A
Access to health care
HIV transmission and, 285–286
immigration policies and, 12, 25, 40, 41
resource problems, 73–74
scope of AIDS pandemic and, 73
short-term vs. long-term programs, 164
Special Immunology Clinic and, 12
AIDS. See also Fear of AIDS;
HIV transmission
activists and activism, 72
and blindness, 47, 48, 50, 51, 53, 54, 55
common characteristics of patients, 11
confidentiality issue, 129
costs of treatment, 95, 284, 285–286
death and dying, 26, 28, 56, 57, 64, 66–67, 71, 73, 74–75, 80, 83–84, 85–86, 143–144
dementia/mental deterioration, 64–65, 78, 79–80
emotional support for patients, 28, 37–38, 41–42, 51, 56
employment issues, 35, 41, 64, 70, 78, 83–84, 285–286
growth of epidemic, 16, 71, 73, 92–93
in Haiti, 117, 128–129, 130, 155, 171, 184, 195–196, 197, 211, 218, 220–221, 231, 233
Haitian refugees, 7–17, 24, 25–26, 35, 40, 44, 46, 50, 64, 74, 95
in homeless people, 74–75, 84, 87–97, 100–101, 129
homosexual transmission, xvii, xviii, 12, 16, 17, 24, 28, 30, 35, 38–39, 44–45, 50, 59, 64, 65–66, 69, 74–75, 76–86, 93, 100–101, 128, 143
infants/children with, 45, 63–64, 73, 97, 257–258
insurance coverage, 285–286
intravenous drug users, xvii, 50, 58–59, 62–65
long-term survivors, 100–101
media sensationalism, 24, 35, 36–37, 72
in Miami, xvii, xviii, 7–17, 100–101, 129
New York City, xviii, 24, 82, 258
opportunistic infections, 7–10, 11, 12, 14–15, 16, 18, 20, 26–28, 37, 38, 58, 62, 66, 73, 78;
see also individual diseases and types of infections
Petri dish theory, 128–129, 130, 131, 287
poverty and social issues and, ix–x, xiv–xv, xix, xx, 10, 26, 47, 64, 73–75, 89, 128–130, 132, 143–144;
see also Prostitutes and prostitution
projections, 72–73
religious views about, 28–30, 46–47, 48–49, 97
risk factors, xx, 17, 36, 50, 73–74, 129–130
San Francisco, xviii
sexual assault/exploitation victims, 93, 128
stigmatization and persecution of victims, xx–xxi, 28, 35, 50, 51, 54–55, 143, 184
T-cell counts, 20, 21–22, 25, 47, 97
testing and counseling, 71–72, 92, 93, 129, 193
treatments, 18, 19, 41, 48, 60, 69, 70, 72, 95, 284, 285–286
vaccine, 69
Affluence, health problems related to, 288–289
American Association of Medical Colleges, 100, 148
Angelou, Maya, 297
Antiviral agents, 70
Aristide, Jean-Bertrand, 105–107, 124, 135–136, 140, 231, 232, 270, 280, 281, 286
Au Basse, Haiti, 151, 155, 156
B
Baille Touribe, Haiti, 183–184, 235
Baker Act, 99
Bassin Bleu, 207–208, 210, 211, 212
Bercail Bon Berger (Sheepfold of the Good Shepherd), 217–222
Black Caucus (U.S.), 106
Blindness, 47, 48, 50, 51, 53, 54, 55
Blood
cryoprecipitate contamination, 95
Boucan Carrè, Haiti, 235
Boucantis, Haiti, 272
Breda plantation, 251
Brothers of the Good Shepherd, 88, 136, 137–139, 217–222, 244–245, 246
C
Camillus Health Concern, 87, 88, 89–91, 98–102, 126
Camp Perrin, Haiti, 152
Cancer, 274
Cange, Haiti, 163, 164, 165, 171, 175, 183, 235, 258, 259, 260, 261, 281, 283, 291, 292
Cap Haitien, Haiti, 114, 161, 188, 230, 231, 244, 245, 246, 247, 251, 253, 259, 270, 280–281, 282, 286, 291
