Daljit Dhaliwal sits down with Julia Greenberg, the associate director of AIDS-Free World, a global advocacy group tackling HIV/AIDS. They place Jamaica’s AIDS epidemic within the context of the Caribbean region, address anti-sodomy laws in Jamaica and around the world and identify the successes and shortcomings Jamaica has experienced in containing the epidemic.

Daljit and Julia also look at the role women play in the epidemic. Women make up half of the adults living with the virus in the Caribbean, and are infected by “bridging populations” — bi-sexual men who are leading double lives. Julia raises the possibility of linking women’s rights with gay rights to tackle the spread of the epidemic.

• Watch all the Worldfocus In the Shadows video signature series
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• For more information on homophobia and HIV in Jamaica, visit The Glass Closet, a multimedia project produced in partnership with the Pulitzer Center on Crisis Reporting

TRANSCRIPT:

Daljit Dhaliwal: Hello, I’m Daljit Dhaliwal of Worldfocus, and joining me now is Julia Greenberg. She is the associate director of AIDS-Free World, a global advocacy group tackling HIV and AIDS, and she responsible for the Caribbean region. Julia, thank you very much for joining us.

Julia Greenberg: I’m delighted to be here.

Daljit Dhaliwal: So, give us some background on AIDS and HIV in the Caribbean, especially in Jamaica. Start off with that. What are the rates of infection and what are the trends that we are seeing?

Julia Greenberg: Sure. I think the most important thing to know is that in the general population the HIV prevalence rate is 1.6 percent. But if you look at the population of men having sex with men — the gay community — that prevalence rate soars to 31.1 percent.

Daljit Dhaliwal: And what is being done about trying to reach out to these groups and to try and educate them about HIV and AIDS, and to come up with preventative measures?

Julia Greenberg: Well, I think you have to step back when you look at the issue when it comes to men who have sex with men in Jamaica and look at the terrible culture of homophobia that is pervasive throughout the country. So there is a sodomy law — gay men’s lives are criminalized. So, in one of the segments thatWorldfocus aired earlier this week, in fact, there was a gay man who said, “AIDS is not killing us, people are killing us” referring to the very high murder rates of gay men in Jamaica.

Daljit Dhaliwal: Do you think it would make a difference if these laws around sodomy were decriminalized in Jamaica?

Julia Greenberg: I think it would be part of making a difference. I think we have to attack it several different ways. One is definitely getting rid of this sodomy law, which criminalizes sex between men. So if you’re going to do effective prevention for the population most affected by AIDS in Jamaica you would have to actually talk about the kind of sex that they engage in, and you can’t do that because that kind of sex is against the law.

Daljit Dhaliwal: And in terms of the big picture in Jamaica and in other parts of the Caribbean, do you think in the discussion of HIV and AIDS that we are moving away from treatment to prevention, or not?

Julia Greenberg: Well, I think the Caribbean is a perfect example of why we have to do both. So let’s look at treatment for a second. Jamaica has 43 percent coverage rates. So, 43 percent of the people who need AIDS treatment to extend their lives right now are getting it. Then, if you look at the prevention picture overall in the Caribbean, for every five (5) people put on treatment, 10 are newly infected. So we’re swimming against the tide. And it’s my opinion and I think the growing understanding in the AIDS movement that if you want to effectively deal with prevention, you have to deal with the concentrated epidemics among men who have sex with men, sex workers and in some regions drug users.

Daljit Dhaliwal: Right, and these trends that you’re talking about in Jamaica, do they also reflect a pattern in other parts of the Caribbean or is it too much to generalize? As far as you can generalize, what would you say is going on?

Julia Greenberg: They absolutely reflect a trend. If you look at Trinidad and Tobago, the prevalence rate is 1.5 in the general population and it’s 20 percent among men who have sex with men. In the Dominican Republic, for instance, where there isn’t a sodomy law, I believe the general prevalence rate is 1.1, and it is 11 percent in the gay population. So, it’s less than of a divide and maybe that speaks about the criminalization of gay men’s lives. But the trends are absolutely across the board similar.

