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

[Bob Corbett <corbetre@webster.edu>]

From: leonie hermantin <lhermantin@hotmail.com>

Posted on Fri, Dec. 01, 2006


WORLD AIDS DAY
How the U.S. can help Haiti

BY VINCENT DEGENNARO
vdegennaro@globalaidsalliance.org

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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