Cite Soleil

In this developing nation “on permanent hold,” Cite Soleil is a section of Port-au-Prince known for its extreme poverty and violent neighborhoods controlled by truly ruthless gangs.  Unfairly or not, Haitians themselves uniformly describe the area as a living hell.  Even tough police fear to tread here.  Similar to any ghetto, regular citizens cannot enter without navigating the complicated red tape and in fact, paying protection by arranging an armed guard.  According to sources in government and the medical sector, even NGOs and recognized charitable organizations must pay.  Only the Catholic nuns that have long labored in this township have relative immunity from kidnapping and physical danger.  Its populace used to favor Aristide the deposed President until he recently returned from exile.

In 2004, when Aristide’s popularity was on the wane, street demonstrations were seen, and talk of a coup was heard, I was in Haiti and visited Cite Soleil under unusual circumstances.  A  concierge at a hotel for foreigners was impressed by my street outreach and willingness to interact with regular youth who were often ignored by foreigners.  Originally from Cite Soleil, he asked if I would come to his neighborhood under the protection of a gang leader, his cousin or something.  I immediately said yes.   A beat up taxi appeared outside the hotel the next afternoon, and I was driven into a rough area where we stopped at a single story house (sorry but you will have to wait until my book to hear the rest of the encounter). 

This trip, I wanted to revisit the neighborhood but I no longer had a working number for the concierage or his hotel.  So I mentioned my interest to a few IAS colleagues.  One suggested I contact Dr. Bill Pape and he suggested the organization FOSREF that does AIDS prevention in two centers there.  They reluctantly agreed to bring us.

Approaching Cite Soleil, I saw two soldiers/police in full body armor with guns at the ready – something you do not see in ordinary neighborhoods of Port-au-Prince although most businesses and many private homes have armed security. Our host said I must not go there -- even the FOSREF representatives that work on the outskirts of Cite Soleil also expressed fear for their safety if they attempted to walk the streets. We spent time with Cite Soleil outreach workers, a tough-minded but sincerely dedicated group doing HIV outreach.  They said they could not bring me to the streets. so we settled for a group of lovely teen girls to talk to about spreading the message.

It is sad to think that in such an impoverished country like Haiti there is an even more impoverished neighborhood that is segregated from the general population. What does that say about the government? What does that say about the popular  leaders of Haiti? Of course the worst news is that young people there are treated like third class citizens in their own country. FOSREF tries to give them AIDS information but is not able to do it the way that I do with AIDS Attacks -- but in 2011 it has become even more dangerous and thus impossible

A dirty little secret

Pedestrians in Haiti like their counterparts in many Third World/Developing nations have no security or rights when walking the streets.  This is NOT an exaggeration but the honest to God truth.  Every vehicle has complete right of way and the freedom to drive up to a walking and avoiding them by mere inches.  It doe not matter if this is some callous rich person driving his Land Rover and in a hurry to do business or get home -- this is also the excepted practice for everyone with a car including well-known NGO’s that raise funds to operate for the Haitian peoples’ welfare or Church and religious organizations that preach values to respect your neighbors.  Diplomatic cars with immunity are also prime offenders.

This situation is not exclusive to Haiti but is the case in every poor country where foreigners and the in country elite take advantage of special privileges and very lax police oversight (many who look the other way in exchange for gifts/bribes).  The last country that I visited exhibiting this same king of shocking road madness was the Congo, D.R.  There I saw dogs being hit left and right in front of children – and once a pedestrian, a woman carrying water on her head.  Bystanders rushed to her aid and she got up but the offending driver honked incessantly to get the crowd to move.  She was standing up when our car passed.

Some of you know that I am physically challenged (no complaints, just an observation).  I have had quadruple bypass and have coronary disease; I have serious diabetic neuropathy that affects walking and my eyesight; and while doing street outreach, I fell and broke my right arm – TWICE in the space of three months – necessitating surgery for a steel pin to attach my lower and right arm above the elbow (I also had broken finger and toe bones).  So I walk very carefully now especially in traffic.

In Port-au-Prince, simply the worst city traffic conditions that I have seen mostly due to major earthquake damage,  I have been extra cautious and tried crossing the road waiting for a break in the traffic.  However, vehicles of all sizes rush upon me and honk and honk and honk!  I could not turn back to go the other way.

On two occasions I made a gesture of striking the vehicle and if I had my walking cane I would have struck out.  I hit the side of one passing car and he was surprised.

Yet the dirty little secret is everyone is cognizant of the fact that as a white man, I have special rights.  It is decidedly not fair but that is the truth.  Even vehicles accustomed to their own way, are aware that hitting a white foreigner would be inviting trouble and police (investigation and resulting bribes).

That said, I am as guilty as the drivers and their privileged passengers because when people drive me in this maddening manner, usually to help the TeenAIDS’ mission, I don’t say enough.  I compromise my principles along with offending church people, foreign government aid workers, diplomatic personnel, etc.  When you think about it, we should all be embarrassed by our acceptance of this racist, class attitude that preys on poor pedestrians including little children walking to and from class.

You can see the fear and anger on pedestrians’ faces especially parents holding on to their babies in a death-grip. We did say “Watch out” a few times in frustration.  Yet, one afternoon, t Maryna, Samantha and I yelled in unison when we thought that a weakened, hungry dog was going to be hit by our car and ones coming the other direction.

Aquin (Fond des Blancs)

Drack had told me that he would like to bring me to the central high lands of southern Haiti, his hometown. The drive can be anywhere from 3 to 6 hours depending on the time of day, the rivers to be forded, and the traffic. It is only a 100 or so miles so you get an idea of how bad the roads are. Many still show the damage of the 2010 earthquake with huge potholes and large cracks criss-crossing the roads. Because most of these country roads have never paved or were years ago, their condition is, frankly deplorable. However that does not slow down drivers of cars, motorcycles, trucks or buses. Pedestrians walk on the roadsides at their considerable  risk (see post “A Dirty, Little Secret”).