CARE, 283
Castro, Fidel, 3
Catholic Church, 33, 34, 125, 131, 217, 235
Cellulitis, 261
Center for Haitian Studies, 243
Center for Humanitarian Medicine, 267
Centers for Disease Control, 18, 24, 34–35, 93
Central Intelligence Agency, 119, 270
Central nervous system infections, 8, 9, 11, 26–28
Children. See Infants and children, Haitian
Chloroquine, 156
Christian fundamentalists, 28–29
Christian theology, homophilic origins theory, 29–30
Citadelle, 251
Cité Soleil, Haiti, 123–132, 133, 134, 144, 147, 151, 171, 217, 241
Clinton, Bill, 107
Clinton, Hilary, 185–186, 188, 189–190
Columbus, Christopher, 246
Communism, 232
Community health workers/accompagnateurs, 234–235, 249, 258, 262–264, 265, 281, 287–288
Congenital rubella, 240–241, 245, 257
Croix des Bouquets, Haiti, 161, 230, 232, 233
Croix Rondo, 271–279
D
Death and dying, AIDS patients, 26, 28, 56, 57, 64, 66–67, 71, 73, 74–75, 80, 83–84, 85–86, 143–144
Deforestation, 111, 165, 283–284
Dementia/mental deterioration, 64–65, 78, 79–80
Dentistry and dentists
Project Brossé-Dent, 219–220
in Thomonde, 294–295
Diarrhea, 177–178
Doctor-patient relationships, 228
Dominican Republic, 163, 169, 171, 179, 278
Duvalier, François (“Papa Doc”), xviii, 124, 140, 164, 232, 233, 270
Duvalier, Jean-Claude (“Baby Doc”), 106, 140, 270
E
Economic embargoes and, xiii, xiv, 106, 107, 109, 115, 123, 133, 136
Electricity, 133, 146, 151, 152, 154, 159, 164, 166, 183, 193, 197, 253, 282
Elephantiasis, 274
Employment issues
AIDS and, 35, 41, 64, 70, 78, 83–84
in Haiti, 171, 175, 179, 181, 191, 192, 216
F
Family planning, 173, 261, 291
Farmer, Paul, 161, 163–164, 165, 171, 172, 175, 286, 287, 291–293
Fauci, Anthony, 70
Fear of AIDS
families of patients, 37–38
patients, 30–31
physicians and health care workers, 28, 37, 58–59, 60, 71–72
Fonds Verrettes, Haiti, 282
Fonkoze, 290
Fort Liberté, 252
G
Gallo, Robert, 36
Gates, Bill, Sr., 190
“Gay-Related Immunodeficiency Disease,” 12, 16, 28, 30
George Washington University, 292
Global Fund to Fight AIDS, Tuberculosis, and Malaria, 287
Gonaïves, Haiti, 282, 283, 284
Grande Plaine du Nord, 251
Grande Riviere du Sud, 208
Green Family Foundation, 233–234, 257, 259, 263
H
HAART (Highly Active Anti-Retroviral Therapy), 182, 285–286
Haitian AIDS study
limitations of, 35–36
opportunistic infections and, 10, 11–12
stigmatization of Haitians, x, xix, 131, 224
Haitian life and culture. See also Infants and children, Haitian;
individual places
affluence in, 121–122, 156, 200
African influence, 13, 33, 121, 220
agriculture, 162, 200, 209, 284
AIDS epidemic and, 117, 128–129, 130, 155, 171, 184, 195–196, 197, 211, 218, 220–221, 231, 233, 265, 286–287
alcohol and drug use, 92
artisans and artistry, 6, 114, 142, 149, 166
attitudes about life, 153, 157, 159, 236–237, 264, 293
Bassin Bleu, 207–208, 210, 211, 212
begging and beggars, 112, 113, 114, 119–120, 125, 126–127, 130, 134–135, 208
bicentennial, 280
boats, boat building, and fishing, 6, 151, 154–155, 156, 210
charity, 121–122
