Women often face the dual challenge of caring for children and being the breadwinner for the household in places where formal jobs are hard to come by. Partners In Health helps women find dignified work and the social support they need to be healthy and economically productive.
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Betania's Story: A mother learns to live with HIV in the Dominican Republic
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A mother learns to live with HIV in the Dominican Republic.
“I saw my mother hang herself! I cut the rope," cried 9-year-old Jennifer. She had just run from her home to find her mother’s social worker. It was the third time she had interrupted her mother’s suicide attempt.
Three years ago Jennifer’s mother, Betania, tested positive for HIV. Only 26 years old at the time, Betania knew little about HIV, but believed it was “a disease that removes people from the society.” As an illegal immigrant and her young daughter’s only caregiver, separation from her family was not an option. With no financial support from her new husband, Betania recalls her exhaustion and despair: “I wanted to die." she said.
She was afraid that if she sought medical treatment, her husband would find out she was sick and leave her.
Instead, she kept her secret. And she became increasingly sick.
An emergency intervention
When staff from Partners In Health’s sister project in the Dominican Republic, Socios En Salud, began treating Betania in 2011, she was near death. Treatment for HIV is recommended if a patient’s viral load—the measurement of the amount of HIV virus in the blood—is greater than 100,000 instances per milliliter of blood. Betania’s viral load was an unimaginable 10 times higher, at over 1,000,000.
The HIV virus was storming Betania’s body; her immune system had collapsed. She was underweight, had several infections, including pulmonary tuberculosis (a contagious form of TB that affects the lungs), a cellulitis skin infection in one leg, and herpes.
The medical team at Socios En Salud knew they needed to act quickly. Betania was immediately put on an intensive drug regimen and enrolled in the organization’s psychosocial program. She was assigned a community health worker—called an accompagnateur—who began visiting her house each day.
Life as an illegal immigrant
For Haitians living with HIV in the Dominican Republic, the stigma around the disease is only part of the problem. Betania lives with the constant threat of deportation. Though she has lived in the Dominican Republic for 14 years, and despite being married to a Dominican, Betania is considered an illegal immigrant. This status transfers to her daughter, Jennifer, despite having a Dominican father. Because of this, Jennifer will have to leave school after she turns 10 later this year.
Today, SES staff are working with a lawyer to help Betania fill out the paperwork necessary to stay in the country, and her whole family is enrolled a support group for Haitians living in the Dominican who are also affected by HIV—a double stigma. She is currently in the process of seeking legalized status for her daughter.
In its first year, SES provided 33,900 people with the same kind of medical care and social support Betania received.
“When this project started, I was given all the orientation I need to live better. They gave me medications for free, besides the ARV, food, and legal and health advisement,” recounts Betania. “I can finally look after my daughter again after all of this.”
Betania received more information about her illness and received psychological and nutritional support. Within six months she had gained 51 pounds, and was back to a healthy weight. She felt strong enough again to start working.
Recently, she decided that it was finally time to disclose her HIV status to her husband. But she did not have to maneuver this stressful, risky situation alone. SES staff were with her as the family worked through the issue. Betania’s husband was tested, and discovered that he too is HIV positive. He has also been enrolled in SES’s HIV program. The family is meeting regularly with a psychologist.
PIH’s successes in the Dominican Republic
In late 2010, Partners In Health and its sister organization in Haiti, Zanmi Lasante, launched SES. The project specifically focuses on HIV/AIDS prevention and treatment in the Dominican Republic border town of Elias Piña. SES targets migrant farm workers from both the DR and Haiti who live in the region.
While still a small and very new program, Socios En Salud has tested over 4,000 people for HIV and educated nearly 35,000 about the disease. Today, 131 women living with HIV receive care from SES. Of these women, half are Haitians living illegally in the Dominican. Like Betania, they largely fear seeking health care.
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