For Lucky Few, 'Recycled' HIV Drugs Keep Hope Alive

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By E. J. Mundell

NEW YORK (Reuters Health) - Like many Americans living with HIV (news - web sites), New York writer and activist Mike Barr takes regularly scheduled, physician-sanctioned drug 'holidays,' giving his body a temporary break from the side effects of powerful anti-retroviral medications.

What's uncommon about Barr is how he disposes of drugs he has no use for during these treatment interruptions. Partnering with a Manhattan-based nonprofit agency called Aid For AIDS (news - web sites) (aidforaids.org), Barr and hundreds of like-minded patients across the US and Canada sort, ship and distribute these life-saving, 'recycled' drugs to HIV-positive individuals in the developing world.

"If I can take half as much therapy, and give the other half of that therapy to someone in South America or Haiti, then for the same amount of money two lives are being saved instead of one," he explained.

For hundreds of patients spread across Africa, the Caribbean and Central and South America, Aid For AIDS remains a vital lifeline, providing them with a reliable supply of medicines that would otherwise be financially out of reach.

And since many of those enrolled in the program are AIDS educators and activists in their local communities, their continued survival has a ripple effect, helping prevent the spread of HIV/AIDS in these countries.

"We don't pretend to solve the problem, but we're making it a little better for those who are making a real difference," explained Venezuelan-born Jesus Aguais, who started Aid For AIDS in 1996 with just three patients. That number is now 520 -- and growing.

With no advertising, the simple idea behind Aid for AIDS spread quickly via word of mouth through the HIV patient community in the United States and Canada, resulting in a steady supply of donated drugs.

"People for whatever reason -- they die, they change their regimen, they never took the medicine -- they give it to us," Aguais explained in an interview with Reuters Health.

After removing the donor's name from the label on the bottle, donated medicines are carefully inventoried and sorted as per the requirements of individual patients -- or "clients" as Aguais calls them -- in the developing world.

Every foreign patient who applies for assistance from Aid For AIDS must first undergo a careful medical assessment, because the program's small store of medicines is best spent on those who closely adhere to the strict treatment schedules HIV drug therapy requires.

Working via fax and email with doctors in the client's home country, Program Director Dr. Jaime Valencia reviews application forms that outline prospective clients' proof of HIV status, current medical history, and CD4 immune-cell blood counts.

Priority is given to AIDS activists and educators, "people who are making a difference in their countries," Aguais stressed. In this way, donated medicines do more than just keep individual patients alive -- they also help prevent new infections, as individuals helped by the agency spread the word about the dangers of HIV.

Once accepted into the program, clients must submit CD4 counts every six months so that Valencia can chart their progress and adherence to the medications. As often happens, specific medications can decline in effectiveness over time, but Valencia said the agency's drug inventory is usually flexible enough to accommodate changes in drug regimens.

"I have to talk with the client's doctor, telling him which medications we have available, and he chooses the (new) treatment for the patient," he explained.

Working out of a few small rooms in lower Manhattan, Aid For AIDS remains unique.

"There are other recycling programs," Aguais said, "but none of them work like we do. We have complete control over where these medicines go." Because there are currently no U.S. laws allowing or prohibiting the export of donated medicines, Aguais said it is important from a legal standpoint "to know who the patients are." He said abuse of the program (such as reselling donated medicines) is almost nonexistent, due to close bonds that have formed over time between the New York office and trusted doctors in the Americas and Africa.

Aid For AIDS also accepts non-HIV-related drugs and devices for distribution in the developing world. Walking into a room stacked floor-to-ceiling with donated medications, Aguais pointed to one pile in a corner.

"Here we are preparing 13 boxes so far of medical supplies," he said. "This is going to an indigenous area between Venezuela and Columbia called Guajara, the Guajara tribe. We send it to a hospital that we know is going to distribute it."

Lynn Shulman, director of communications with the pioneering AIDS outreach group Gay Men's Health Crisis, said initiatives like Aid for AIDS are desperately needed, "because it enables people with HIV/AIDS to have greater access to medications they need."

But money remains a problem. Although the medicines are donated, they still require storage, sorting and shipping.

"We always struggle for money," Aguais said. "Last year with a budget of $240,000 we sent over $5 million of HIV medicines abroad."

"We have proved, though, that things can be done -- and done well -- when you want to do it," he added. "I hope I can raise a million dollars this year. And instead of helping 500 people, help 5,000. If we help 5,000 of the right people, this will multiply into 20,000. This is how it happens."

Sessions aim to draw students of any age to St. Leo
DEBORAH BACON dbacon@heranndotoday.com.
Published: Apr 14, 2003

By ANDRES CALA, Associated Press Writer

SANTO DOMINGO, Dominican Republic - Its mast blown off and captain dead, a boat loaded with more than 100 Haitian migrants struck a reef and capsized after drifting for a week. Four passengers drowned and at least 18 were missing.

