On January 12, a massive earthquake struck Port-au-Prince, Haiti, utterly destroying the capital city and many Haitians’ lives. An estimated 217,000 people were killed in the quake, about 300,000 were injured and more than 1 million displaced. Since then, individuals, communities and international organizations have come to Haiti’s aid. But many advocates argue that the Caribbean country’s HIV-positive population—many of whom have since experienced care and treatment interruptions—haven’t received enough attention during the rebuilding process.

On March 31, the United Nations was the meeting place for the International Donors’ Conference Towards a New Future for Haiti. Outside the iconic headquarters in Manhattan, a Haitian AIDS coalition called PHAP+ joined New York City–based AIDS organization Housing Works and host of local AIDS groups to call on global leaders to develop a specific relief plan for Haitians living with HIV/AIDS, including expanded access to antiretroviral treatment.

In 1998, the president of PHAP+, Esther Boucicault, became the first person in Haiti to publicly disclose his or her positive status by announcing it through a series of television and radio ads. However, before she emerged as the face of Haiti’s HIV/AIDS epidemic, she was already helping Haitians most affected by the virus through the Fondation Esther Boucicault Stanislas (FEBS), which she founded shortly after her 1995 HIV diagnosis.

Boucicault recently spoke with POZ about the challenges PHAP+—which is supported by UNAIDS, the United Nations Population Fund and Family Health International—has faced following the quake. More specifically, she explained why it’s so important for HIV-positive people to be included in the country’s post-disaster needs assessment (PDNA) and recovery framework.

What are some of the challenges PHAP+ has faced since the earthquake?

Esther Boucicault

Since the earthquake, many people and members of our organization have been displaced or misplaced. There [have been] no support and attention being paid to people living with HIV/AIDS specifically. Many of them have been traveling in the countryside and provinces, and nobody is aware of where they might be. [We don’t] know if they died or passed away after the earthquake or if they have been somewhere else with their families in the countryside.

Nobody has been thinking that people with AIDS are much more vulnerable, and this is one of the reasons that we came to the United States and New York specifically—to make sure that people living with HIV/AIDS are included in the PDNA plan [by demonstrating outside the United Nations].

Many of the organizations that collapsed have been building back up comfortably. Many of those members had to find a place to live in St. Marc [near Port-au-Prince], food and [whatever else they need] to stay alive and keep them strong. In Port-au-Prince, they were running out and in need of everything: shelter, food, security, clothes and medication. This is one of the reasons why we keep working [and] struggling really hard to see if we can find resources for them.

Have Haitians received most of their resources from foreign aid?

This is one of our fears because the Haitian government has not provided anything for people living with HIV/AIDS. [All of it] has come from abroad. We are concerned because if the donors stop providing aid to Haiti, how are people living with HIV/AIDS going to keep staying alive?

Has PHAP+ had to suspend services because of lack of supplies and shortages?

We’ve had Housing Works’s assistance since the beginning. They were there to help us because there were a lot of shortages of services throughout all of the clinics around Port-au-Prince, Leogane and Jacmel, where the cities have been seriously diminished.

Housing Works helped open two HIV clinics to serve Haitians after the earthquake—the PHAP+ clinic [in Port-au-Prince] as well as the FEBS clinic based in St. Marc. [In addition, Housing Works helped reopen] Centre Medico-social de Port-au-Prince, which provides general practitioner care.

These clinics have been providing support seven days a week. Without the support of the clinics, we don’t know how people with HIV/AIDS or their families would have received care and treatment. There was a shortage of treatment for more than four weeks. We had to have a demonstration in front of the office of the city of Port-au-Prince to show the higher ranking member of The Global Fund, who was visiting the country, that people with HIV/AIDS were running out of medications [and that they were also in need of] food, clean water, shelter and clothes: everything that can help them recover from this devastation.

Has anything improved since the earthquake?

The only thing that we can consider being great is the support that has been provided by those three clinics in addition to the field hospitals that are remaining on the ground. The hospitals that [are still] standing are very overwhelmed.

And one other concern is how many people are sleeping in tents. There are so many tent cities in Port-au-Prince. And people are actually in need of condoms. The people that are in need of condoms are the ones that are by themselves. They are young, and they are in need of food and everything. They don’t go to school. There is nothing that they can do instead of staying in the tent or sitting around. [That leaves the possibility] that they can get raped or any sexual harassment can occur. Many young ladies, some of them have [gotten pregnant], and now we need to test them for HIV and tackle it quickly so they are not waiting to have the test to be done. Another concern is about the children who are still living out on the streets, and one other point that needs to be raised now is how are we going to teach abstinence to these kids.

What steps are being taken to make sure that people are getting their medication no matter their situation?

In St. Marc we did the same thing that the PHAP+ clinic did in Port-au-Price, which is outreach to the community [through] media advocacy as well as a PSA to let people know that they have a center clinic providing health care and support treatment for people with AIDS and their families [as well as general health care]. The clinic provides care and treatment for free––medication and examination and everything free. Care is being provided to all people in need, but specifically those who are living with the virus.

Why were you not invited to participate in the International Donors’ Conference Towards a New Future for Haiti?

We are trying to see why that happened, because [there are] so many organizations from Port-au-Prince; Washington, DC; Florida; and other international organizations that we know had probably gotten cleared [in advance], but when they [arrived at the U.N. headquarters], they were turned away because their application was denied.

Before we got here to New York, we’d been trying very hard to get accreditation inside the U.N. headquarters to attend the presentation. We’ve been working very hard and trying to get in contact with people at UNAIDS. They were very helpful. It seems that the [Haitian] government probably put a ban on this, and so many organizations that were trained to get their clearances from the prime minister’s office were turned away.

Photo courtesy of Housing Works