We forded two rivers in the dark; one relatively large and one small. We were driving at night and Drack had to yell to men bathing on the other side where was it best to cross. Essentially we had to do a u-shaped maneuver. He rolled up all the windows as he explained that he had previous experience where the water poured into the car.  This being the rainy season, there was no way to judge in the night how deep was the river.  At one point, Maryna accidentally spilled some water on Sam’s foot causing her to scream – she thought it was something alive and slimy.

To kill the time, Samantha and Maryna play a game called “20 Questions” although the new rules in the car were as many questions as it took to get the right answer (some answers were “black hole;” “The U.S. Constitution;” “Mt. Everest;” and “Christina Aguilera.”  (Go figure… )  I joined in on a couple of rounds. Although we asked Drack to join he declined preferring to concentrate on driving, though he did listen and loved the final answers.

Drack’s family home was nestled in a tropical-wooded area. The house was built of unfinished concrete blocks with a tin roof and had no electricity. The bathroom and the shower (water in pails) were outside and open to the heavens. However I paid for the gas to run the generator so that I could run my sleep machine (C-PAP), to charge our batteries and have lights. An older woman with a kindly countenance cooked our meals -- the best being the grilled white fish direct from the sea that she had marinated in fresh limes. 

For the two days, all of us became engaged in conversations in and outside of the house. I was busy with my AIDS outreach – it’s my main activity wherever I go.   Drack visited many of his old buddies. I spoke with a very interesting young man Yves who was one of Drack’s childhood buddies. Like many Haitian young people, his dream is help his country and its people. However a contentious part of our conversation dealt with the assassination of Osama bin Laden. He wondered why the United States hadn’t treated the terrorist like it did Saddam Hussein, who had a perfunctory trial before being hanged. I explained that there were political considerations that overrode a strictly legal rules.

And that Obama’s decision was approved by an overwhelming majority of Americans who wanted to see this sad chapter finally put to rest with Bin Laden’s death.

We started off the morning at a town meeting in an open-sided hall overlooking Aquin. The acting Mayor Mr. Briel introduced me to the crowd of 160 that was mostly adults. I told the story of Ben, my PeerCorps member who was born with AIDS. Like all my stories, it was both sad and uplifting and the facts of HIV/AIDS were imbedded in the storyline. Mr. Briel asked for financial help for the town. I explained that I was not a wealthy NGO and did not have funds to contribute – explaining that my volunteering to come to his area was my major donation. However, I am going to talk my Rotary club in Norfolk and see if there is some way it can donate bio-sand water filters to ensure clean water and the prevention of Cholera.

On Saturday afternoon Drack drove Samantha and Maryna to the beach for some well-deserved R & R.  It was essentially a deserted beach for miles on Haiti’s southern coast.  Maryna described it as a paradise and their photos back up their claim.  Why do beautiful, deserted beaches exist along Haiti’s pristine Caribbean waters when million dollar hotels crowd the sands in other locales.?  It is the result of a collapsed tourist industry that was devastated by the initial news that Haitians were among the first AIDS carriers (that we now know was an injustice and a slander of a nation).  Also factors were the political unrest that brought in UN peacekeeping forces and the horrific 2010 earthquake – and now the spreading Cholera epidemic.   Poor Haiti.

While they were at the beach, I spoke to teens at the high school, to both music and English language classes.  Later, I spoke on the local radio station so people that hadn’t come to any of our meetings or to the school were informed about TeenAIDS’ mission.  

Earthquake stories

It was on a mild January afternoon in 2010 when the ground underneath Port-au-Prince and its environs began to violently shake. People were just arriving home as office businesses were starting to close. Kids were on their way home from school or playing with friends.  The market places were full with shoppers buying food for dinner and children were doing their homework or watching TV. The initial shock was so huge that Drack said it sounded like a deafening roar – a thumping series of tremendous loud noises as the earth split apart.. At the time, he was talking with teens in a building in the slums about his vision for a future Haiti.

Immediately he KNEW it was an earthquake and ran quickly to avoid the crashing concrete of collapsing buildings all around him.  Within minutes he witnessed hundreds of dead and dying some with missing heads and limbs with blood running everywhere. The screams of people permeated the  air as large dust clouds rose into the skies from the devastation. He ran to find his car – luckily, it was only slightly damaged.

Drack was still able to get a cell signal and called his fiancé Stephanie who had arrived home a short while before and was miles away up in the hills above the city. They spoke briefly and reassured each other that each was safe. Drack said he would be home when he could but he had no idea of the time because many thoroughfares were blocked by massive piles of concrete rubble, broken telephone poles with bodies everywhere. He tried to help get people to safety and was stopped by one man who begged Drack to give him his car’s jack so he could help his sister get out from under a fallen wall. He told Drack that he was going to cut his sister’s arm off to save her life. Drack never heard what happened. He finally made it home hours later.  Both Stephanie and he were some of the lucky survivors.

A total of 250,000 people are estimated to have died in the earthquake a number that approximates the amount of Haitian lives lost to AIDS in the last 30 years.  With AIDS deaths, most victims were given Christian burials by devastated family members.  But the authorities had to dig huge pits in and around Port-au-Prince where the decomposing bodies were unceremoniously buried.

