A Matter of Access
The greater the unevenness of the playing field, the more numerous the barriers to resources.
On December 6, 1999, at the "AIDS in the New Millennium" World AIDS Day observance, Therese R. Rodriguez, Executive Director of the Asian & Pacific Islander Coalition on HIV/AIDS (APICHA), was honored by Manhattan Borough President C. Virginia Fields. Also honored were two other major figures in the AIDS community, Dr. Betty Primm, Executive Director of the Addiction Research and Treatment Corporation, and Ana Luiza Machado de Oliveira, Executive Director of Gay Men?s Health Crisis.
Rodriguez was cited for her "devotion to advancing education, outreach, service and advocacy." In accepting the award, she made a cogent plea for HIV and AIDS services for those who need them most. Her remarks follow.
Two years ago, the good news was: people living with HIV/AIDS were living longer because of a new treatment therapy--a combination of protease inhibitors. Though it was not a treatment vaccine nor a preventive vaccine, nevertheless, it slowed the rate of people dying of AIDS in more fortunate countries like the United States.
Resources for Whom?
But the impact of the good news on the lives of people worldwide is related to the level of development of each society, each country, each nation, or related to the will of its people and leaders to even out people?s chances and access to treatment and education. The more level the playing field between societies or within each society, the more even the distribution of resources. The greater the unevenness of the playing field, the more numerous the barriers to resources. In other words, the treatment of the most vulnerable members of society is a great indicator of how healthy is its sense of fairness and justice. When we fail to examine the issues behind the disregard, neglect, and lack of real interest in underserved communities, we will see a society that can easily be divided, communities divorced and alienated from each other, leaving the wealth, resources, and power of this nation in the hands of the real minority ruling over the vast majority of needy, constantly short-changed masses of people.
Thus when power, quality of life, or in particular HIV/AIDS healthcare and prevention education are determined by one?s economic status, or determined by the shade of one?s skin, or determined by one?s gender or by one?s sexual preference or self-identification, the good news becomes an elusive and illusory blessing for those who are at the margins of power. In fact, two years after the good-news announcement, it was declared that HIV/AIDS is raging in crisis proportions in the African-American community and in the Hispanic community, and galloping among the youth and women in these same communities in this same United States of America.
HIV and API
HIV/AIDS highlights the many human rights challenges that face Asian and Pacific Islander communities, both in the U.S. and around the world. According to the CDC count, there are about 1,000 API AIDS cases in the State of New York. True, we do not have the numbers. However, the diversity of the Asian and Pacific Islander communities makes our work in APICHA very intense. The rate of increase of the disease in the API communities is very high. Yet many have no access to insurance. Many are newly arrived, unaware of what resources are available. They speak in many tongues and bring with them many belief systems. They come from very different cultures. There is stigma attached to death and disease. Prejudice toward homosexuality is very strong. Women have little to say about their own well-being. These are very special needs.
These challenges include discrimination based on HIV/AIDS status, taboo, shame, and stigma. AIDS stigma and the resulting discrimination are particularly rampant in Asian and Pacific Islander communities. The stigma surrounding AIDS and the taboos surrounding related topics make it extremely difficult to talk openly about AIDS and how to prevent HIV transmission. This is a barrier to educating our communities about how to protect themselves.
As well, we face discrimination based on immigration status and discrimination based on language and cultural differences. Welfare reform legislation and recent immigration legislation have negatively affected many Asian and Pacific Islander immigrants living with AIDS, denying them life-sustaining support. Most service providers are not equipped to work with our populations because they cannot deal appropriately with language and cultural barriers.
The Underserved Worldwide
It is the same power and economic imbalance and information deprivation that is ravaging a great part of the world. Consider the following: An estimated 34 million people living in sub-Saharan Africa have been infected with HIV. Eleven and a half million of those have already died, a quarter of them children. In 1998 alone, AIDS was responsible for an estimated two million funerals in Africa.
China has more than 400,000 people living with HIV or AIDS, Cambodia nearly 180,000. Vietnam may have up to 135,000 infections by next year. In India, two states have HIV prevalence of two percent--in other words, two percent of the general population is HIV positive. Bangladesh has equally high infection rates among injecting drug users.
Alliance and Empowerment
Advocacy, coalitions and cross-class alliances, empowerment, sharing of power, reallocation of wealth, grassroots and institutional partnership, north?south mutual support--these social and human relations have to be summoned to shape a world agenda. A common yet regional/ country-specific agenda is needed to undertake cooperative research, multinational/multicultural/technologically appropriate and comprehensive education. Data sharing and information transfer must be undertaken. A new world infrastructure for the delivery of information/education and treatments must be built.
To begin these tasks we must first open our minds, open our hearts, and open our doors. There must be a political will to begin this work. It will take all of us--government, scientists, kings and princesses, medical professionals, artists, philanthropists, corporate executives, community leaders--to pool our efforts to bring healthcare access to people living with HIV/AIDS and to bring the message to stop the spread of AIDS.
But providing access is not enough. We must be able to surmount the shame that overpowers us all. The human spirit must move us to think with our hearts. Compassion must rule over the compulsion of tradition to save face.
In the AIDS movement, it has become a tradition to call out names of those who have passed on. If we are to honor our dead, let us rip the shame from out of our hearts. Call on them now, and make a promise that their deaths will not be in vain.
Until a cure is found, World AIDS Day must be commemorated to remind ourselves that as we break down barriers we must also open doors. We must open doors, not just for our own specific racial and ethnic communities, but for all. After all, we belong to only one race, the human race. Call it trite, call it corny, but when you come down to it, we are all we?ve got.
Back to the May 2000 Issue of Body Positive Magazine.
This article was provided by Body Positive. It is a part of the publication Body Positive.