Christian beliefs and practices, 21, 22, 33, 131, 134, 136–137, 143, 200–201, 202, 209, 235–236, 242
civil war, 120
climate and, 112–113, 142, 271, 273, 282, 283–284
Clinton (Hilary) visit, 185–191
coastal villages, 151–157, 192–197, 207–212
community health workers, 234–235, 249, 258, 262–264, 279
costs of health care, 206
crime and punishment, 34, 170–171
deforestation, 111, 165, 283–284
dress and undress, 6, 134, 136, 137, 153, 162, 188, 202–203, 206, 213
economic embargoes and, xiii, xiv, 106, 107, 109, 115, 123, 133, 136
electricity, 133, 146, 151, 152, 154, 159, 164, 166, 183, 193, 197, 253, 282
employment issues, 171, 175, 179, 181, 191, 192, 216
endemic diseases, 17, 111, 117, 155, 156, 160, 165, 170, 172, 175, 181–182, 184
family life, 92, 115, 117, 125–126, 135, 152, 153, 156, 163, 167–168, 171, 221, 239
French influence, xxi, 13, 33, 34, 111, 120, 121, 135, 166, 186, 207, 220
government and politics, xiii, xviii, 105–107, 111, 120, 123–124, 135–136, 140, 149, 152–153, 164, 170, 188, 213, 216, 217, 231–232, 233, 234, 243–244, 245, 247, 248, 251, 270, 272, 273, 280–284
health care system, xii, xiv–xv, 18, 22, 73, 107–108, 109, 112, 115–118, 123, 124, 125–126, 137, 142, 151, 156, 158, 159, 160, 165, 166, 171, 173, 175, 186, 197, 199, 252–253, 288
health fairs and, 169–184, 192–197, 203–206, 207, 214, 215–216
homelessness, 123–132, 142, 282, 287
housing and furnishings, 152, 153, 156, 163, 165–166
humanitarian medicine and, x–xi, xii, 107, 109, 112, 115, 118–119, 123, 124, 125, 133, 136, 151–157, 232;
see also Project Medishare
international aid, xiv, 164, 189, 231, 233, 281, 283, 286, 290
Lac Péligre (Danger Lake) project and, 162, 163, 164, 270, 284
land as birthright, 164, 231, 289
language, 5, 12–13, 15, 21, 51, 115, 121, 142, 169, 183
literacy, 111
malnutrition, 153, 160, 170, 172, 173, 179, 181–182, 184, 194, 218, 241, 273
markets and sidewalk industry, 114–115, 124–125, 135, 154, 162, 201, 219, 246, 251, 282
media portrayal of, 170, 234, 243–244, 248, 256, 273, 280, 281
medical education system, 185–191, 254
midwives (fanm saj), 190, 263, 276
missionaries and missionary work, 21, 107, 108–109, 117, 119, 137–139, 141–143, 152, 181, 217–222, 283
museum, 142
music and dancing, 132, 133, 139, 166, 179, 180, 220, 236, 238
Neptune ferry boat disaster, 119, 218
old people (granmoun), 173–174
plantation economy, 232
politeness and hospitality in, 137–139, 157, 160, 166, 209, 218–219, 265, 293
poverty, 6, 111, 112, 113, 119–120, 121, 123–132, 144–145, 151, 153, 155–156, 164, 171, 191, 218, 239, 284
prostitution, 171, 197, 210–211
richness and contrasts, xxi, 134, 136, 145, 246–247, 261, 266
in rural areas, 141–144, 151–157, 159, 162
sanitation issues, 113, 114, 116, 117, 124–125, 128–129, 134, 151, 152, 193, 282
sexual practices and taboos, 14, 35–36, 44, 52–53, 54, 70, 82
slavery and slave revolt, xiii, xvii, 33, 34, 120, 121, 124, 135, 166, 203, 232, 250, 251
social class structure, x, 51–52, 120–122, 135–136, 252, 254
Spanish influence, 166
sports, 149