Yves, a childhood friend of Drack’s recounted how he was living in a two-story house in Port-au-Prince. They were all students that had just returned from afternoon classes and were getting ready to eat their communal meal. Wearing just their basketball shorts and no shoes or shirts, they sat down to enjoy their student rations of rice and beans with spicy fish sauce on the second floor where a breeze cooled the stifling air. Seconds later it sounded like bombs going off in rapid succession.  Suddenly the front wall facing the street crashed to the ground. Without a moment’s hesitation, Yves jumped and slid down the wall into the street followed by his  screaming roommates. Then there was a calamitous roar as the entire building collapsed on its foundation. No one died except for their cat.

Everywhere he saw mangled bodies surrounded by families wailing over their lost loved ones. Barefoot, he lead his friends out of Port-au-Prince in large columns of fleeing refugees as the aftershocks continued to toss them off their feet and tumble weakened structures.  They walked almost 50 miles in two days on their way back to their homes in Aquin. Family members met them at a river crossing and brought them to the relative safety of the central interior where damage was less.  With tears in his eyes Yves told me that 600 of his fellow students and most all of his teachers perished in that first hour including his best friend. Unfortunately, they had not left campus. 

The aftershocks went on for months and buildings continued to fall killing thousands more desperate people that had sought shelter wherever they could from the rain and cold evening temperatures.. Drack said that there were so many dead which had to be buried within a matter of days that huge pits were dug and decomposing bodies where dumped en mass and covered over.

It really seems as if the people of Haiti have suffered an inordinate amount of tragedy in their history beginning as slaves from Africa.  Certainly, they are proud of the fact that they were the first black republic established in the world and the second democracy after the United States in the Western Hemisphere. At various times, they have been occupied by foreign powers, suffered from tremendous maladies, and from the abuses

High School Visits

Lycée Francais

We visited two special secondary schools in Port-au-Prince. One was the exclusive Lycée Francais Alexandre Dumas. The other top-notch institution was the privileged Union School founded in 1908.   Many of Haiti’s top families and diplomats send their children here where they learn impeccable English as well as French (Creole is optional).  Future leaders in business and government will graduate from these schools.

At both place, I spoke in English – I needed no translation. I much prefer speaking without a translator because it takes half the time to tell a story about AIDS compared to waiting for the interpretation. I can also better judge the reactions of the teens when I say something dramatic or humorous, both important points to my story telling and that teens love.  They respond best to human interest stories of real people that I have known – the human pathos stays in their mind better than a dry lecture on HIV prevention fact6s.  I hear, “I really liked how you talked to us  - it is very interesting.”  I put in facts as part of the story.

Lycee Francais

Lycee Francais: At the end of the school day, we met in the library with 25 older teens. It was equally mixed between boys and girls. So I knew I could have some serious fun in my lecture.  I always try to start off each talk by shaking hands, looking them in the eyes, and introducing myself -- and asking for their names.  This approach is unusual and adolescents respond because they feel the special attention.  It is a technique that I learned from my early political days. When I lectured at Harvard’s School of Public Health, I taught health and medical professionals that they needed to use this approach to be more effective.  With teens, it sets a mood that I am interested in who they are and I am not just talking down to them.

At the end of the talk, there were a lot of questions. One dealt with the origin of HIV, which is a question that I get a lot. One young woman asked I thought that since condoms protect young people from HIV, why should teens postpone sex if they want to have it?  I explained that condoms sometimes break but more importantly, the first sexual experiences for young people can impact them psychologically,  especially if one partner is using the other, used coercive peer pressure or lied about loving them..

Union School:  I spoke to 130 young people from grades 6-12. I asked the head teacher to mix the students up so that the youngest were sitting with older students. A remarkable young man named Karim Duval (18) arranged this assembly after hearing about Dr. Bill Pape’s request to Union to arrange my talk.. When speaking with him beforehand, he told me that he is going to Northeastern University in Boston in the fall.  He has already visited to see the school and so we had a lot to talk about because I lived in the Cambridge-Boston area for close to 20 years while doing graduate studies at MIT and Harvard and running my art publishing business, Paté Poste on Beacon Hill. He is also going to Costa Rica this summer and I plan on putting him in touch with Giovanni, who is our Global Board representative in that country.

I started off with the story of Rafael of Guatemala and how he had contracted HIV/AIDS as an illegal alien living in Boston. Because Rafael was so angry with his situation, he told me that he was going to give AIDS to as many women as he could because someone had given it to him! When I explained that I would have to contact the public health authorities, he disappeared and I heard that he “lost” himself in New York City.  This story always generates shock in a teen audience.

The questions were perceptive. One young student asked if dogs got HIV?  After the initial laughter, I explained that monkeys have a form called SIV (for Simian) and so do cats  but they don’t die.  This gave me an opening to ask, “Do any of you have dogs?”  A sea of hands jumped into the air.  And of course, I spoke about the love of my life Jazz, my 10 year old Yellow

Potpourri

Traveling towards the border, the Dominican landscape is dry and not very interesting. There are many little villages with neat cottages and wooden fences.  People sit outside on benches under skinny trees. Because wood is an important commodity for impoverished families, the hills are denuded.  Occasionally you see teenagers gathered around a few motor bikes talking, but usually it was older and men and children who were about.  Crossing into Haiti you are immediately there's a beautiful vantage point overlooking a large lake and dramatic mountains in the background. Some kids were fishing and except for a very few vehicles, there was little human presence.

The border crossings on both sides were in shambles and needing much repair. However, both countries care little for these land crossings because the big bucks come from the tourists landing at the airports and the visiting cruise ships. We had a wild and interesting ride on well-respected Caribe Tours. This bus ride was not one of their stellar achievements. Within an hour of leaving Santo Domingo, we stopped on a busy town street and waited for quite awhile. Nothing was said to anyone about this wait. At first I assumed that it was to bring on new passengers but that didn't make sense because the bus was full. We drove on and had to stop and change to a new bus. This meant also checking on our bags in the luggage area to be sure that everything was removed to the new bus. One thing that visitors are told over and over again is that theft is rampant -- often with official collusion.

