With help, Cuba copes with AIDS
by Mary Murray, NBC NEWS
U.S. charity comes to the rescue of Havana mission
Dr. Jorge Perez, Cuba's foremost AIDS expert, addresses AIDS sufferers in Havanas Nuestra Señora de Montserrat Church.
HAVANA, June 27, 2002 Seven years ago, a young Cuban runaway named Regino found out he had AIDS. Regino lived in Havana, broke and alone, searching for work after having left the family farm. His timing could not have been worse Cubas economy was in tatters and Havana overcrowded with many others like Regino fleeing the poverty of the provinces. He ended up working Cubas black market, selling cigars and sex to foreign tourists.
ONE MORNING, after spending the night
on a park bench, Regino felt desperate. Even though not religious, he found
himself knocking at the rectory door of Havanas Nuestra Señora
de Montserrat Church. The priest who answered his knock, Father Fernando
de la Vega, would be his temporary salvation until Reginos death several
years later.
We talked for hours. Regino told me about
others living alone with AIDS. Then and there, I decided to open the church
to them, de la Vega said.
Regino came back for supper with a friend, another
homeless person infected with the HIV virus. The meal they shared that night
was a preview of what would become the citys first soup kitchen and
community support group for people living with AIDS.
Every Thursday night since then, about 100 people
gather in a makeshift dining room in the back of the church to share what
for many is their only hot meal of the day.
De la Vegas volunteers serve up rice, beans,
chicken and salad at a cost of about $1 per person a bargain price
by U.S. standards but a fortune in cash-strapped Cuba, where neither the
Catholic Church nor the government funds such grass-roots operations.
When asked how he has kept the soup kitchen running all these years, de la Vega answers, with a miracle albeit an earthly one. Donations come mainly from the Boston Archdiocese and a tiny non-profit called the Cuba Aids Project that operates with a U.S. Treasury Department license allowing humanitarian aid to circumvent the economic embargo on the island.
Father Fernando de la Vega opened his door to AIDS sufferers.
FOCUSING ON THE VULNERABLE
At Nuestra Señora de Montserrat,
there is no money to spare not to replace a collapsing roof or a
ramshackle car for the parish priest.
Built in 1843, the stone church throws off an
impressive shadow at dusk, but the glare of the tropical sun reveals an aged
façade literally falling to pieces. The church blends in with the
rest of the neighborhood, a seedy commercial zone with empty storefronts
outnumbering the few businesses whose doors remain open.
De la Vega shrugs that off focusing instead
on helping the most vulnerable in his community. He is also unusual in that
he refuses to convert the Thursday evening AIDS support group into a forum
to proselytize. I worry about their souls, but I worry more about their
food, their housing and their state of health.
De la Vegas more traditional flock at first
rebelled at the idea of making their church a sanctuary for people sick with
the HIV virus. At the start, people simply assumed the priest must be a
homosexual to welcome the AIDS community into the church.
About 70 percent of Thursday
nights participants are gay men, reflecting Cubas national AIDS
statistics.
After that speculation died out, his parishioners
still balked at sharing the church with HIV carriers. The congregation
was hysterical. They thought I was deranged. Little by little, they came
around. Regular church members now serve up the Thursday night dinners
on chipped china donated by the congregation.
On a recent Thursday night, a delegation from
the Cuba AIDS Project delivered several dozen care packages to de la Vegas
support group. These are simple things but make all the difference,
said Orlando, a 26-year-old Cuban physician living with AIDS, as he opened
a shopping bag containing aspirin, a toothbrush, flu medicine, appetite
stimulants, calamine lotion and a bottle of
vitamins.
RED-BLOODED
REPUBLICAN
Since 1995, the Cuba Aids Project has shuttled tons
of medicines to HIV/AIDS sufferers on the island. Several times a year small
groups of average Americans travel to de la Vegas church to hand over
the aid and meet with Cuban health care providers. The only requirement stipulated
by the U.S. Treasury Department license authorizing the mission: Travelers are
forbidden from engaging in tourist activities during their stay.
