Those were the days, my friend...

           As part of my duties as an Embajadora, I had to moderate a discussion panel titled “Diagnosis and Treatment of HIV in Prisons: Obstacles and Opportunities,” which took place at the Global Village at the XIX International AIDS Conference. The panel included videos of two organizations that work in the prison system: Programa de VIH/SIDA in Ciudad de México, and Comité Contra el SIDA (CoCoSi), from El Salvador.

            At the beginning, I was a bit reluctant to do this, as discussion moderation is not one of my strongest skills, but I accepted the challenge anyway.  And after getting to know the presenters I was definitively convinced that this was a perfect opportunity for me. Nathalie Gras Allain, from the Programa de VIH/SIDA, and Elizabeth Membreño, from CoCoSi, still display that excitement, that motivation that you have when you are close to the people you are assisting.  Unfortunately, this is something that many of us lost after several years in the field, when proposals, finances and the agency’s survival take over and take you away from the most intimate aspect of the organization which, in my view, is precisely the contact with those we support. Nathalie and Elizabeth still have it; they have not lost it.  You can hear it in their words, in the tone of their voices, in the pride that was reflected on their faces as they watched the videos from their respective organizations.

Both videos were very moving, presenting the reality faced by people with HIV/AIDS in the prison system in these two countries. Homelessness, physical and emotional abuse, prostitution, hunger, drug abuse, lack of family support: these were common threads that the participants faced before they were incarcerated. It makes you wonder how the lives of these brothers and sisters would have turned out to be had they not faced such harsh situations.  And then, once inside the prison system, the new set of challenges they had to deal with, such as discrimination based on their HIV status or their sexuality, lack of representation, and lack of access to basic services. 

But there is also another side to their stories.  You also get to know about the love and support they have found inside the system and from each other.  Time and again we saw the participants express how these two things have made them face their reality. They strive to be informed about issues related to HIV and their wellbeing and this must have an impact on their lives. Like treatment adherence, for example; many of the people featured in the video claimed to be fully adherent to their treatment, which could account for their good health despite the conditions in which they live and despite the lack of access to other services, overcrowding, poor nutrition, etc.  One of the doctors featured on the video mentioned that many times the inmates are more knowledgeable about HIV than other health professionals.  And one of the inmates made a statement that can account for this; he said “estamos en el caballo y hay que jinetearlo” – which can be translated into we are mounted on the horse and we must tame it.  Perfect analogy for their situation.

This experience made me reflect on how things have changed in the last 30 years of this epidemic, or at least in the last 20 years in which I have been involved in the struggle against HIV/AIDS.  Before cocktails, before all the medical advances, before the behavioral interventions, there were some basic things that kept people going.  There was love; people loved each other and helped each other out of love, out of a common struggle against something that seemed insurmountable. There was support; people helped each other, volunteers going to delivered hot meals to those in need.  People came together regularly to talk about the challenges, to solve problems, to look for options.  We did what had to be done, what it was necessary, not what was prescribed as the optimal solution. 

We have lost some of that.  And while I am grateful for all the advances and the millions of lives they have saved, I long for those days.  Obviously, not for all the death and despair of back then, but for the common bond that existed and that seems somewhat lost now.  The urge to educate ourselves, to know more, to see what else could be done to improve the chances of staying alive, including taking medications religiously.  Some of that seems to have also been lost in the process. So sometimes is good to view a different reality than our own. Sometimes it is good to see where others are at in order to put into perspective what we have.  And for us, service providers, it is also good to come down from our dark offices full of papers and deadlines, and come back in contact with those we are trying to help.

That is precisely what the videos by these two organizations did to me: it made me come to terms with the reality faced by some organizations today, including my own.  And it has renewed my commitment to face the obstacles just like we did years ago, and take advantages of the opportunities that we have to regain some of what has been lost. 

My acknowledgements and respect for these two organizations and the work they do, and to Nathalie and Elizabeth for the well-placed pride they have on their organizations. You are doing a wonderful job!