Daljit Dhaliwal: In terms of Jamaica’s anti-sodomy laws, they would say, “Why is Jamaica always having the finger pointed as us? There are other countries around the world that also have anti-sodomy laws?” What would you say to them?

Julia Greenberg: I would say that’s true. I think there are about 80 countries around the world with sodomy laws or some kind of laws that criminalize relationships between men or relationships between women and women. And I think that’s really important. Look at the United States — it was only in 2003 that our Supreme Court ruling essentially nullified all state sodomy laws. So, that’s true. I would point to the recent Human Rights Watch report on the militia-sponsored attacks against gay men in Iraq. It would make your blood turn cold to read these reports. So, it’s a problem all over the world, absolutely. But the quality of the violence in Jamaica is quite stark. In fact, there are immigration lawyers here in the U.S. working with asylum seekers from Jamaica and they say that across the board, the quality of attacks is extreme, and, in fact, it makes it easier for them to win cases because of the nature of the violence perpetrated against the gay community there.

Daljit Dhaliwal: Is there some insight you can give us as to why this culture of homophobia is so pervasive in Jamaica, say, compared to other parts of the world? Are there cultural factors that make it that way?

Julia Greenberg: The story that is important to understand and tell, but is really difficult to face in Jamaica is that the prevalence is so high in the gay community and stigma is so strong, that gay men are getting married or having female partners and they’re acting as a bridging population to the heterosexual community, and specifically women. And that’s not something that’s discussed. It’s a very difficult issue to discuss again because of the culture of homophobia, but also because it feeds into homophobia. So then, the homophobic elements in the culture can say, “See these gay men are infecting our innocent women.” And, obviously, that’s not the picture.

Daljit Dhaliwal: And what role is Jamaica’s government playing? Could it be doing more? Is it doing what it can do with the money and resources it has available within its widerhealth care budget?

Julia Greenberg: Well I’ll break it down again between the government and the Ministry of Health. So the government has said some terrible things about how they’ll never repeal the sodomy law, the prime minister has said he’ll never have a gay man in his cabinet. So there is a lot being done at the highest levels of government to fuel homophobia. And when homophobia is fueled, you’re not going to, again, contain the AIDS crisis. The Ministry of Health is another story. They’ve recognized that they’re not going to get their job done unless they deal with the epidemic among men who have sex with men.

Again, if I might refer again to one of the Worldfocus segments, the former head of the national AIDS control program said, “It would be good if we could repeal the sodomy, and that the entire government and Ministry of Health needs to understand that they’ve failed when it comes to prevention.”

Daljit Dhaliwal: Is it a political issue for the Jamaican government that they don’t want to decriminalize or repeal the sodomy law, or is it more to do with this culture of homophobia, which you’ve been describing?

Julia Greenberg: I think it’s really integrated and complex. I think it’s a political issue because it really is ingrained in the culture and the society and there would not be popular support for such a move.

Daljit Dhaliwal: Give us a sense of what Jamaica has done — the kind of progress that it has made. And give us some context about the antiretroviral drugs, which have been provided by Jamaica, which are free, whether they are accessed or not accessed by individuals.

Julia Greenberg: There’s been an increase in the uptake of antriretroviral drugs in Jamaica. And it’s fantastic that they’re given for free. They are now achieving 43 percent coverage of people who need the treatment. But it’s important to state that the global community — the heads of state, the U.N. — have all said that universal access must be achieved by 2010. We’re about a third of the way there, and Jamaica is only a little ahead of the curve.

Daljit Dhaliwal: Is Jamaica unique in using community liaison groups and individuals like Ida, the woman that we saw in our film, in terms of educating communities and trying to reduce the stigma around HIV and AIDS?

Julia Greenberg: I wouldn’t say they’re unique. I think it’s been generally understood because of activism in the global AIDS advocacy community, that communities have to be involved in every aspect of AIDS prevention and support. So, governments are actually required to have communities involved in all of their programs. It seems to me that the Jamaica program is quite strong. The parish AIDS communities seem to be doing really great work. And you see communities adhering to their drug regimens and really absorbing prevention messages when they’re working with community leaders such as Ida.

