HIV/AIDS Conference

Well, this has been an interesting several days. Thursday afternoon, Shiela, myself and Martin, one of the clinic workers, headed off to Xela (pronounced shay-la) and then Quezaltenango, where we attended a two-day seminar/workshop/meeting of public health administrators regarding the epidemiology of HIV/AIDS in the country. The program consisted of a series of workshops, presentations, group discussions and tours of facilities in a handful of towns. Sheila had mentioned the trip to me on Wednesday, but she didn’t say anything spending the night until after we got in the Land Rover to leave. Oops. Anyhow, it was only a one night trip, so I ran into my room, haphazardly grabbed a few things, and then we took off.

The trip to Xela, which is one of the larger cities in the country, was about 2 hours long. Before coming down here, I had been of the impression that the majority of the roads here are a delightful mixture of dirt and mud. It turns out that the people I know who have been here and told me the road are absolutely terrible have never driven on Old Woods Road (or up Grizzly Gulch, for my Montana readers). Yeah, they’re rough, and terribly uncomfortable to ride on, especially for hours on end. But they’re all paved, even if it is poorly so. Long story short, we’ve seen worse in South Tillamook County. The only difference is that what the county roads department eventually repairs at home, after a year or ten, is the general state of affairs everywhere here.

We drove through some pretty impressive scenery on the way to Xela; densely vegetated mountains veiled by thick fog towered over deep values populated by little farming villages. I tried to take some photos as we drove along, but was relatively unsuccessful.

Um. I just saw a giant, unidentified insect scurry in through my open door and under my bed. I’m not squeamish about bugs, but this one looked particularly malicious. And deadly. I think I’ll be sitting here for a while.

Anyhow. We arrived in Xela and went to a local hospital which has a specific HIV/AIDS comprehensive treatment clinic. After a brief round of introductions (even though I generally feel pretty comfortable speaking Spanish one-on-one, I tend to get a bit nervous when I have to tell 30 people who I am and why I think I belong in a meeting of public health experts. It was a bit uncomfortable.) We toured their small facility, then went to a women’s health clinic nearby where we had a multitude of people present and discuss their prevention and treatment projects. It was all very interesting, especially with respect to the incredible sociocultural barriers which they’re dealing with. While some stigma regarding the disease still exists in the US, we’ve now got a historical context of over 20 years in dealing with it. Here, it’s just now becoming a more public issue, HIV+ people are still heavily discriminated against and no one wants to admit they have the disease. To address this, they are careful to have very discrete clinics with side entrances, etc, as well as being very sensitive to the fact that, when doing home visits of patients, it’s entirely likely that their family may not be aware.

Also, the culture is heavily machisto, and infidelity is a major problem. Men often have mistresses, and even if a wife knows that her husband is sleeping around she can’t insist that he use a condom. Additionally, even though prostitution is legal and widespread here, professional prostitutes have relatively low incidences of the disease. Instead, women who’s husbands have left to find work in other parts of the country, or in Mexico or the US, are often left abandoned. In order to feed their families, they are forced to have sex with neighbors. While it seems safer to them than actual prostitution, this false sense of security is causing the disease to spread. The population with the fastest growing rate of diagnosis is, in fact, housewives.

Additionally, the majority of people prefer to deliver their children in the home. This means that outreach programs to pregnant women and midwives regarding the huge risk of vaginal birth with an HIV+ mother are incredibly important.

It was heartening to see many faith-based organizations, specifically Catholic ones, collaborating with medical ministry programs. Many of them are very open about saying that they’ll certainly present people with the Catholic Church’s official position on family planning, but they’ll always emphasize education.

Crap. There’s that bug again. Apparently he flies. Onto my mattress. Eek.

Anyhow, it was very nice to see that nationwide Catholic institutions are very willing to educate people about how to best protect themselves, and leave the decision up to the individual. Carroll could take a lesson from that stance.

Another thing which was particularly shocking was the absolutely dismal economic situation many of these clinics are in. Sure, people working in public health in the US complain about funds, with good cause. But more incredible is the state of affairs here, where nurses spend their spare time making earrings and decorating pens to sell – in order to pay for antiretrovirals. Wow.

(I feel like a TV evangelist right now “If ya hear the Lord ca-ll-in’ ya name, a-ask-in’ ya ta GIVE, pick up tha phone raght now an’ give us ya credit card numba!!!”) But seriously, it’s bad.

After spending several hours hearing about various successful projects and regional statistics, we went to dinner, then drove another hour and a half to Quezaltanango, where we checked into a hotel and went to bed exhausted. Just driving around for a while on those roads really wipes you out!

The next morning we went to another set of similar meetings, then visited the “Proyecto Vida” house, which is an AIDS outreach center. They provide testing, counseling, medical care, home visitations and hospice care. They gave a very fascinating, incredibly moving presentation simply explaining what it is that they do. Although it wasn’t anything incredibly complicated, it was clearly very difficult work, and the people working there are passionate about what they do. Following that, we went to a hospice care home run by Catholic Relief Services and the Proyecto Vida center, where we toured the facility and had lunch with the patients. All in all, it was a great experience, and I feel quite fortunate to have been able to take part in all of this. Really, I was actually pretty out of place the whole time, since everyone else were clinic administators, project managers and government employees, but I was just tagging along behind Sheila. Luckily everyone was very nice, and no one dislikes a redhead with a foreign accent, so I was clearly very welcomed.

We came back in the late afternoon, in torrential rains, which were a bit refreshing after spending the day in scorching, sticky heat. The weather is entirely mercurial here (in both the Shakespearean sense and in the thermometer sense, actually). It’s pretty much always hot, but it changes rapidly from rain so hard you can’t see the road very far ahead to sun blazing through a haze of humidity. Thank God I’ve had 18 years of intensive immersion (get the joke?) training in living damply, so it doesn’t bother me much.

Well…I probably should try and write a lesson plan, or at least think about it, so maybe I’ll give that a shot right now. Hasta luego!

Postscript: I typed this last night, and am posting it in the morning. After eating breakfast, I was sitting in my room and saw the scary bug again. I got a picture, but I've got a really slow connection speed so I need to figure out another way to upload it. I do want to emphasize, though, that I was not overexaggerating. It's about an inch long, very very fast, and has literally dozens of long spiky legs jutting out from its torso. I'm pretty sure it could kill me just by thinking bad thoughts.