
years old.
Siempre
Unidos began in the 1990s at a time when people in its support community were
dying at a rate of nine per month and coffins were one thing the ministry
provided.
“At the
beginning of the pandemic it was bad,” said Torres during a conversation at the
clinic in San Pedro Sula.
In 2003,
when patents expired and drugs became more affordable and accessible in the
developing world, Siempre Unidos began providing medication to treat the immune
system disease.
Today,
between 21,000 and 33,000 people live with HIV and AIDS in Honduras,
population 7.9 million, according to UNAIDS statistics.
Siempre
Unidos operates two additional clinics, one in Siguatepeque, in the central
mountains, and the other in Roatán, the largest of Honduras’ Bay Islands,
providing care for more than 1,500 people in partnership with the Diocese of
Honduras.
The
ministry receives medication from Honduras’ ministry of health, international
pharmaceutical companies and from individuals in the United States who collect
unused drugs, and depends on local and international financial support.
Each year,
particularly in the aftermath of the global economic crisis, fundraising is
difficult, said Torres.
“Also we
have challenges with our beneficiaries: poverty, lack of work, malnutrition,
drug dependency … Some don’t have money for transportation so we provide that,”
said Torres.
Poverty, unemployment and underemployment
are pervasive in Honduras, where the average adult has 6.5 years of education; despite health confidentiality, a
positive HIV diagnosis makes finding a job even more difficult.
“It’s
against the law to discriminate against a person who is HIV positive, but
sometimes they’ll find ‘other’ reasons,” said Torres. “For a man or woman with
HIV, it’s hard to find work.”
The waiting
room in San Pedro Sula was two-thirds full of patients, men, women,
transvestites, on a March morning; in the adjacent kitchen a traditional
Honduran breakfast of baleadas was served.
For some,
the breakfast, a folded tortilla with refried beans and crema, would be the
only substantial meal of the day, said Torres.
Improvements
in treatment, including the advent of antiretroviral therapy and other drug
cocktails, have led to better outcomes, expectations and quality of life. Eventually,
Siempre Unidos added integrated services for HIV- and AIDS-infected individuals
and their families, including scholarships, pastoral care and educational
outreach to the gay community and sex workers.
Over the
last eight years, in partnership with Episcopal Relief & Development,
Siempre Unidos has run a community education and prevention program aimed at
reducing the spread of HIV and other sexually transmitted diseases among
commercial sex workers in San Pedro Sula, the country’s industrial center.
The outreach team provides sex workers with rapid HIV
tests, STD prevention education and social and emotional support.
“The work
they [Siempre Unidos] do is really important,” said Kellie McDaniel, Episcopal
Relief & Development’s program manager for Latin America. “Part of that
work is also human rights, gender-based-violence work.”
Honduras
has the highest murder rate in the world; criminals and criminal gangs often
operate with impunity; the marginalized, including the LGBT community, suffer
greater incidences of violence.
Local and international human rights
organizations have thoroughly documented violations against LGBT individuals.
Between 2009 and 2012 more than 90 homophobic killings were reported in Honduras.
Siempre
Unidos receives patients at its clinic by referrals from hospitals and through
word of mouth. The program designed to educate sex workers goes out to the
streets, and the nurses and educators have gotten to know the people they
serve.
“They are
closer to the danger, they are exposed to drug dealers, extortion, and are
being used by the gangs and the drug cartels,” said Xiomara Hernandez, who
works with sex workers. “And the people who live in the streets are targets of
the government when they want to do social
cleansing.”
Because of
its work with the LGBT community, Siempre Unidos has become a repository for
documenting human rights violations.
“There’s a
lot of hate crimes and social cleansing,” said Torres. “Our files of violence
and hate crimes are better than those the police and state institutions have.”
The
country’s Congress recently made changes to its penal code to “ensure legal
protection against discrimination based on sexual orientation and gender
identity.”
“The
authorities ask us for information, but for us it’s also a very dangerous
situation because of the corruption that exists in institutions,” said Torres.
–
Lynette Wilson is an editor/reporter for the Episcopal News Service.
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