UW News

July 7, 2005

Harborview and Haiti

Haiti is a metaphor for disaster,” says Dr. Marie-Florence Shadlen, a UW assistant professor of medicine in the Division of Gerontology and Geriatric Medicine, based at Harborview Medical Center.

With 80 percent of the population living in poverty, Haiti bears the painful legacy of its past: colonialism and slavery prior to becoming an independent republic in 1804; dictatorships, political unrest, social division and failed leadership in the years after independence. Since the 1980s, the spread of HIV/AIDS has served only to intensify the suffering and isolation of this island nation, the size of Delaware.

Today, despite having only 25 percent of the Caribbean population, the country accounts for 60 percent of the region’s HIV/AIDS cases. Life expectancy has dropped to approximately 44 years. Young women account for 50 percent of all HIV cases. And, 40 percent of inpatients were seropositive for the HIV virus when tested in the 1990s.

For Shadlen, the antidote to despair over conditions in her native country comes from her work as program director for Haitian Health Allies, a nonprofit group dedicated to helping the most destitute individuals living with HIV/AIDS in Southeast Haiti.

Haitian Health Allies has raised more than $50,000 in cash, medications and in-kind donations over the past two years. While this may seem like a drop in the bucket compared to the scope of the problem, Shadlen finds hope in the words of Mother Teresa: “We cannot do great things, we can only do small things with great love.”

Through Haitian Health Allies, Shadlen fulfills a personal and family mission. When she was an infant, her father, a physician and activist, was arrested for treason by the Duvalier dictatorship. Although he escaped to America with her mother, Shadlen and her sister were left behind and raised by two great aunts. In those early years, Shadlen recalls visiting the sick with her aunts and learning that the privilege of having food, education and shelter comes with a spiritual obligation to serve the less fortunate in the community.

At the age of 10, Shadlen was reunited with her parents in New York and lived in a community of recent Haitian immigrants. Her journey outside this narrow world began when she was accepted into the seven-year medical program at Brown University and experienced, for the first time, the freedom of the American youth culture. Still, years later, when serving as the medical director of the Alzheimer’s unit at the Veterans Administration hospital in Palo Alto, Calif., Shadlen found that the experience of being Haitian in America helped her identify with these patients “who were unable to communicate their needs and who seemed marginalized from society.”

In 1995, Shadlen joined UW Physicians in Seattle, and she began practicing at Harborview’s geriatric unit in 1999. She credits support from the Harborview community for much of the success of Haitian Health Allies. Martine Pierre-Louis, manager of interpreter services and community house calls at Harborview, serves as the organization’s executive director and Dr. Chris Behrens, medical director of I-TECH (International Training & Education Center on HIV) and clinical assistant professor at Harborview’s Madison Clinic, serves as treasurer. For all of these leaders, their involvement is a natural extension of Harborview’s mission to serve the most vulnerable members of the local community.

“There’s so much goodness at Harborview,” Shadlen says. “Carol Glenn raised more than $1,000 through her network of colleagues to fund programs. Carol Munch created our brochure as an in-kind donation. Karen Crabb coordinated our April 2005 medication drive. Dr. Chris Behrens secured a donation of $22,000 in medications from Direct Relief International. Jennifer Osborne found a non-profit supplier of 3,000 condoms. And, nurses at the Harborview geriatric inpatient unit raised over $500 with a pre-Valentine’s Day bake sale.”

In the field, Haitian Health Allies partners with local grassroots organizations to promote programs that improve the quality of life and empower individuals living with HIV/AIDS. For example, because medical treatment alone will not cover the needs of the most destitute families, Haitian Health Allies provides stipends of $25 per month to cover other basic necessities of life: sanitation, drinkable water, nutrition and transportation.

Sponsoring children orphaned by AIDS is a second area of priority. The cost to support an orphan is $25 per month, and the money goes directly to relatives or guardians for the child’s care. As a further step, Haitian Health Allies is supporting programs to help these children become self-sufficient by training them to sell arts and crafts objects.

Deeply ingrained cultural attitudes foster the spread of HIV/AIDS in Haiti and present obstacles to its treatment and prevention. On the one hand, gender inequality and economic vulnerability create conditions favorable to the disease. On the other hand, a powerful social stigma keeps individuals from acknowledging that they are infected and from taking precautions to protect their sexual partners.

To begin changing these cultural attitudes, Haitian Health Allies promotes an outreach program to train individuals living with HIV/AIDS to serve as community leaders. In this role, they receive stipends of $45 per month, and they provide educational and peer support services designed to keep patients in treatment programs and counter their sense of social isolation.

In the future, Haitian Health Allies is looking toward establishing new projects to promote economic development, improve the health care infrastructure and change cultural attitudes. One goal is to raise $45,000 to sponsor a nurse-run clinic. Another is to secure donations of laptops and office equipment. On the cultural front, work is under way to create health fairs and song contests promoting HIV prevention and condom use.

While Shadlen and her colleagues travel regularly to Haiti to assess conditions and monitor programs, much can be done right here in Seattle to contribute to a brighter future for Haiti. For more information, contact Haitian Health Allies at 206-612-3083 or go to http://www.haitianhealthallies.com.