The man heading the humanitarian effort couldnt
be a more unlikely candidate for the job: Dr. Byron Barksdale, a red-blooded
Republican who traces his American ancestors to two Barksdale brothers who settled
in Virginia in the mid 1700s and French Huguenots in 1650s. Francis Marion,
another Barksdale ancestor, was a patriot leader in the American Revolution.
Byron, a scion of a military family, proudly points to his great-grandfather
who fought in the Civil War, his father who took part in World War II, and his
brother once stationed at the U.S. Naval Base in Guantánamo, Cuba. Theres
also a Louisiana Air Force base and a Texas Army camp named after the family.
Byron Barksdale became involved in the AIDS Project
when he learned how medicine scarcities on the island were killing AIDS patients.
The pathologist now living in Nebraska blames the U.S. embargo on Cuba as one
factor causing the shortages.
Cuba has
a first-class AIDS surveillance system and prevention program.
Many
of the AIDS treatment modalities are available. Theyre producing their
own anti-retroviral drugs. Their problem is cranking up the supply to satisfy
the increasing need in Cuba, he said People with AIDS die of
common infections, and they lack common anti-fungal or anti-microbial agents
to combat this. They dont have proper anti-cancer therapy to combat
tumors. This is their problem having access to the powerful weapons
to control the disease.
Barksdale is also spurred into helping Cuba by
the fact that the AIDS virus respects no borders.
Eventually the embargo will be lifted and
well have 1 or 2 million U.S. citizens coming down here. The last thing
you want is a high prevalence of AIDS. Imagine if Cuba gets to be a hot spot
during spring break. Our sons and daughters will be coming down here, contracting
HIV and taking it back to the United States. You cant cure AIDS in
the U.S. but not wipe it out in Cuba. Its just like polio. You have
to eradicate it globally.
PERILS OF THE CARIBBEAN
As of November 2001, Cubas rate of HIV infection
was 17 times lower than the rest of Latin America, where an estimated 1.8
million adults and children are living with HIV.
According to the United Nations, the Caribbean
is in danger of becoming the second most-affected region in the world. Nearly
700,000 people in the Caribbean are HIV-positive. In the Bahamas, adult HIV
prevalence has risen to about 4 percent and in Haiti to nearly 6 percent.
Cuba retains the lowest AIDS rate in the Americas
and one of the lowest in the world with an adult prevalence rate of 0.03 percent.
Testing of all pregnant women has resulted in a zero mother-child transmission
rate since 1997.
At the start of the global AIDS outbreak,
Cuba succeeded in keeping down the numbers through harsh measures running
from mandatory testing to forcibly isolated HIV carriers in sanatoriums. While
these institutions still exist, most patients are now free to return to their
communities.
Since Cuban doctors diagnosed the first AIDS case
in 1986, a total of 3,750 people have been found infected with the HIV virus.
Of these, 2,923, or 78 percent, are male, and 827, or 22 percent, female.
According to Cubas foremost expert on AIDS,
Dr. Jorge Perez, the greatest challenge to caring for his patients is securing
an adequate supply of the right medicines. In 1997, soon after the anti-retroviral
medicines hit the world market, Cuba could only afford to buy enough of the
cocktail for HIV/AIDS children and the most seriously ill adults.
By the summer of 2001, Cuban chemists successfully
duplicated the anti-retrovirals and began producing enough for local use to
make a difference.
Previously, Perez had routinely hospitalized 90 patients
a month in Havanas sophisticated Tropical Medicine Institute. By November,
that rate had been slashed to a dozen. Still, there is not enough of the medicines
to go around.
Under Cubas socialized health care system,
complete medical attention for HIV/AIDS sufferers, including the anti-retroviral
treatment, is free of charge. Underscoring the emphasis on health and education,
the Cuban government allocated 65 percent of its national budget this year to
funding social programs.
Perez, a frequent lecturer at de la Vegas AIDS
support group, often counsels on prevention strategies. But the same economic
hard times that lured people like Regino to Havana and into the sex trade, hamper
the cash-starved island from importing sufficient quantities of condoms.
U.N. money this year should help ease this shortage
along with a national task force that aims to integrate prevention strategies
by involving educators, health care providers, government agencies and non-government
organizations.