Working in conjunction with these governmental organizations are international
NGOs which have taken on the responsibility of helping to fight the disease.
Present in the Dominican Republic is Amnesty International, which deals with the
rights of people who are infected. The World Health Organization, UNICEF, the
American Peace Corps, USAID, UNAIDS, and FHI (Family Health International) are
also present in the country, lending their support. |
The World Bank, USAID and other donors have provided funds to the Dominican
Republic. Also, the Dominican Republic has been approved for a 47 million dollar
grant from the Global Fund to Fight Aids, Malaria, and Tuberculosis, (Global
Fund), adding much needed financial support. Additionally, in 2004 the US
government gave 6.2 million dollars to the Dominican Republic for HIV prevention
Legal issues have unfortunately plagued the national response to HIV/AIDS,
though there are laws related to HIV/AIDS in the Dominican Republic.
Specifically there is law 55-93, La Ley Sobre el SIDA, but enforcement is uneven
and inconsistent. This law is supposed to protect people who are infected by the
disease from being discriminated against, but more often than not discrimination
occurs in the workplace, at school and in communities all around the country.
In the Dominican Republic it is unlawful to test someone for the purpose of
employment. It is also illegal to dismiss someone from their job if they are in
fact HIV positive, but the reality is often different. In addition, laws of
privacy are in place to protect patients’ rights, but this is also rarely
upheld, as the results of HIV tests are seldom kept private.
Apart from being an issue of legality, HIV/AIDS is also a human rights issue.
Once a person in the Dominican Republic has tested positive for the disease the
person can be ostracized by his or her community, rarely receiving the same
rights as he or she used to enjoy previously, almost immediately becoming a
second class citizen. Research by Amnesty International suggests that human
rights violations occur in particular relation to rights to health,
non-discrimination, privacy and information, which in itself is a hindrance to
the HIV/AIDS health objective.
Fortunately there are many initiatives in place to help stop the spread of AIDS.
Because the sex worker industry is held responsible for many of the AIDS cases
reported, the Dominican government has begun support of a “100% condom use”
program, modeled on a similar program in Thailand, to ensure usage of condoms as
a means to suppress the spread of the disease. Along with this campaign there
have been mass media AIDS education campaigns in order to get information out to
the public. The film Daniela, which chronicles the struggles of young women
affected with AIDS, was screened on national TV, providing a different context
with which to relay information about HIV/AIDS.
Much of the help in coordinating these campaigns comes from Conecta. Conecta is
also continuing the work done by IMPACT, which has helped in reducing the
transmission of AIDS from mothers to children at birth.
Peer education and communication activities are helping to reinforce the message
of AIDS prevention, and helping to change the behavior that leads to HIV/AIDS
infection. There has also been the creation of RedPav centers, through Conecta,
that provide counseling for patients who have been diagnosed with the disease,
something that was almost non-existent in the Dominican Republic.
Dissemination of information is a crucial factor in the fight against HIV/AIDS.
‘Lack of information about where and how to access antiretroviral treatment is
often a barrier to accessing medication.’ Though there is the possibility of
free effective treatment through government funded programs, policy makers,
social workers and doctors often encounter patients who are dying from the
disease. This is also due in part to the high cost of a doctor’s appointment;
therefore many patients are excluded from getting help for their condition.
Centralization is also a key issue in the future fight against the disease. An
AIDS patient needs to travel to clinics for treatment several times a month,
which becomes very costly. Lack of access to these necessary medicinal materials
in the clinics and hospitals away from the center of Santo Domingo have caused
countless unnecessary deaths. "While the government is receiving lots of funding
from the donors for HIV/AIDS work and treatment, people are dying only thirty
minutes away from Santo Domingo, with its shiny private hospitals. In the last
two years, [I have] seen many, many people die needlessly for lack of
Quality within the health care system is also a cause for concern. There is only
one CD4 machine in the public sector, (“a CD4 count machine measures the amount
of CD4 cells - that normally protect a person from infection - and is the most
common way of determining if someone needs to take antiretroviral medicines.”)
and it is located in Santo Domingo. Furthermore, HIV/AIDS tests, viral loads,
liver function tests, and all surgical procedures have to be referred to larger,
better equipped hospitals, extending the duration of a patient’s treatment. More
frustrating is that there are at times limited medical resources available to a
clinic. Doctors report waiting anywhere between two and four months for
essential antibiotics, which can be a hazardous period of time for infected
But there have been advancements in the quality of treatment of HIV/AIDS
patients. Antiviral drug provisions, through programs funded by the William
Jefferson Clinton Foundation and the World Bank, and USAID, through Conecta,
have provided access for 700 patients currently requiring treatment. Also,
Global Fund will provide treatment for an estimated 8,000 people, approaching
the estimated 10,000 people clinically eligible for treatment. And to combat the
increase of orphaned children due to HIV/AIDS small non-governmental grants have
helped over 1,000 children and 250 families. In addition, because of the
opportunistic nature of TB, the Dominican government signed several agreements
to collaborate on HIV and TB cross-border prevention programs with Haiti in
Awareness of the issue at hand is being raised by the variety of organizations
present in the Dominican Republic. In addition, identification of the necessary
improvements to the medical situation is ongoing, and can only lead to increased
responsiveness towards the disease. Finally, commitment to finding efficient and
effective solutions in accordance with international health guidelines is
imperative for success in the fight against HIV/AIDS in the Dominican Republic.