Notes from the 2002 Forum on Health and Human Rights at the Clinique Bon Sauveur
by Joia S. Mukherjee

September 1st, Cange, Haiti

On August 28, a 17 year old girl, ill and wasting presented to the Thomas J. White clinic. She had been alone for years. At 12 without schooling she garnered the pity of a stranger who paid her school fees as she slept on the ground, suffering hunger and profound sadness. Eventually, the deal changed, she was offered a bed instead of school fees. Tired and hopeless, she consented and left school at the age of 15, turning tricks for food and shelter. Somehow, this girl came to the Clinique Bon Sauveur (CBS), bringing with her a new diagnosis of AIDS, only a symptom of her travel log of pain.

And then on August 29, Sante ak Dwa Moun, Tout moun se moun, the 8th Annual Forum on Health and Human Rights at the Clinique Bon Sauveur, everybody is a person.

Starting with prayer and song we are reminded that in fact, more than health, hope itself is a human right and dignity is a human right. Patients testify, bearing witness to the hope that has been brought by treating their illness, rebuilding their homes, remembering that tout moun se moun... Paul and Fernet discuss the importance of the right drugs and the right care, Didi teaches that poverty and gender inequality are the major risk factors of sexually transmitted diseases. Proje Sante Fenmm, we are told, leaves the boundaries of the clinic to see the reality in which people live and dig deep to the roots.

Meanwhile, the roots of the HIV equity initiative run deep from a long history of prevention. These really spectacular prevention efforts continue - children's groups singing songs about human dignity and self respect and a group of girls, ages 11-13 sings with condoms in hand. Not New England propriety to be sure, but a reality of their lives.

Bruce Walker, the famous HIV researcher had never been in the home of a poor person until Serena insisted that though short on time, we must see a newly diagnosed TB patient from the expansion site in Lascahobas, who lives with 9 people in a one room, windowless house. Bruce is transformed. He sees the hope and the change in people's lives that come from treatment with dignity. He vows to bring real diagnostics for HIV treatment to Cange: a flow cytometer and the techniques to do viral load. Dr. Yves Polynice, the new Dean of the Medical School in Port au Prince (started through a collaboration with Cuba) eloquently states that people are not poor, they are dispossessed, robbed of their land, robbed of their voice, robbed of their hope.

Jaime ends the day recounting the changing of the world, improving the treatment of MDR-TB starting in Cange, Haiti, and spreading to Peru and Russia - indeed even to the WHO - showing the world that tout moun se moun, HIV, is the next challenge. Starting again in Cange and spreading to the world, as Bruce said earlier in the day, this is the most famous demonstration of HIV treatment in a resource poor setting in all the world. And Jaime says, 'step 1': hope is a human right.

A spirited poetry and song competition hosted in the name of the Schodner scholarship ensues, emceed by Fernet with great poise and humor (as it turns out any number of the CBS staff may end up as a talk show host; Oprah has nothing on our Dr. Leandre).

Day 1 ends with a group of doctors and health workers from CBS and from the Ministry of Health with Melissa, Joia, and Bruce sharing the fellowship of song till round about 2 a.m. under a crescent moon. Because hope brings joy, even in the face of profound sadness.

Day 2, hosted by Maxi, who gives both Oprah and Fernet (sorry pal) a run for their money, takes place under the high security of a visit by Mildred Aristide. Anxiously awaited by the people of Cange, she arrives in wonderful spirit full of hope and joy but with a real understanding of the lives of the poor. We hear about the prevention of Maternal to Child HIV transmission in Cange, in Cite de Soleil, about hope for children, and further commentary by our lazarus-like HIV patients, Tiofa, Simone, Nerlande, and others, many now accompagnateurs themselves.

The first lady delivers and impassioned speech promising support of the effort... and, did we hear her say electricity????

Cange has beared it soul these days, and it is full of light through the pain. Our patient from August 28th says it is the best thing she has ever seen, and I agree with her. And I know you all would too. And I give thanks for all of the people in Cange, in Lima, in Tomsk, in Chiapas, in Roxbury and all around the world who get it. Thank God.

In solidarity,
Love from the Forum to You,
Joia

Joia S. Mukherjee is a member of the faculty in the Department of Social Medicine at Harvard Medical School and works with Partners in Health in Peru, Russia, and Haiti treating patients with tuberculosis and HIV and advocating for the equitable medical treatment of the poor.