Daljit Dhaliwal: Give us some examples of the kind of grassroots campaigns that these activists are involved in. And can you share some of the strategies that they are using, which perhaps have or haven’t worked, or you feel you can make better?

Julia Greenberg: To say grassroots campaigns is to overstate it because the lesbian, gay, transgender community in Jamaica has to basically exist underground. Again, as one of the excellent segments you aired shows, if you so much as embrace in public you’re at risk of being attacked by a mob. So, the kind of work the gay community is doing is underground, it involves speaking out when the government or the church says something egregious about the lives of homosexuals and how they should be criminalized, how they’re an abomination in the eyes of the lord.

Daljit Dhaliwal: So what is the best way of tackling that?

Julia Greenberg: Tackling that? I think one of the most important ways is finding leaders within the culture, in the church, in the communities — where you can find an opening. Where they’re willing at least to say that it is not OK to beat or kill gay people. And start working with them to see if they can begin to take a leadership role in making changes.

Daljit Dhaliwal: Let’s talk a little bit about how women are being infected by these “bridging” populations and the way in which they access treatment. Does it happen along gender lines that they have difficulty accessing treatment? Or, are they more stigmatized as a group if they become infected? What is the role of women in HIV and AIDS in Jamaica?

Julia Greenberg: Again, it’s another complex picture. When I was there last February I had the opportunity to meet with a group of HIV positive women at the office of an excellent organization called Jamaica AIDS Support. And these women, I have to say, after spending 10 years working in sub-Saharan Africa in some of the poorest communities in the world, there was no difference between the lives of these women and lives of the women that I met in my work and my travels in Africa. The stigma is intense. The poverty is intense. They’re not able to stay on their drugs for lack of food. They’re not able to get to the clinics for lack of transportation.

Daljit Dhaliwal: Right, and what kind of role can these women play in helping to lessen the epidemic?

Julia Greenberg: I’ve talked to a lot of activists about this — how can we get the gay community and the women’s rights community together talking about this issue. And it’s not happening yet. It really needs to happen. There needs to be an understanding that both communities are affected and they’re in it together.

Daljit Dhaliwal: There is also a culture of blame, as well.

Julia Greenberg: There is a culture of blame.

Daljit Dhaliwal: How do you get beyond those very, very emotional issues when a women becomes infected by a man she thought was straight, and it turns out he’s bisexual or he’s gay? How do you have those conversations?

Julia Greenberg: I don’t think those conversations as far as I understand — they may very well be happening at a personal level, but they’re not happening at a national level or even an organizational level, among the organizations that are working on this issue. It’s really, really tough.

Daljit Dhaliwal: Alright, Julia Greenberg, thank you for talking to us and giving your insights.

Julia Greenberg: A pleasure to be here, thank you.

Lisa Biagiotti produced this interview.

Teresa Bo of Worldfocus partner Al Jazeera English travelled to Port-au-Prince to see how expecting mothers are coping.

For more on humanitarian conditions in Haiti, see our extended coverage page on Haiti’s Poor.

Haiti is plagued by severe poverty and life expectancy is some 20 years lower than in the U.S.

Imagine a country in which a child is 10 times more likely to die before reaching five years of age than a child in the United States, a country where the overall life expectancy is 57 years old, nearly 20 years less than in your own country — a country where human beings sometimes eat dirt pies for nourishment.

And imagine finally that something can be done to resolve the tragedy facing the majority of the 9 million people who live in a nation not far south of the United States. That country is Haiti.

Haiti comes to the news pages when there is some new spot event, like the sorry case of a boat overloaded with 200 migrants capsized in the Caribbean this week, throwing a number of people to their deaths. But the nightmare of desperation never ends for Haitians, wracked by violence, hunger, fear and deprivation across generations.

Forget for the moment that U.S. policymakers looked the other way during decades of kleptocracy by the Duvalier family in Haiti during the 20th century; or that the Bush administration essentially tricked the elected president of the country, Jean-Bertrand Aristide, out of the country in 2004; and that thereafter, the United States has cared little and thought less about Haitians, whose lives were made even worse last year after the punishing hurricane season.