The boat, which set off from Haiti's northern Cap-Haitien city on April 8, tipped over late Monday about 200 yards off Punta Rusia in the northwest Dominican Republic, the Dominican navy said.

A fisherman who saw the 30-foot sloop hit the reef picked up dozens of people and ferried them to shore, U.S. Coast Guard  spokesman Ryan Doss said by telephone from Miami.

A Dominican coast guard boat patrolling the area arrived early Tuesday and rescued many others, a Dominican navy statement said.

Officials said some of those reported missing may actually have made it to shore and hid from authorities.

The four victims were brought to a hospital in Villa Vasquez, about 125 miles northwest of Santo Domingo, administrator Luis Brea said. They appeared to have drowned, he said.

A survivor being treated for dehydration at a hospital said the boat's mast blew off on the second day, striking and killing the captain and another man. On the third day, they ran out of food, he said.

"We were lost, and the wind took us until we hit something, and we started sinking," Henri-Claude Beausejour, 26, said by phone. He said he paid $220 for the voyage.

Beausejour said they were hoping to reach the Turks and Caicos Islands, a wealthier British territory north of Haiti.

The fisherman told U.S. authorities he saw at least 15 migrants make it to shore and run into the mangroves, Doss said.

He said the U.S. Coast Guard sent a C-130 plane, two cutter ships and a helicopter to the rescue.

A Coast Guard ship and helicopter remained searching for survivors Tuesday afternoon, along with two Dominican coast guard ships, he said.

Thousands of Haitian migrants risk their lives to escape their impoverished and politically embroiled country by crowding into homemade boats and heading north. Many die at sea.

"The economic situation is deteriorating and driving people to risk their lives at sea," said Lovinsky Pierre-Antoine, director of Haiti's national migration office. "We warn them not to go, but their desperation is greater than their fear."

The flow of Haitians sneaking into the Bahamas and the nearby Turks and Caicos Island is intensifying, prompting concern from both governments and bringing some calls for mass deportations.

About 400 Haitians arrive monthly in Turks and Caicos, where the police force is getting more vehicles, equipment and staff to seek out illegal migrants.

There are about 8.3 million people in Haiti, while an estimated 8 million live abroad — including 1 million in the United States, 600,000 in the Dominican Republic, 200,000 in Canada, 20,000 in Turks and Caicos and up to 40,000 in the Bahamas, according to the Ministry of Haitians Living Overseas.

By DAVID B. CARUSO, Associated Press Writer

PHILADELPHIA - Mor Sene said separatist rebels tore off his toenails and stabbed him in the chest when he lived in Senegal, while government soldiers accused him of conspiring with the enemy.

But when Sene fled to the United States and applied for protection under the Convention Against Torture, an immigration judge ruled he should be sent home.

His experience in U.S. immigration court is a common one.

Last year, immigration judges rejected a record 16,744 claims by foreigners who said they would be tortured if forced to return to their home countries, according to the Executive Office for Immigration Review, part of the Justice Department ( face=Arial color=#0000ff news - face=Arial color=#0000ff web sites).

The judges allowed 558 people to stay under new immigration rules adopted by the United States under the convention in 1999. In 2001, immigration judges granted 544 requests and denied 11,929.

The international treaty has been ratified by more than 120 nations that have pledged to punish torturers and protect victims.

Immigration lawyers say the U.S. numbers show that the convention, designed as a last-resort for refugees who don't qualify for political asylum, provides relief to only a fraction of the people it was intended to help.

"I have no doubt that people are being sent into danger," said Morton Sklar, director of the World Organization Against Torture USA.

Judges have many reasons for turning cases down, said Kathleen Sullivan of the Catholic Legal Immigration Network, including a U.S. law requiring non-citizens to show they are "more likely than not" to be tortured if removed from the United States.

They also need to show evidence of government involvement in their persecution, a ruling Sullivan said prevents women fleeing domestic violence from qualifying as torture victims.

In Sene's case, the 3rd U.S. Circuit Court of Appeals ( face=Arial color=#0000ff news - face=Arial color=#0000ff web sites) questioned his credibility and noted he had been tortured by rebels, not the government. The court said he might avoid trouble by moving to a part of the country less affected by war. The decision wasn't final and the case is pending.

Backers of the law said courts treat many immigrants' claims with skepticism for a reason.

In another 3rd Circuit case, a man claimed he would be tortured if deported to Haiti because he had been a member of the island's dreaded secret police, the Tontons Macoutes. To bolster his claim, he offered photographs of himself walking with Francois "Papa Doc" Duvalier, a dictator who tortured and killed thousands.

Unsympathetic judges ruled that Marc Pierre Joseph Miguel, who had been convicted of trafficking cocaine, should be sent home.

The Federation for American Immigration Reform, a group that lobbies for stricter controls on immigration, said the system set up to screen dubious claims works well.

"We also have seen nothing that indicates that any people who have been removed from the country as a result of an unsuccessful torture claim have in fact been subjected to torture when they were sent back," spokesman Jack Martin said.

