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29595: Hermantin(News)How the U.S. can help Haiti (fwd)

From: leonie hermantin <lhermantin@hotmail.com>

Posted on Fri, Dec. 01, 2006

How the U.S. can help Haiti


O n this World AIDS Day, my thoughts are with my friends and colleagues in rural Haiti who I know are working tirelessly to treat their AIDS patients. I was recently privileged to work there with the destitute sick as part of my medical studies. During my six-week stay, I saw the obstacles that the U.S. global AIDS program has encountered -- and sometimes exacerbated -- as it seeks to dramatically ramp up access to life-saving health services.

In rural parts of Haiti, the lack of healthcare workers leads to the inability to test, diagnose and treat AIDS patients. There are only five doctors for every 100,000 people in the country.

In the hospitals where I worked, I saw children dying of dehydration because there were not enough nurses available to give them intravenous fluids. There are almost no doctors living in the rural central plateau, and the few that are there are commuting three hours from Port-au-Prince. Physicians told me of their frustration at the lack of nurses and community healthcare workers to help care for their patients on a more consistent basis.

Dr. Renard Cruff, the director of HIV/AIDS for the government clinic in the city of Thomonde told me, ''Because patients live so far from a doctor, they either wait until they are very sick to come to the clinic or go to see the traditional healers who are closer to them.'' Adding to the problem is that salaries are low. Several doctors spoke to me about their intention to leave Haiti for the United States where they could better provide for their families.

In the United States, modern treatment has transformed AIDS from a death sentence into a chronic disease like diabetes. However, in places like Haiti, people living with AIDS often suffer without treatment. While some progress has been made in making treatment more accessible, only 12 percent of those Haitians who need it are receiving the drugs. So far, the President's Emergency Plan for AIDS Relief is taking only limited steps to address this problem. The United States just increased its budget to hire local health workers to provide treatment and care whenever possible.

However, the United States is actually weakening the primary-care systems of recipient countries and draining professional staff from the public sector by hiring from the same pool with no efforts to increase the overall supply of doctors and nurses. Many more doctors and nurses will need to be trained through the opening of new professional schools in developing countries, coupled with substantial new efforts to retain the struggling health workers who are already in place.

Fortunately, there are steps the United States can take to address the severe lack of healthcare workers:

• The United States can provide its fair share to the Global Fund to Fight AIDS, Tuberculosis and Malaria, whose grants can be used to bolster retention of healthcare workers in Haiti. While support for the Global Fund in the U.S. Congress has been strong, each year President Bush has proposed a large cut in the U.S. contribution. For the United States to meet its goals in Haiti, Bush should begin backing the fund wholeheartedly, and the full Congress should pass what the Senate has already approved: $866 million for fiscal year 2007.

• Congress should pass and fully fund the New Partnership for Haiti Act of 2005, which would help Haiti improve basic healthcare infrastructure and sanitation. This bill has lacked the support of such key Republicans as Rep. Ileana Ros-Lehtinen, R-Miami, who sits on the Foreign Relations Committee, but it is not too late for her to fight AIDS and other diseases by co-sponsoring this bill. Florida's senators, too, should take the lead in making sure that companion legislation gets through the Senate.

• Congress must look broadly at the problem, since Haiti is only one of 57 countries that the World Health Organization has identified as facing a severe healthcare worker shortage. A bill sponsored by Sen. Richard Durbin, D-Ill., would support training and retention of a capable, indigenous healthcare workforce in Africa, and Congress should pass and fund this critical legislation.

To fully fund a healthcare workforce to treat AIDS and other diseases in developing countries, $8 billion over five years is needed from the United States alone. To some, this may sound like a lot. But unless we fully fund the workers that are on the frontlines of the battle against disease, our efforts for stability and prosperity in countries like Haiti could be as much a hindrance as a help.

Vincent DeGennaro is a University of Miami medical student and an advocacy fellow at the Global AIDS Alliance.

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