Change could come in the form of a new commitment to attacking the cycle of misery. The first signal was the appointment of former President Bill Clinton as the United Nations special envoy to Haiti. His role is intended to raise awareness of the problem and he has already won more than $300 million in pledges for international aid to Haiti. That’s not enough, not by a fraction.

Significant change could come if Dr. Paul Farmer, as expected and hoped, is named the new administrator of the U.S. Agency for International Development, which happens to exist on the flow chart under Secretary of State Hillary Clinton. Farmer has been in the running for the job for months now, with no announcement.

He is the visionary co-founder of Partners in Health and established a free health clinic in Haiti 20 years ago, treating the dire problems of disease and nutrition among Haiti’s impoverished majority. He has now extended his formula of consciousness-raising and local-based problem solving to Rwanda and Malawi. Partners in Health looks beyond individual health care to sustainable ecology and infrastructure. And the organization is careful to work with local governments, rather than dictating solutions on high.

Farmer’s inspiring mission was the subject of Tracy Kidder’s 2003 book, Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World.

It could be that the administration doesn’t want another high-profile issue on the front burner. Farmer, meanwhile, might not want to be dragged down by government bureaucracy. Whether or not he gets the job, his commitment inspires people to move mountains –- and the need in Haiti and other countries requires new thinking and global commitment to change. We are all diminished by suffering of such a scale that goes along chronically, untreated and ignored.

- Peter Eisner

Photo courtesy of Flickr user glasshalffull91 under a Creative Commons license.

Many Haitians migrate to the Dominican Republic for employment and are subsequently subjected to discrimination.

Up to one million people of Haitian origin currently live in the Dominican Republic, and many are subjected to discrimination and violence.

Many impoverished Haitians cross the border into the Dominican Republic looking for arable land, fuel and work. Often, they face racial prejudice and their Dominican-born children are refused citizenship because they are considered “in transit.” These children are left stateless.

In May of this year, a Haitian migrant was beheaded in the Dominican Republic. The incident sparked renewed outrage over treatment of Haitians in the country. Roger Leduc of “Upside Down World,” a Worldfocus contributor, describes the escalating human rights concerns.

Recent incidents involving Haitian workers in the Dominican Republic should alert even the most jaded observers that an already very serious human rights problem is getting worse.

A confluence of factors — a rapid succession of executions in the last few months, arrogance and defiance from Dominican government officials, institutions and citizenry vis-a-vis the plight of Haitian workers, the shameful indifference of the Haitian government, and the relatively superior economic and military position of the Dominican Republic — has created a pre-genocidal atmosphere that raises the specter of the 1937 mass murder of tens of thousands of Haitian immigrants.

What is alarming about these events is the rapidity, spontaneity, anger and brutality with which Dominican mobs react to rumored misdeeds of Haitians. This points to a deep well of prejudice and hatred, fed by a negative, stereotyped view of Haitians. It also denotes the distorted self-image and misconceptions some Dominicans have about their cultural and racial differences with their island brothers. Some of these opinions are typical anti-immigrant resentments: Haitians are stealing jobs, depressing the price of labor, etc.. Other sentiments, evoking fears of the proverbial “barbarians at the gates” and of Haitians changing the DR’s supposedly European and Christian culture, stem from century-old events and a misunderstood history. They are emotional and even visceral - and therefore more explosive and dangerous. Haitians are considered as the “enemy” who deserve their lot and who should be punished whenever Dominicans deem it appropriate.

Dominican government pronouncements feed this xenophobia. They not only deny any mistreatment of Haitians but accuse Haitians of fomenting violence. Haitians, they say, should then be thankful that Dominicans, more than any other nation, give them aid and succor, a Dominican version of Rudyard Kipling’s “white man’s burden.”

In 2005, the Dominican government reacted rabidly to the decision of the Inter-American Court of Human Rights that children born to Haitian parents in the Dominican Republic should be given full citizenship rights as Dominican law prescribes. It claimed that there was an international conspiracy against the Dominican Republic. Similarly, Haitian Prime Minister Michelle Pierre-Louis’ mild protest over Nérilus’ decapitation received vigorous rebukes from both President Leonel Fernandez and the archbishop —  the DR’s putative moral leaders. The Dominican police and judicial authorities are not only conspicuously silent but also take part in massive abuse and repression.