We drove on for perhaps another hour when a large sound came from the undercarriage. Again we were told nothing, either in French or Spanish. It seems to just be their policy not to share information with passengers. Approaching the actual boarder perhaps 20 miles away, the bus stopped again and we were told to disembark again. The Caribe Tours representative tried to commandeer one of its bus coming back into the Dominican Republic (to get us to the border more quickly) but those passengers refused to get off amid much yelling.  So we waited and waited until they decided to take the malfunctioning bus to the crossing -- with fingers crossed.

I was surprised when I saw passengers filling out their exit and entry cards and they all seemed to have their passports. We were the only three that were not in possession of ours because Caribe Tours said that they had to hang onto them. Knowing that Drack had been waiting on the other side for quite awhile, I wanted our passports returned asap when the bus stopped. The Caribe woman just said no. She said that she was going to get our passports stamped herself. I was leery because I had experienced this control before and it was usually done to secure a large tip for services rendered. When we got to the border crossing on the Dominican side, she disappeared and we waited interminably for her return -- while our fellow passengers had already got theirs stamped.

While Samantha was taking the bags off the bus, Maryna went in to get her passport stamped. Immediately she was surrounded, first by one man and then by five and they and started riffling through her things in front of where the immigration windows were . Understandably she was very upset until one middle-aged woman came to Maryna's rescue and indicated that she shouldn't let them do this. They tried over and over until the women took Maryna's suitcase away and told them to stop!  Tourists crossing the remote border are a rarity and predators who spot a single woman will take advantage of the situation.  It's amazing how many people stand by and say nothing.  Kudos to this unnamed woman.

Finally the Caribe Tours woman showed up with the two passports but I was in no mood to give her any tip. We had a tough two kilometer walk to the Haitian Immigration and Customs and much of it was through knee-high water because this is the rainy season and the roads are really impassible except for Land Rovers and buses. A taxi driver said that he could drive us the 2 kilometers for 40 US dollars. Instead I told the bus driver through interpreters that it was Caribe Tours' responsibility to get us to the Haitian side to meet our ride where they themselves were heading. At first they said no but then relented (I blocked the door). We finally met Drack and his friend and had a good ride into Port-au-Prince. Drack and his fiance Stephanie have a beautiful home in a gated community named Belle Ville that overlooks downtown Port-au-Prince. Drack will be devoting a good amount of his time to driving us around which was something that Harold couldn't do because of his new job.

Today we are going to do some business with the newspapers and visit one or two neighborhoods for AIDS Attacks including one of the many tent cities set up by mostly foreign organizations. On our brief entry into the city, it was not readily apparent how much earthquake damage had been done, but maybe we will see today. We hope to take Drack and Stephanie out for dinner tonight and get filled in on Haitian culture.

AIDS is Haiti is a difficult topic. The government hates any mention of it because it destroyed their burgeoning tourist economy back in the 80's, when the first international reports showed that the Haitian American community in southern Florida had very, very high rates of HIV. The U.S. and many countries cut off all immigration at that time and even professionals were afraid to come to Haiti on humanitarian projects (in the first days, much confusion existed as to transmission routes -- even intelligent people thought mosquitos could transmit HIV -- they cannot).

The Haitians themselves felt that they were being unfairly stigmatized and truth be told, they were and the early reports were biased and incorrect. My Harvard mentor, the late Dr. Jonathan Mann, was outspoken on the human rights issue -- a position that we also push forcefully as the only youth AIDS organization that says it is teens' "human right" to have accurate information.  What we know medically now, is that it is not who you are (i.e. what particular subset of the population) but what you do. A discussion of AIDS has been at the bottom of most Haitians priorities and consequently most of the young population here have not heard about how HIV is transmitted, in clear medically accurate terms. That is our mission here in Haiti. And for the thousands of young people we will meet and distribute our cards in Creole, I know that we can reach hundreds of thousands more through positive press coverage and social media. In a country like Haiti it is essential that youth receive information directly that doesn't just emanate from churches or reluctant government, that could be censored and not truly helpful. That said we will see what today's adventures will bring. 

Sunday AM

We are on the bus to the border of Haiti where we will cross through customs and look for Drack’s vehicle, borrowed from the U.S. Embassy.  All the other passengers are traveling directly through to Port-au-Prince. We arrived plenty early just to be on the safe side and get seats together; Samantha and Maryna are sitting in one row to the left -- and me opposite with a window seat.  We are lucky to find seats nearby.

I am used to traveling on public transportation around the world.  In some countries you line up in queues and don’t dare to cut. In others there’s an orderly rush (not an oxymoron) with pushing to get on and grab a seat. Today, the women lined up behind the few people who arrived early.  Soon latecomers appeared and just moved in front.  They were enveloped within a tightly packed crowd.  In these instances, I maintain my position and know how to use my weighty hips to keep a competitive edge. If you read my African blogs from Kenya, you might remember one where I related an incident how people almost came to blows but my calls for ”police” were answered and the well-to-do offenders were physically removed to applause.  Even with a ticket, you might not get a seat on a long journey.  From conversations, I know that local people see two types of foreigners – those that wait politely and are shoved aside and those that claim their seats.