___

On the Net:

Executive Office for Immigration Review: face=Arial color=#0000ff http://www.usdoj.gov/eoir

Federation for American Immigration Reform: face=Arial color=#0000ff http://www.fairus.org

World Organization Against Torture USA: face=Arial color=#0000ff http://www.woatusa.org/uscomp.html

April 19. 2003 11:27AM
Cruise ships drop anchor in paradise off private beach _ and no mention it's impoverished Haiti

By PAISLEY DODDS
Associated Press Writer

LABADIE, Haiti

he turquoise bay ringed by ruins of a 19th century plantation and crimson-flowered flamboyant trees is everything the tourist brochures promise - tranquil waters, pristine beaches, good food, exotic local culture.

But few tourists realize they've taken a cruise to Haiti, the Western Hemisphere's poorest nation.

"Can you see Haiti from here?" asks Linda Tracy, 59, of Camden, Maine, disembarking from the cruise ship Explorer of the Seas with 3,400 other passengers who scurry toward banana boats, Jet Skis and art stalls.

Since 1986, the Royal Caribbean line has provided the largest source of tourism revenue to Haiti, sometimes bringing more than 7,000 tourists a week. Each passenger pays a $6 tax to the government, which comes to more than $2 million a year, and more than 200 or so Haitians are paid to attend to them as bartenders, musicians and cabana boys.

The jobs are a blessing in a country where political instability has stunted growth, leaving two-thirds of workers without jobs. But some people say more knowledge of Haiti and its problems might bring more help.

"In America, we've taken opportunities for granted," says tourist Ron Winslow, a customer service representative from Akron, Ohio. "Here, people would love to have opportunities but we hardly hear anything about their country."

Winslow said he had to research his travel itinerary to realize he was going to Haiti.

Some passengers were told only that they were headed to Hispaniola, the island shared by Haiti and the Dominican Republic. Most said they were told they were going to a private beach off the coast of Haiti.

Royal Caribbean's Web site refers to the bay as "Labadee, Hispaniola." Another section calls the beach, on Haiti's north coast, a "private island."

"This is merely an effort to be inclusive and refer to the entire island of Hispaniola, which is geographically correct," said Michael Sheehan, a company spokesman.

He described the cruise as a win-win situation: "Our guests get to experience the unique nature of the given destination - and the destinations experience a positive economic impact."

The company leases Labadie Beach from Societee Labadie Nord SA, which puts on the entertainment. It also provides rifle-toting guards on days there are no cruise ships, usually Wednesday through Sunday, when they allow in Haitian tourists who can afford it.

"On cruise ship days this place is very different," says Jean-Arrol Santel, 32, a beach supervisor who earns about 2,000 Haitian dollars ($400) a month. "Hopefully even more people will come and there will be more jobs. It's important for Haiti."

Maryse Penette-Kedar, president of Societee Labadie, which is known by the acronym Solano, said more jobs could be created if the brisk business continues. She also said that if conditions improve, tourists might start going farther afield, such as to the Citadelle fortress or Sans Souci castle.

"I think it's improved the country's image abroad and helped Haitians," she said. "Solano is the No. 1 employer in the north, with more than $1 million of payroll a year."

On Mondays and Tuesdays, cruise ships sail into the harbor and small boats ferry thousands of people across the idyllic bay. They flock to hear Haitian musicians, slurp pina coladas and snack on hot dogs and hamburgers brought from the ship. Some jump on inflatable jungle gyms in the water, then run back to the beach to collapse on lounge chairs.

The excursions last about seven hours. Then they're off to their next Caribbean stop.

Musician Felix Valcourt, 75, wishes the tourists would do more.

"If each one of them dropped a quarter in a bin during their visits, it would help build a high school or a clinic," says Valcourt, dressed in a tropical shirt stiff from pressing. In two weeks he and his band of four earn 1,000 Haitian dollars ($200).

He complains the tourists rarely tip and says none has ever ventured across the bay to Labadie Village or shown much interest in Haiti.

"No one ever asks us any questions about our lives, and the ships keep coming without bringing us any kind of real rewards," he says.

For those locked outside the gates of Labadie, the rewards are even slimmer.

Many craft vendors stand outside, hoping the stall operators will buy their cha-cha rattles and paintings that sell at a 30 percent profit inside. Other people rummage through garbage in search of leftover food.

Still, Tracy, the visitor from Maine, said the stopover had made her think about the broader Haitian culture.

"This has been a humbling and educational experience," she said. "Voodoo, witchcraft and poverty - that's all I knew."

In reference to the article above... I think It woud be a great idea to send the travel company... a few thoughts about how they half truth the location.. Hispanola... as excluding Haiti specifically.

"This is merely an effort to be inclusive and refer to the entire island of Hispaniola, which is geographically correct," said Michael Sheehan, a company spokesman.
 

Geographically correct or not.. they are on Beautiful Haiti...

http://www.royalcaribbean.com/asp/default.asp Royal Caribbean

Anyone know the Travel/Tourisim Minister?