One of the reactions to Pierre-Louis’ whiny protest was that she should have toed the line set by President René Préval, who refused to denounce the beheading and stated that the case should be left to the Dominican authorities. There could be no better signal to Dominicans that they can do as they please with Haitians. [...]

Many petit-bourgeois Haitians ignore the plight of Haitian sugarcane cutters, who come from either the poor peasantry or the slums. In the feudal caste system in Haiti, such working-class people are considered disposable sub-humans. Some well-to-do Haitians are proud to trumpet how often they go on vacation in the Dominican Republic and spend their money, oblivious to the abject situation of our compatriots and enthralled by the great “development” of our neighbor. Haiti’s moneyed class feels no remorse in taking profits reaped in Haiti and investing them in the DR, claiming that the situation is too unstable at home — an instability and precariousness many of them helped create.

To read more, see the original post.

The views expressed by contributing bloggers do not reflect the views of Worldfocus or its partners.

Photo courtesy of Flickr user elmarto under a Creative Commons license.

In Haiti, freedom of expression is alive and well despite nearly constant turnover in the government, from the president and prime minister all the way down to obscure ministers often forced out over corruption charges.

But one of Haiti’s signature political expressions is this: A huge rally for a senate candidate shutting down an already traffic-clogged part of Port-au-Prince, the island nation’s capital. These types of demonstrations are part political rally, part Mardi Gras, and a big excuse to party. There is nothing subtle about these impromptu celebrations, which start small and then drag in people and onlookers with very little political interest into the fracas.

For people living in terrible poverty, the political rallies are an excuse to cut loose and dance in the streets. Haiti’s police help direct traffic and onlookers as the rallies grow and grow.

Haiti’s sanitation, sewage and plumbing are nonexistent for large pockets of people living in crowded conditions in Port-au-Prince. It means that nearly forty tons of trash and sewage and debris literally wash into the Caribbean each year after the storm season. The result is that the large slums in Port-au-Prince like Cité Soleil bleed into the sea. People fashion houses and living quarters out of the mounds of trash and sewage that accumulate.

It creates havoc for fishermen who say the fish are getting smaller, are harder to find and are sometimes poisoned by all the trash and nasty stuff seeping into the water. Also, the storm season each year contributes to the trash problem as rains form mudslides that wash everything into the ocean.

- Benno Schmidt

The cookies — made of dirt, butter and salt — hold little nutritional value, but manage to keep Haiti’s poor alive.

Worldfocus special correspondent Benno Schmidt and producer Ara Ayer report from Haiti, showing how far some people are going to fill their stomachs.

On the outskirts of Port-au-Prince’s infamous slum – Cité Soleil – we stumbled into this explosion of noise, excitement, money and above all else, anticipation.

We couldn’t understand why the Haitian men, just a few feet from the Caribbean in the outer extremes of the slum, weren’t letting the roosters off their leashes to fight.

This was one of the several cockfights held every Sunday in various parts of Port-au-Prince. The whole point is for two prized roosters to fight it out unrestrained, with betting and bragging rights going to the winners.

In a country where many live on less than a dollar a day, gambling is a way to make a lot of money fast. The men were clearly getting their prized fighters ready: Washing them down, winding them up and pointing them in the direction of their anticipated foe.

But then our Haitian fixer/guide told us they were waiting for us — the Worldfocus crew — to make a bet. They weren’t going to bet their own money and thought the camera crew might be interested in placing a wager. So, the extraordinary images in the above video were as close as we came to seeing an actual cockfight here in Haiti.

No money to wager meant that these roosters got a pass — at least that Sunday. They didn’t have to battle it out because no one was putting any money on the table — at least not for the fights.

- Benno Schmidt

Chosen by Haitian President Rene Preval, Pierre-Louis — the country’s second female prime minister — directed the Foundation Connaissance et Liberté (FOKAL), a non-governmental organization that works for economic empowerment.

But she faces enormous challenges in a country with a history of government instability and pervasive political, economic and social upheaval.