Oh, the bus just stopped and they are passing out food: rice and beans and a mashed plantain concoction with meat and gravy.  At the same time, a news reporter from Massachusetts called to do an interview.  Juggling the cell phone and my spoon, I was wondering why the bus couldn’t keep driving when suddenly people started rushing to the front. Sam said, “We’re changing buses.”  The rush to get a seat was beginning anew.  I grabbed the video camera (used to document our work) and jumped up to stay with the women and our bags. Sticking my arm out into the aisle, I blocked a guy cutting me off.  He kept pushing but was surprised I wouldn’t let him pass, all this while trying to answer questions on a cell.  We did get seats together on the new bus.

A mother is singing softly to her seven-month old baby across the aisle. As I look out the window with droplets of rain streaking downward, the sun has not yet appeared from the cloud cover but it is getting brighter by the minute.  Everything is tropical green because of the daily rain showers during the month of May.  I just saw a young family pass by on a motorbike sharing a wildly flapping blue tarp over their heads. I wonder where they are going on a Sunday morning?  Judging from their bag of supplies that their child is sitting on in mama’s tight grasp, maybe they are going to relatives for the day. If it starts to rain harder, they will not be able to drive on.  Despite the downpour, the urban rivers are mostly brown sludge with old litter on their banks.  As someone who grew up in a paper mill city, I’m no stranger to pollution.

It took just 25 minutes to clear the city limits; we are now traveling through a verdant landscape of low foliage. Wooden shacks appear momentarily, tucked away not far from the road. This jungle of densely packed palm trees has now given way to a rolling landscape with fields of what looks like young pineapple plants but I don’t know for sure.  Perhaps a few miles or so away is a range of small mountains.  We just crossed over a bridge where the rainwater makes it look much cleaner than the urban ones. Teens are out in small groups around their bikes perhaps talking about who hooked up last night and what adventures are on the schedule for the day. They are definitely not dressed for Church.

Yesterday we spent a good part of the day at the beach at Boca Chica, mostly populated by Dominicans with a tourist here or there.  That was fine by me; the women went swimming and I walked the beach.  Saturday is a great day for finding teens with friends. I managed to distribute 200 cards and filmed many of the encounters with my other hand.  I love to do this kind of solo outreach even if the lens is not always centered on the subject when I am talking with them.

I met girls and boys singly, in pairs and in noisy groups.  Merengue music was blaring everywhere as youth danced to the Latin beat. I have always found merengue fun to watch because everyone smiles a lot.  Per usual, a lot of curiosity was expressed why I was doing this kind of outreach at the ocean side.  “Because that is where I find young people.”  It is really amazing how positive is their reaction. Until you have walked with me (or seen the video), it is difficult to “see” their appreciation that there are adults and peer volunteers interested in their welfare. 

Oh, I broke a plastic chair while drinking a soda. I mean, I felt one side tilting and sinking into the sand and then the very bottom of the leg snapped off. As I tumbled over slowly, I held on to the video camera and actually was able to hand it to a passing trio of military recruits. One gave me a hand and of course I used the situation to give them cards. We talked for five minutes. They were with the Dominican air force and were trolling for “chicas.” I asked what information they received about SIDA in the military and Ronaldo, a 20 year-old mechanic said they are told to “use condones” when going to prostitutes. He said his friends were worried -- and most but not all used protection. He pointed out a twenty-something year old beach masseuse giving a businessman a massage.  “She’s one. Many at Boca Chica.”  He said he had gone with prostitutes using the vernacular term; his younger friend laughed, a bit nervously it seemed but what do I know?

Unlike last time at Boca Chica almost 20 years ago, I didn’t see the same numbers of hustlers prostituting themselves.  I believe this can be accounted for because the economy is better so more choices exist to earn an income and provide assistance for families are available. Also younger people have more opportunities to have casual sex to let of steam (friends with benefits) as culture has changed and the media sells consensual sex.  It’s just not a necessity or cool to have peers know you are selling your body.  There were still the young teen girls sitting with businessmen old enough to be their fathers – somethings will never change.

 

The D.R. is a country that is richer than Haiti (per capita) but both have extreme poverty.  Can you visualize people sorting through refuse for food at a trash dump?  As anywhere in the developing world, a small minority of families control the vast amount of income and property.  Pure communism has mostly vanished and capitalism in its many forms is here to stay because young people want choices and rewards. 

The youth revolutionary spirit is not as great as in decades past with the exception of the youth-fueled and Facebook inspired social  revolutions now sweeping the staid, out-of-touch Middle East.  Youth want to have jobs so they can have discretionary income to but their favorite consumer products.  Owning a cell phone to stay connected is all-important and they can be purchased at less expensive rates than in the states (with fewer features). Harold bought us two used ones for under $15 each – we will leave them when we return home.  Sam designed some cool business cards with our numbers that come in handy when we are looking for volunteers. 

Angels and Sinners NOT

Hi guys! It's well after midnight on Friday/Saturday as I sit here and type. We have had a busy Friday. It started off per usual with a pre-breakfast meeting to go over unfinished business and then it was on the road. We had to change money at a Western Union and buy our bus tickets to Haiti. Our original plans to drive the southwestern route to the frontier did not materialize because our Santo Domingo host Harold Mateo just started a new job less than 2 weeks ago so he cannot take time off to drive us as he wished. To hire a private driver and pay the equivalent of $6 per gallon for gas was not practical (over $800!) so we opted for the Caribe Tour Bus at $40 per ticket and an additional $26 for customs/taxes. That we could afford.

For those of us who are not geography majors, the Dominican Republic shares the island of Hispañiola with Haiti. The Dominican Republic is twice the size of its neighbor with some of the loveliest beaches in the world. Tomorrow we are heading to Boca Chica's beaches so Maryna and Samantha can have some R&R in the sun and surf and I can work the strand talking to youth. I actually prefer working to relaxing unless I am at the movies or at the beach in Norfolk watching my dog Jazz play in the ocean. The last time I was in Boca Chica years ago, I ran into groups of teen hustlers, both girls and boys, trying to make a living selling their bodies. For a momentary gain; ironically, many would pay the ultimate sacrifice. It might sound crazy to my American readers but street prostitution is considered a viable occupation by many impoverished young people with no chance at any other paying job.

