Haitian Doctor's Success in the Fight Against Disease

December 22, 2002

PORT-AU-PRINCE, Haiti Hope is an elusive commodity here. But Dr. Jean W.
Pape has found enough of it to confront one of the world's highest AIDS rates.

He has managed to slow the epidemic here, one of the worst outside Africa,
by nimbly adapting his medical techniques to the country's political
upheaval, withering poverty and crumbling infrastructure.

Dr. Pape has been so successful, in fact, that the world is now recognizing
the work he and others have done by making Haiti the first country in the
Western Hemisphere to receive a grant from the new, United Nations-initiated
Global Fund to Fight AIDS, Tuberculosis and Malaria.

"Haiti's work has shown conclusively that you cannot use a lack of
infrastructure as an excuse not to treat patients," said Anil Soni, adviser
to the fund's executive director. "We want to show you can adapt what is
being done in poor settings to stabilize patients. That is a lesson for the

The funds will increase treatment and prevention in a country where more
than 250,000 people are infected by the virus, out of a population of about
seven million. Last year, AIDS claimed 30,000 lives.

"We are using this project to say you can't do such a program by ignoring
public facilities," Dr. Pape said. "We still have the greatest presence of
H.I.V. outside of Africa. What is important is we have been able to control
this epidemic in a place that people usually talk about as being in chaos."

He has had impressive results fighting severe diarrhea with antibiotics, has
developed methods of diagnosing sexually transmitted diseases and has found
some less expensive drug combinations to treat AIDS.

Although the country faces a host of problems with water and electricity as
well as public health and poverty, a number of clinics have managed to flourish.

Paul Farmer, a founder of Partners in Health, which runs a clinic in the
Central Plateau town of Cange, said that although the vast majority of
Haiti's AIDS patients live in areas where advanced laboratory tests are
unavailable, doctors have relied on simpler blood tests and detailed medical
histories to determine who is most in need of medication.

His group, which will receive part of the grant, sends health educators to
villages to visit patients and help them to stick to their medical regimen.
It has also sponsored educational programs, including video presentations
and informal public talks, to increase awareness of the disease and how to
avoid it.

Dr. Pape's group now plans to train staff from government clinics as part of
his project's activities financed by the Fund. He is confidant that with
enough resources, the country can hold the line on the disease until a
vaccine is discovered.

And maybe, they can teach the politicians something, said Rene Max Auguste,
a businessman with a foundation that helps Dr. Pape.

"The Global Fund process was easier then the political process," Mr. Auguste
said. "It showed us we can work together. What is the other choice?"

Lawrence I Silverberg <brosil@EROLS.COM>

Sent by: "Academic Family Medicine Discussion." <FAMILY-L@LSV.UKY.EDU>


Haiti and potential low cost interventions on the web Dr. George Papanicolaou, a dedicated researcher - seen end piece on Dr. Goldie and Haitian women