In January, Worldfocus correspondent Benno Schmidt interviewed Pierre-Louis. In this extended interview, she discusses how she and the rest of the government can work to overcome Haitians’ ingrained distrust of political leaders.

Visit a few inhabitants of Gonaives to learn how the mud has interfered with their lives.

Worldfocus special correspondent Benno Schmidt and producer Ara Ayer visited there recently and report that in their struggle to survive, Haitians are destroying the very elements of their environment that sustain them.

Months after the storms have passed, some Haitians are trying to dig their homes out of 10 to 15 feet of mud. The video Hurricane mudslides bury Haitian towns explores how long-gone storms continue to interfere with day-to-day life.

Below, bloggers discuss the environmental disaster in Haiti and what can be done.

A blogger at “Haiti Tales” describes her experience visiting Haiti for the first time:

We were “prepared” to be bombarded by locals when we arrived begging for money, but never was I ready to see the amount of people waiting - for our plane only (only two fly in each day). Surreal thing - as we landed in Port au Prince, you could see the devastation on the mountains from past and recent storms [...] I was dumfounded by the amount of people in the streets - very dirt[y], very condensed streets. There were fires started in the roads, stray (skinny) dogs everywhere eating from garbage and little kids walking around near dark by themselves. [...] The air wreaked of fire.

Very devastated place here — very poor — very sad. Lots of beauty though too, and I am hopeful that I will see more of all of it.

Blogger Daniel Schnitzer, the director of an organization working on environmental innovation projects, writes about possibilities for building Haiti’s future:

Back in August of 2008, during my first trip to Haiti, I was standing in front of the heaviest paperweight I had ever seen in my life.  It was a perfectly new 170 kW diesel generator, connected to a non-functional streetlighting grid in a coastal town called Tiburon on the western tip of Haiti’s southern peninsula.  My Haitian friends had told me that the local congressman invested tens of thousands of dollars and a great deal of effort into developing this project. But now that he had been re-elected, no one was sure whether this generator would ever give light to Tiburon. Electricite d’Haiti built the grid, but had since abandoned it.

This was just one of several personal encounters I had on that trip with symptoms of the governmental and market failure we read and hear about. [...]

In Les Anglais, InterIntel is building a clean energy retail store to stock appropriate energy technologies like solar lamps, solar home systems, and efficient charcoal stoves. Of course, merely having a brick and mortar store is insufficient to engender the transition to cleaner energy sources. This project is characterized by three other key features - cooperation, training and microfinance - to foster this type of change.

Another Web site, Konkou Biznis Ayiti, has launched a contest for entrepreneurs, hoping to bring biogas — a form of renewable biofuel — to Haiti.

Haiti was hit hard by Hurricane Ike.

A school partially collapsed in Haiti today, the second in a week. Nine people were injured in the collapse and no one was trapped inside.

Last week, another school collapsed and killed at least 94. Officials admitted that the building had been rebuilt after starting to collapse earlier, renewing concerns about Haitian infrastructure.

Four hurricanes hit Haiti within the span of 30 days this summer, killing hundreds and leaving many cities uninhabitable and buildings destroyed.

The “Operation Green Leaves” blog discusses hurricane relief and urges the Haitian government to prioritize basic infrastructure to curb the impact of natural disasters, warning that international aid and celebrity attention are waning.

Ben Terrall of “Haiti Analysis” writes about widespread questions swirling around hurricane relief efforts, including a statement from Doctors Without Borders that blasted international response.

“The Haitian Blogger” strongly criticizes the United Nations Stabilization Mission in Haiti (MINUSTAH) in the aftermath of the first school collapse, and blames the U.S. for destabilization after the bloody ouster of former President Jean-Bertrand Aristide in 2004.

The U.S. has sent search and rescue teams to the site of the first school collapse, but there are increasing calls to give Haitians temporary protected status (TPS).

Mark Schneider of the International Crisis Group writes at “World Politics Review” that TPS should be granted, and that the U.S. should be more involved in reconstruction efforts — pointing to comparitively large aid to Central America in the aftermath of Hurricane Mitch a decade ago.

Photo courtesy of Radio Nederland Wereldomroep under a Creative Commons license.