You can read the history of the D.R. on wikipedia but it was long a colony of Spain and once was invaded by 23,000 U.S. troops under President Lyndon Johnson in a questionable use of American power to prevent an unfriendly government from taking control. Before that event, we actually supported the longstanding dictator Rafael Trujillo until CIA trained agents assassinated him when his brutality and corruption made him an embarrassment to Washington. Ever wonder why Hollywood action spy thrillers take their story ideas from the news headlines? Reality is usually stranger than fiction.

The D.R. is relatively peaceful now -- most of its income is derived from tourists. Every citizen is cognizant of that dynamic. So now, when the cholera epidemic is spreading throughout Hispañiola, it is not surprising that the government is downplaying the epidemic. The medical community is complaining but el Presidente and cabinet are preventing the truth from being told to avoid a tourism collapse. So we avoid tap water, use hand sanitizers and wash our fruit. In Haiti, I hear the cholera is worse.

As I sit here alone (Maryna, Samantha, Georgina and Harold are out nightclubbing), I can hear partying outside. Heck, it's Friday night after all. Why Latin love songs have such a strong emotional tug on me is not clear but no matter how schmaltzy and pedestrian, it brings sadness and happy feelings at the same time... does that happen to you when you hear a particular genre?

Our mission marches on. We visited two schools today. A UASD student Cristina whom we had invited to join us a few days ago while on her campus, volunteered her time before her evening job. She translated and helped immensely at a Catholic school that allowed us entry before classes started. We reached about 200 kids outside and inside -- until La Directores showed up late from lunch (also a happy hour evidently). When she heard we wanted to talk to her students about "SIDA," it was a no go. But before her nyet, we were able to get the word out… (to be continued)

Blogus interruptus

It’s 5 AM, and I am back on the internet because I was not able to post the long blog I typed late last evening. Interrupted internet connection and power outages prevent posting so it must be re-typed. We have tried copying and pasting from a saved Word document into a blank blog but it doesn’t work, requiring extra time to re-type everything again. A waste of my time. Do any of you know how this step (Word doc to the Blog) can be accomplished? I have sent this question to Peter Keto, Erik Weikert and Nam Subramamian but we will appreciate any feedback.

Continuation:

... The second school we visited was attached to the Police Academy. I was surprised when Chello drove through the guarded gates (complete with young soldiers with rifles) until I saw even younger high school students in semi-military uniforms with insignias. We met Colonel Francisco who graciously gave his permission for us to speak to Senora Mary's class of thirteen year olds with translation help from teacher Mr. Sanchez.

I told the story of Karen, an HIV-positive girl I once knew who died from AIDS. I refer to it as the Romeo and Juliet tale of HIV. There were a few tears at the end. I find stories of real people have the greatest impact on impressionable teens rather than boring medical or moralistic lectures. I always make sure there is some humor in the storytelling as well as pathos. I use inflection to the max at just the right moment with accompanying facial expressions to keep interest high -- and always, I repeat always, I look every student in the eye as I scan the audience. There is nothing more that I hate than a speaker who can only maintain sole focus on a few people during a speech... trés boring.

I also spent time talking to press for stories in Massachusetts where TeenAIDS formerly had its national headquarters using the local angle. And then to Virginia media now that we are located there and Samantha and Maryna reside there for the present. Maryna is helping contact D.R. TV stations with our PR and sending out previous television news to show them the value of reporting on our unique "AIDS Attacks." I emphasize that the action visuals of street outreach with teens -- on a controversial medical message with the goal of saving lives -- is good for increasing viewership. TV stations always say they get an uptick in public comment when doing a TeenAIDS story.

My next priority, to spread the word to hundreds of thousands more, is to convince at least one TV station to send a crew with us when we return to Guachupita. As noted previously, this sprawling urban neighborhood has the worst reputation among Dominicans who fear to tread there. Like all stereotypes, the rep is unfortunate because while Guachupita is obviously extremely impoverished by any measure and has a high crime rate, the youth we met were wonderful, friendly and willing to help our mission -- because they clearly understood it was helping themselves. I am going to challenge the three major TV stations to cover our AIDS attacks on the streets of Guachupita by using the compelling argument that they can help publicize worthy humanitarian work in a slum where grossly underprivileged youth are volunteering their time to a local project!

We will now have news coverage in three leading D.R. dailies: Listin Diario, El Dia and El Nacional.

We heard from our Virginia-based staff and friends. Sandra Brown and baby son Hudson were at the office running off mailing labels and getting ready for a major postcard mailing. She is our resident PR guru. Our dear friend, Barby Lumb has been holding down the fort visiting every day: morning, afternoon and evening, to take care of Jazz and helping the TeenAIDS mission in innumerable ways. Dyvontae Pierce, in charge of our online Teen Advice Column has been coming over to work on projects and play with Jazz before heading to Granby High (Barby drives him).

I will keep you informed. But until then, how about digging into your pockets and making a tax-deductible donation via PayPal on our website (VISA, MC or AMEX) or by check: P.O. Box 7114, Norfolk, VA 23503. You can help us save young lives from premature death -- from the comfort of your living room with a cool drink in hand and remote at your fingertips.

Adios. More stories from Boca Chica. Perhaps an interview with a teen prostitute(s) and their perceptions of the risk of HIV.

