BLOG ENTRY PROVIDED BY CAROL WHITTAKER, DIRECTOR AND ASSISTANT DEAN OF THE CENTER FOR GLOBAL HEALTH
We have traveled from Santo Domingo to El Seibo, one of the poorest providences of the country located inland and to the east, a couple hours from the capital.
Here we, the team of University at Albany School of Public Health students and faculty, will work with ten members of a community health promotion organization called PACES (Proyecto Alianza Communitaria El Seibo) for the remainder of our study tour. We were connected to PACES by our partner organization, Community Service Alliance (CSA), which had received a grant from USAID to support peole living with AIDS in the community. They are working through local people, some who are themselves HIV positive, who know their neighbors and neighborhoods including the bateyes, the small communities where sugar cane workers reside with their families.
About 70% of those who live in the bateyes are Haitia; many have lived in DR all their lives but lack official documents so interactions with government authorities, including health providers, are regarded suspiciously. It is important that local health workers seek out these who need services.
The PACES project will provide anti-retroviral medications to those with AIDS, special nutritional support to patients and then families, and provide the equipment and training to obtain an ongoing supply of pure water.
They will also clear land and plant house hold gardens so that families have access to healthy and easily obtained food items.
We learned that 70% of households in the provence of El Seibo are classifieds as “in poverty.” The AIDS prevalence rate here is double the national rate and 60% of positive individuals are women, a large portion in the 30-34 age group. Although HIV is a major problem here, there are many other health concerns including TB, other sexually transmitted infections, vaccine-preventable diseases and domestic violence. Even rabies within the human population is a major problem.
Of those identified with AIDS, only 20% are currently receiving antiretroviral medications as ell as counseling and following services by health officials. People in this provence are especially geographically dispersed and live at great distances from health and hospital services.
But, there are also other reasons that people are not seeking services – lack of money and fear of stigma. Throughout discrete outreach they can be successful in getting people with AIDS into testing, counseling, treatment and follow-up services.
The health workers bring basic services directly to the patients’ homes. They are well trained and act humanely and compassionately to provide, in addition to the services described above, training for incoming-generating activities.
Our role is to provide nutrition advice, plant gardens and install water filters.