Earthquake could impede Haiti’s gains in fighting HIV

THE 7.0 earthquake of January 12 has dealt Haiti’s health care system a wrecking ball blow, destroying many health centres, killing health workers and patients alike, and leaving in its wake no trace of records for many persons on antiretroviral therapy (ART).

Undoubtedly, many young children, now orphaned, and who would have been on medication, may not be able to communicate to health care workers, or others, their status and what medication they were using.

Essentially, for many persons on TB and HIV treatment who have been dislocated or otherwise separated from their medication — resulting in treatment interruption, unless these would have been quickly restored, then the threat of the development of drug-resistance looms large.

That said, weeks after the deadly quake, public health is now emerging as a critical consideration in terms of health care for the people of that country, and there is great demand for resources. There were appeals coming out of Haiti, from reputable NGOs doing HIV/AIDS work there, for donations to keep their operations afloat.  The disaster, they claim, has put an unprecedented strain on them. Donations requested included medicines and other medical supplies.

Additionally, the Global Fund is making an emergency provision of US$ 800,000 for a supply of six months of stocks of antiretroviral medicines for that country.  That organization recently said that antibiotics and other health supplies are being taken to Haiti in close cooperation with Global Fund partners in Dominican Republic.

With some 120,000 persons living with HIV there, and an adult prevalence rate of 2.2 per cent, Haiti has the highest HIV infection rate outside southern Africa. Of that amount, 36,000 people are on record as being on antiretroviral treatment to stay healthy.  But the devastating earthquake would have reversed much of the progress made in that direction.  More than that, in an already impoverished country now torn by earthquake, being able to access and maintain the recommended diet for persons on ART constitutes another serious problem.  Hence, many PLHIV who would have been spared death in the aftermath of the quake, are now undoubtedly worried for their future safety, in terms of suppressing their HIV and gaining immune-reconstitution.  

Concerned about the health of the people of Haiti, Guyana’s Health Minister, Dr. Leslie Ramsammy sees as an imperative, rigorously addressing their public health needs. 

To this end, he says areas to be dealt with, applying all due haste, include vector control and putting back on treatment, persons with Tuberculosis and HIV/AIDS, who would have been on treatment when the earthquake struck, but whose treatment regimen would have been either interrupted on discontinued as a result.

Whilst agreeing with the initial focus of giving priority to persons seriously injured, bleeding and in urgent need of surgeries and tetanus shots, Dr. Ramsammy is hopeful that by now, there would have been a comprehensive response to public health concerns. 

Asked what he sees as being the chances of procuring the required amounts of medication, given the magnitude of the disaster, he was optimistic that it could be put together.  “I am not so concerned about that. What I am more concerned about is the human resource. I believe that Haiti will need the human resource for a long period of time,” Dr. Ramsammy told the Guyana Chronicle HIV/AIDS Mailbox.

The Health Minister noted that even though countries such as Guyana and others in CARICOM dispatch health workers in response to public health needs during such situations, it cannot be on a permanent basis.  “And so I think that the great, great challenge that we may face, is how we’re going to he able to provide human resource for public health and health in general in Haiti, over an extended period ,” he lamented.

And in relation to requests from some other quarters for ‘unused HIV medication’, Dr. Ramsammy had a word of caution:  “We have to ensure that what we give is not just anything you have (in terms of HIV medication).  We have to ensure that we follow the protocol.  For example malaria drugs will have to be of a certain kind  … So those are things that we have to  be careful about.  It’s not anything people have, but anything within a certain guideline, because we could end up sending things that they cannot use.”

Empathizing with the people of Haiti, Dr. Ramsammy commented that there is no country on earth that can respond to such a natural disaster by itself, therefore Haiti needs help.

“I think this is where it tests our hearts and our solidarity. There is no nation on earth that is too poor to help, so I hope we all put our heads and hearts together and help our sisters and brothers in Haiti.” Dr. Ramsammy said the goal should be to bring immediate relief, recovery and reconstruction in such a way, that Haiti ends up being better than it was.