Guachupita

What a really fulfilling day. We visited some wonderful young people of Guachupita, a poor barrio that receives bad publicity in the Dominican press. However, we found the 30 young people we worked with to be intelligent, friendly and interested in the AIDS message (whenever I told people that we were going into Guachupita their faces were aghast). Their visceral reactions put a scare in Maryna but I told her I had visited the barrio in both 1992 and 1993 as part of my doctoral research and never had problems and was always warmly welcomed.  Perhaps earlier today we all had a modicum of trepidation, but deep down I knew there was nothing to fear.

We were warmly greeted by Lino Arturo Castro, the director of the youth center, "La Red Jovenes Unidos de Guachupita," that has been in existence for 7 years. Now folks, this group deserves financial support from our TeenAIDS' friends. They try to do an awful lot with few resources; a story that I well understand from my 17 years at the helm of TeenAIDS. Starting around 4:15 on a warm Thursday afternoon the young people began to arrive in pairs.  I greeted them at the main door of the center that opens onto massive outdoor basketball court. Sam gave them our Spanish business cards.  Maryna was temporarily absent because she went with Chelo our driver to buy minutes for our two in-country cell phones. An hour earlier, it was embarrassing when one cell phone died during a difficult conversation with somebody that I had a disagreement with.  I am sure that they thought that I just hung up on them. The confusion was later straightened out with the new phone minutes.

Most of the young people were between the ages of 15 and 19 with some younger and a few as old as 24. The young women sat together on one side of the room painted in a pale yellow and the young men sat together in the other 2/3 of the seats. With the help of Carlos a young neighborhood translator, I began my spiel in my broken Spanglish but soon left the translation to Carlos. I went through some of the transmission roots and explained what was safe and what was high risk. I also told them that if they do not have sex they will not get HIV/AIDS through its sexual route. Yet if they engage in unprotected sexual intercourse the danger will be higher. They all knew about condoms (condones). I said that I had a few questions that I wanted them to answer with their permission. I asked the boys "at what age do you think that most Dominican males begin sex;" one said 12 but most boys said 13-15.  From the girls' side of the room a few were quite vocal and retorted, " No, 18." So I asked the girls the same questions and the group seemed to defer to one young woman, who also said 18 while a few boys were yelling "no 12, 13."

I explained that sex is a personal choice. I recommended that they wait or postpone first sex as long as they could and used the analogy of Russian roulette forming my hand into a gun and doing the action of spinning the barrel and pointed to my head pulled the trigger. Nothing happened because the chamber was empty. The second time, the same result, but the third time -- I made the noise "bang" and said that that is how HIV occurs.

I have found that boys and girls are concerned about getting AIDS because they believe that it will hurt an awful lot when they die.  So I put it into a different perspective. I query, "How are you going to feel when you go to the hospital and the doctor says congratulations, you have a baby girl/boy -- but unfortunately it was born with AIDS?  Then I looked all of them in the eyes and said, "You don't want to be responsible for that heavy burden."

I told the story of the orphanage in South Africa that was once a large school gymnasium. The room was filled with row upon row of baby cribs, each with 3 or 4 infants, all of whom were diagnosed HIV positive and many of whom were dying. There were only a few wet nurses who could barely keep up with feeding them once a day due to the sheer number.  Imagine how these young babies were deprived of even simple human touch - because of something their parents gave them.  It was an overwhelming memory for me and the young people were silent contemplating the tragic scenario.  I remember one emaciated baby girl's face peering out, little hands holding on to the bars of the crib. I went over to this young child of perhaps a year old and she reached out to grab my finger and tugged on it. I patted her head and as I exited the large space I glanced back and saw the baby standing and staring at me. And then it struck me.  The infant looked like a prisoner behing bars, for in fact, she was.

I then introduced the idea of doing AIDS theater, "Theatro de SIDA." We will talk about this in another blog.

Dr. John 

Day 3 - Wednesday

Another busy day! We were interviewed for a story by "El Dia," one of the leading newspapers in the Capital. The director of the paper, Rafael Molina met with us and assigned one of his "top" reporters Senabri Sylvestre to write the story (publishing in a few days).

We did outreach at Universidad Autonoma de Santo Domingo (UASD), the oldest university here. We first talked with hundreds of students on the steps and lawns of its modern Library. Many expressed surprise that we wanted to talk with them about AIDS. Because I do not want to appear that I am talking down to them about a subject that they might not know much about, I always start off by saying (in my broken but passable Spanish), "I know you know everything about AIDS. I know you are very intelligent - but I am worried about your younger brothers and sisters, teen cousins and young friends. They do not understand the consequences of VIH/SIDA (HIV/AIDS). I believe you must talk to them before a life-threatening mistake is made. Here is my business card with important information on the back."

While I am talking, I see them begin to nod their heads and murmur "Si." They often ask questions - especially about the current risks. I tell them the latest UNAIDS statistics (50% of all new cases of HIV in the world occur among 12-24 year olds). They are usually shocked! At the same time, Samantha is passing out our business cards printed in Spanish (she is also a very convincing speaker and gets them engaged). Maryna talks too but she is often busy videotaping these AIDS Attacks for YouTube and taking stills for Facebook, our website and postcards to donors and supporters. They are amazed that we are all volunteers and do not get paid to do this work. Today, we invited three students to think about volunteering with us in the next few days. I'll keep you informed on who joins us.

I also ask what they are studying because I want to use that personal information in my wrap up to our discussion. They all like talking about themselves and their future dreams as successful adults (too many older people carry on one-way conversations, talk down to young people and rarely ASK for their opinions). Before I walk on to the next group, I look each one in the eye as I shake their hands a final time and say, "You are a good person. You can help us save the life of someone you love from SIDA. Please talk to your young friends. You will have a great career in (Civil Engineering, Medicine, Business, Law, Languages, Accounting, etc.) - but if you get AIDS, it will seriously complicate your future plans. Buena Suerte en su Vida!"

