8971: The Path of AIDS: How it Found Odres Victor (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: leonie hermantin <lhermantin@hotmail.com>

The Path of AIDS: How It Found Odres Victor

August 26, 2001

PORT-AU-PRINCE, Haiti · Like their human hosts, viruses love to explore. 
They test barriers and exploit opportunities. They mingle and move fast, 
recombining into new forms that allow them to thrive.

Throughout history they have moved along trade routes, feasted on wars and 
famine, and taken advantage of poverty and prejudice to grow into epidemics. 
The bubonic plague of the 14th century largely spared Jewish populations -- 
not because of an inbred immunity, but because racist laws forbade them to 
work on wharves and own farms, which is where the plague emerged from rats 
and livestock.

The mingling of American, European and African troops during World War I 
served as the incubator for an influenza epidemic that killed at least 20 
million people in three years. War-stressed hospitals in Europe and the 
United States broke down under the burden of so many ill people. Entire 
families were wiped out by the flu brought home by returning soldiers.

AIDS is the first pandemic of the mass transit age.

Likely a resident of Africa for centuries, it broke out, mutated or 
recombined in the 1970s and became swifter and deadlier. It booked a flight, 
probably with a tourist, and moved around the world on a jet stream. From 
there, the disease arrived in Port-au-Prince in the 1970s, when the island 
was a popular cruise port that advertised its easy sex.

After arriving, it swiftly spread among the beach boys, young men in their 
20s who serviced sex tourists in the Haitian suburb of Carrefour. They 
likely took it home to wives and girlfriends. From there it has slowly moved 
along trade routes on the island, taking advantage of gender inequality, 
non-existent health service and cultural taboos.

For a decade or more, it stayed mainly in the cities, mainly in the slums. 
But as the country's political situation worsened, it spread to rural areas.

In the early 1990s, an estimated 400,000 people were uprooted by political 
violence in the capital city slum of Cité Soleil. Many moved back to their 
home towns, many carrying the disease back to these small hamlets.

Another factor was trade. In a desperately poor, severely overpopulated 
country like Haiti, the men with stable jobs are usually truck and bus 
drivers and soldiers. Poor women, as a matter of survival, are often drawn 
to these relatively well-off men.

An estimated 500,000 people are infected with AIDS in the Caribbean, which 
has the second-highest infection rate in the world behind sub-Saharan 
Africa. The vast majority of those cases are on the island of Hispaniola, 
home to Haiti and the Dominican Republic.

"Many of those at greatest risk already know that HIV is a sexually 
transmitted pathogen and that condoms could prevent transmission," wrote 
Paul Farmer, a Harvard physician who works in Haiti, in an August article in 
The Lancet, a British medical journal.

"Their risk stems less from ignorance and more from the precarious 
situations in which hundreds of millions live; gender inequality adds a 
special burden, and is the main reason that, globally, HIV incidence is now 
higher among women than among men."

The repercussions of this spread are social, cultural and especially 
economic.

Over the course of the last year, the disease has driven Odres Victor's 
family of five off a fragile working-class perch in Haitian society into 
deeper and deeper poverty. He suspects he caught the disease through 
liaisons with women other than his wife. Now, AIDS has wiped out his 
savings, destroyed his trade, and is killing his children's chances for an 
education.

A tap-tap driver in Port-au-Prince, Odres has been taking medicine for 
tuberculosis since he arrived at the Brothersof Charity missionary hospital 
outside of Cité Soleil. His neighbor, an elderly woman who also attends his 
church, carried him to the clinic gates after watching his alarming weight 
loss. She had lost a son the previous year to AIDS.

"This one we might get back on his feet for a little while with TB drugs, I 
just don't know," says Henry Kullu, a Catholic missionary from India, 
glancing at Odres as he lay in a metal bed earlier this year. "We can get 
him back on his feet, maybe he can go work a little. But what we tell them 
is to use that time to prepare. They need to prepare themselves for what is 
coming next."

Odres can stand, but he cannot drive. And if he doesn't drive, he cannot pay 
the rent, tuition or even buy his children food. As he grew ill over the 
last year, he spent more of his savings on doctors.

He was forced to sell his tap-tap to pay bills. He then hired on as a driver 
for a while, working when he had the energy. Finally, he gave up driving and 
spent his days in bed, shivering and coughing.

"All that money I got for the tap-tap -- 30,000 gourds (about $1,500) -- 
it's all gone now," says Odres. "I spent it all on the medicine and the 
doctors, trying to fight this thing."

The children have been pulled out of school, though they still wear their 
school uniforms around the house -- they have little else to wear. Tuition 
for his oldest daughter cost $62 plus fees of $11 a month. The children's 
uniforms average $15 each.

Those amounts are unobtainable now. The oldest son has been sent to live 
with relatives in the countryside. There he might find work and send money 
home. The couple's oldest daughter, 14-year-old Odeline, takes care of her 
three youngest siblings.

The family lives in two rooms on the second floor of an unfinished cinder 
block home. On a cooking fire inside the house is a single small bowl of 
corn meal.

"That's about all we have to eat, but you know, I can't complain, my father 
is sick," says Odeline, a tall thin girl with high cheekbones and almond 
eyes. "What hurts the most, really, is that I can't go to school. I feel 
like I'm losing a lot of knowledge just staying here all day."

The family's loss of the father's income has become so desperate that his 
wife -- who still has not been tested for AIDS -- soon may no longer be able 
to visit him. The tap-tap fare, the equivalent of $2 U.S., just isn't 
available.

"She spends each day going to neighbors to borrow money to come here, but I 
tell her to spend it on food," Odres says. "We've already lost this school 
year for the children, and now they're finding it tough to even eat.

"It gets very discouraging, you know: You want to try to get up and walk, 
but you just get exhausted," Odres adds. "Then you get depressed and angry. 
You want to work for your family. You have to support them."

Over the summer, Odres has grown more ill. In early June, his wife prepared 
to move him back to his mother's house in Port-a-Piment. It is a well-worn 
road traveled by AIDS victims: When they enter the last stages of the 
disease, most return to their birthplace to die. Many, especially the males, 
contract out the building of their coffin so as not to burden their wives 
with the stress.

"I bury a lot of people with this disease, this thing they call AIDS," said 
one coffin builder, a voodoo priest named Edgar Jean-Louis. "I believe that 
there is a disease-caused AIDS, yes, there is a germ, but it's also a bad 
spirit in many cases. Some of them come to me too sick, and then all I can 
do is build the coffin."

For Odres' family, the money to build his coffin is all that's left of the 
family finances. His own savings were exhausted long ago, and his sister, 
who has paid for his medicine, thought it was best now that he returned to 
his hometown.

"If I could help him, I would, but now all my effort has been in vain …," 
said his wife. "Instead of him getting better, he's getting worse.

His wife, alone now with the children, has decided to stay at their home in 
Port-au-Prince to try to make ends meet. She worries that her large family 
would be too much of a burden on Odres' mother.

"Now since we have no more hope that he's going to live and since it is 
pretty hard and expensive to have his funeral in Port-au-Prince ... I gave 
my consent for [his] sister to go to the countryside with him," she said.

Tim Collie can be reached at tcollie@sun-sentinel.com or 954-356-4573.
Copyright © 2001, South Florida Sun-Sentinel


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