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29595: Hermantin(News)How the U.S. can help Haiti (fwd)
From: leonie hermantin <email@example.com>
Posted on Fri, Dec. 01, 2006
WORLD AIDS DAY
How the U.S. can help Haiti
BY VINCENT DEGENNARO
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
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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