By this point, they are all smiling and saying thank you and giving us the Obama bump (tight fists, nudging knuckles to knuckles for those of you over 40). But you don't have to take my word for it; you can see the video and judge the reactions for yourself. This kind of interactive street outreach is my professional expertise that I have personally tested on six continents and in 84 countries to date. No similar program exists in the HIV education field.  I train AIDS workers how to replicate the method in their own communities... but it takes some chutzpah. I want to empower as many youth as I can to spread this important message exponentially before it is too late for a vulnerable generation of maturing adolescents.

I use plenty of humor during my AIDS Attacks to break the ice. I love to laugh and see others laugh too. I always look directly into their eyes so they know I am talking to each of them individually and I put extra effort into any encounter where a young person seems disinterested, aloof or determined not to acknowledge a stranger's appeal. To me, it is a worthy challenge.  Rarely, if ever, do I leave without getting them involved and be part of the conversation. In fact, some of my best volunteers have come from these experiences!

One of my former TeenAIDS Board members and our ex-President Bink Garrison, explained to me the marketing strategy of "starting conversations" for s an all-important  concept in selling. That's what AIDS Attacks are designed to do. TeenAIDS is in the business of starting meaningful conversations about this avoidable danger. With no vaccine for HIV and no cure for AIDS, only proven and effective prevention education works. Whenever young people hear the message and tell a friend, the all important HIV prevention news gets published by word of mouth, Facebook, YouTube or via any and all social media.

AIDS Attacks

For those of you not familiar with my "AIDS Attacks" ( TeenAIDS signature brand of street outreach), let me explain. I initially developed the technique while at Harvard. I knew it was important to grab teen's attention with the HIV prevention message on their turf. Classroom lectures by gum and health teachers were for the most part deadly bores. A key marketing strategy is to "start conversations or buzz" about a product of service - and that is what AIDS Attacks are designed to do.

As I walk down the street and I spot teens young college-age students, even working youth, I zero in on them. I go up to them, smile and say, "Excuse me, but I am Dr. John and I have important information that can save your vest friend's life." We shake hands, I ask their names and give them on of my business cards printed in their languages. Then I launch into my simple message: "AIDS is a huge risk for all teens because you can't see it. But it is there and can be transmitted sexually among other ways." Most teens are very fascinated that an older guy with white hair and a loud Hawaiian shirt is taking tine to come and talk to them.

Ironically, I first put these in practice in late 1992 when I first visited the Dominican Republic (as part of my doctoral research). It worked well on the streets because it was immediate and gives a sense of urgency. Using my rudimentary street Spanish I have always been able to get the basic message across that is supplemented by the information on the back of my business cards. 18 years ago when I first worked in the Dominican Republic I visited the very tough neighborhoods of Guachupita. I had meet teen street boys who brought me there and introduced me to their gang leader. Because there was not much education available to the poor (and most youth were not attending school) the leader thought that the information was important enough for hin to be my guide. I was a bit uneasy that he had a gun, but he just laugh and said "no problema", since then this technique has been effective on every continent and in 84 countries.

On Thursday May 19, we will once again be visiting Guachupita under the hospices of Lino Artro Castro head of La Red de Jovenes Unidos de Guachupita

Dr. John

Day 2

The roosters started crowing at about 5:45. Awakened from a deep sleep, I listened for the next 90 minutes as the city came awake. The shouts of the street vendors wafted up to the 4th floor of the apartment building where we are staying. At one point I heard a mother yell, " An-ge-lo!" If you are of my generation. you may remember the 1950's Prince Spaghetti commercials on TV, where the North End mother would yell "Anthony!"

We spent the morning checking and rescheduling our itinerary in the Dominican Republic and Haiti and it is exciting. We are spending the next few days in and around Santo Domingo before heading southwest to Barahona and Los Patos. Then we will go north and cross the Haitian border at Malpass. Both countries are experiencing a growing cholera epidemic so we are cognizant of drinking only bottled water and washing hands frequently.  Sam's French will come in handy then.

This afternoon I yelled to our taxi driver to pull over when I saw hundreds of kids getting out of school. Our first AIDS Attack in the Dominican Republic! The students were obviously surprised by our presence and were genuinely interested in the message. They heard that it was up to them to take the message to their friends and peers. Afterwards we hit the "Conde," a long street closed to traffic where we also did AIDS Attack in this part of the colonial old town. Tomorrow we are going to be doing some universities, more schools and the "Malecon," the boulevard along the ocean. Check out our pictures that Maryna took.

Hola Santo Domingo

Greeting from the road!

Our plane touched down in Santo Domingo at 1:30pm. Mariano, a friend of Harold's came and picked us up and bought us to Harold and Georgina's condo. I was last here in 1992 and 1993- boy has it changed - very modern. Georgina didn't speak very much English at the beginning, but when she understood that our Spanish is limited she has started to speak more English. Georgina is a medical student a the local university.

Harold came home at about 6  and we had a long talk at the house. We got some great pointers and then we went out for an excellent meal out on the water. I had a wonderful fish soup that was as thick as a step and one of my favorites - grilled Calamari. The recommended mashed plantains and shrimp was a big hit with Sam and Maryna tried the fajitas. Over all a wonderful meal though we wou't always eat this well.

Dinner was followed by more logistics for our itinerary over the next couple of days. Tonight we had a few AIDS encounters and people seemed very receptive and appreciative. However tomorrow will be our first real AIDS Attacks at a couple of the local high schools and parks.

Harold and Georgina

Maryna, Dr. John and Samantha