Speeches & Op-Eds
Combating Stigma and Discrimination: A Regional Overview
2007 Chief of Mission's Conference on HIV/AIDS
Introductory Remarks by U.S. Chargé d'Affaires, a.i. D. Brent Hardt
Kingston, Jamaica
October 4, 2007
Good afternoon and welcome to our final public session of what has been a thought-provoking and edifying conference. I would like to add my heartfelt thanks and appreciation to Ambassador Brenda Johnson and her staff at Embassy Kingston, especially Leigh Shamblin of USAID, for their flawless organization of this conference.
This morning we addressed the challenges of the sustainability of the HIV/AIDS response in the Caribbean including how to improve access to health care and secure funding from public and private sources. While our ability to fund HIV/AIDS treatment and prevention programs and to target that funding with precision is critical to the success of our efforts, all the funding in the world will be of limited value if we fail to address the equally vexing challenges of stigma and discrimination against Persons Living with AIDS.
The sad fact is that stigma and discrimination can affect peoples’ lives on a daily basis in ways that are psychologically as difficult to manage as the physical challenges of the disease itself. While many diseases can invade our bodies, HIV/AIDS is unique in the debilitating impact it can have on how a person is viewed by their employers, colleagues, family and friends. You don’t lose your job when people hear you have cancer. Your neighbors don’t gossip and stop inviting you to their home when you have diabetes. Your loved ones aren’t afraid to touch you when you have heart disease. But all of these things happen to people living with HIV/AIDS on a daily basis in our countries.
Critically, for the success of our efforts to prevent and treat HIV/AIDS, this fear of stigma and discrimination stops people from being tested, from seeking treatment, receiving counseling and taking personal precautions that could stop the spread of the disease. It holds government leaders back not only from dedicating money, but also from standing side by side with people who have HIV/AIDS to express their solidarity with them. It is, in short, a critical piece of the HIV/AIDS puzzle, and our Embassies can play a key role in working with governments, NGOs, the media and people in Caribbean countries to overcome.
Itrequires no more than a passing glance across the region to find startling cases of HIV/AIDS-related discrimination.
In Suriname, a family member was released from the hospital only to die two weeks later because his bed had been moved to a corner of the hospital yard and no one would assist him.
In the Bahamas, an-HIV positive child who lost her parents was forced to live in the hospital ward for 10 years because no family or orphanage would take her in.
In Trinidad and Tobago, primary school children with HIV/AIDS have been denied the right to attend school.
A nurse in the Dominican Republic was tested for HIV and, once the laboratory staff saw the results, the news spread through the hospital like wildfire. Her life was turned into a, “living hell” and in short order she was chased from her job.
The Minister of Health in Trinidad states that he can’t find doctors interested in treating people with HIV/AIDS.
Again, in Suriname an HIV-positive man was kicked out of his house and is no longer allowed to see his children. He is now trying to fight for his rights through the court system.
These are real stories of real people throughout the Caribbean region and they are reflected in broader practices of discrimination that affect thousands. For example, it is a common practice for employers in many countries to use screening methods to select out those who have HIV. Employment discrimination is particularly damaging because it takes away the very resources people need most to take care of themselves and to support their families. Even doctors, government leaders, and health care workers have been guilty of discrimination. Some doctors in the region are hesitant to treat people living with HIV/AIDS, believing that limited public resources should be "saved." As a result, people living with HIV/AIDS are often the last priority for surgeries. In some countries, pathologists are unwilling to perform autopsies of people who were known to have AIDS. Issues of stigma and discrimination are often compounded because doctors and nurses do not respect confidentiality. This can have a devastating effect on people’s lives, particularly in the small close-knit communities of the Caribbean.
At the root of all these stories is the continued prevalence of stigma and discrimination against victims of HIV/AIDS. Stigma is defined as the classification of an individual who acquires an attribute that is not accepted by society. Discrimination, which is the direct result of stigma, is the action or lack of action committed towards a person who has the perceived unacceptable attributes. Stigma is often likened to being a disease, while discrimination is the external manifestation or symptom of this malady.
Reducing stigma and discrimination is vital not only for people living with HIV/AIDS but for the health and well-being of the society as a whole. That's because we are all affected when members of our society are unable to contribute, or when disease is spread because people don't know their status or seek treatment.
Still today, people cite their fear of what will happen to them if they test positive as a leading reason for not being tested Often this fear is not so much fear of the disease itself, but fear of being ostracized by their family, friends and coworkers. And it is this fear we must seek to overcome. Only by working with governments in the region to develop and implement effective policies against stigma and discrimination can we turn the tide against these irrational fears.
And when we do that, the face of HIV/AIDS in the region will no longer be that of victims and outcasts, but of survival, strength, and perseverance. Indeed, it can become the face of everyone battling and living with a serious disease.
As one domestic worker in the Dominican Republic observed: "The truth is that since I found out I have HIV, I live better than before, because the support groups I am working with have taught me how to value myself, to have self-esteem, and they respect me in the group like no one did before. I have met a lot of wonderful people and I have been able to help other people so that what I went through at the beginning doesn't happen to others." In the face of the persistent negativity and misunderstanding that exists in much of the region, it is words of hope such as these that help us to see the changes in people’s lives that can come about through successful strategies for combating stigma and discrimination.
Our diverse and talented panel today will offer distinctive an also very personal perspectives on the battle against stigma and discrimination in the region.
Mrs. Rosemarie Stone, the author of the widely acclaimed “No Stone Unturned,” will share with us her experience, first as a caregiver to her husband, and then in dealing with her own HIV-positive status. I started reading her story last night and it was riveting. Mrs. Stone is currently a volunteer with Jamaica AIDS Support and spearheads numerous outreach and charitable activities.
Mr. Ainsley Reid, a program officer from the Caribbean Conference of Churches, is also the founder of the Jamaica Society of Seropositives. He has traveled throughout the Caribbean to advance HIV/AIDS initiatives with faith-based organizations. He is also one of two courageous pathbreakers who are speaking openly about their HIV-positive status in the Jamaica National Anti-Stigma Campaign, entitled Positive, Truly Positive and Getting on with Life.
Dr. Kwame Boafo has had a distinguished career with UNESCO dating back to 1993 and is an expert on communication and education. He is currently serving as the Director of the UNESCO Cluster Office for the Caribbean. Dr. Boafo will tackle the subject that is central to any successful effort to combat stigma -- education.
Then, before we break into our small group sessions, I will have an opportunity to share with you some of the policies and partnerships that have made a difference in the Bahamas in combating stigma and discrimination.
As we listen to our presenters tell their stories and share their experiences, I encourage you to think about the issues that are most pertinent in your country and what your country teams can do to combat stigma and discrimination.
There are no easy solutions and the creation of new attitudes will require a tremendous amount of political will and carefully targeted resources. While a cure for AIDS will be found in a laboratory somewhere, someday, reducing stigma and discrimination and allowing people to live normal, dignified lives is something that is within our grasp today. So let's get the ideas flowing!
Thank you.