squatters’ settlements, 208–209, 251
stigma and shame of disease, 181, 184
tourism and, 120, 192, 197, 200, 208, 211, 233, 246
trade, 152
transportation and roads, 113–114, 118, 151, 152, 153–154, 160–162, 163, 169, 171, 183, 188, 199–200, 230, 232, 246, 272–273
twins (marasa), 195–196
United Nations intervention, 107, 133, 211, 231, 272, 278, 282, 283
U.S. foreign policy, xiii–xiv, xxi, 105–107, 119, 164, 232
U.S. military in, 105, 107, 112, 116, 123, 281
violence, x, 170, 217, 243–244, 245, 247, 248, 270, 272, 273, 278, 280–284, 286–287
Voodoo practices and beliefs, xiii, 6, 7, 16, 32–34, 35, 119, 134, 165, 166, 178, 184, 199–206, 242, 250, 263–264, 266, 275, 277, 280, 283
water supply, 133–134, 146, 151, 152, 154, 156, 180, 193, 197, 279
weddings, 153
women’s status and roles, 133–134, 137, 141, 152, 162, 171, 182, 190, 201–202, 210–211, 219, 234, 283, 287
Haitian refugees and Haitian Americans
AIDS epidemic, x, xvii, xix, 7–17, 24, 25–26, 31, 35–36, 40, 44, 46, 50, 64, 74, 95, 131, 224
blood donation, 95
communication problems, 12–13, 15, 21
education of medical personnel about, 32–33
homelessness, 92
immigration issues, 40, 41, 42, 44, 46, 47–48, 68
Miami community, xvii, 3–6, 35, 92, 106, 131, 134, 148, 158–159
New York City community, 24, 171
ocean crossings and interdictions, 3–4, 6–7, 43–44, 68, 154, 231, 233
opportunistic infections, 7–10, 11, 12, 14–15, 16
personal characteristics, 5–6, 12–13, 19–20, 21, 92
poem, 297
poverty and health issues, 7, 9, 10, 26, 40
prostitution, 44
stigmatization and discrimination, xix, xxi, 13–14, 26, 110
violence against, 47–48
volunteering in Haiti, 108, 109, 112, 123, 131, 132, 135, 139, 140, 142, 145, 147–148, 149, 193–194, 224
Harvard University, 260
Center for Health and Social Justice, 269
Health care workers
with AIDS, 18, 22, 71, 74–86, 143–144
availability for treating patients, 73
barefoot doctors of China, 249
community accompagnateurs, 234–235, 249, 258, 262–264, 265, 279, 281, 287–288
and cultural sensitivity, 35, 36, 52–53
emotional toll on, 28, 41, 56, 60–61, 77, 110, 143–144, 146–147
fear of AIDS, 28, 37, 58, 60, 71–72
and gay patients, xvii, 38, 52–53, 70, 77
midwives (fanm saj), 190, 263, 276
stereotyping and labeling, xvii, 35, 36, 223–229
testing for AIDS, 71–72
violence against, 72
Health fairs
in Haiti, 169–184, 192–197, 203–206, 207, 214, 215–216
Heart murmurs, 244
Heterosexual transmission, xvii, 11–12, 50, 58–59, 62–65, 72, 82–83
HIV transmission
access to care and, 285–286
blaming/scapegoating, xvii, 12, 24, 28, 35, 36, 52–53, 128, 143
hemophiliacs, 50
heterosexual, xvii, 11–12, 35, 50, 58–59, 62–65, 72, 82–83, 93
homosexual, xvii, 12, 17, 24, 28, 35, 44–45, 50, 69
immigration policies and, 285
maternal–infant, 45, 63–64, 65, 254
myths about, x, 35, 44–45, 83, 128, 143
poverty and, ix–x, xiv–xv, xix, xx, 10, 26, 47, 64, 73–75, 128–130, 132, 143–144, 284–285
prevention, xii, 79, 129, 254, 286
prostitution and, 72, 75, 89, 93–94, 96, 132, 144, 284–285
routes, xx, 22, 35, 54–55, 63–64, 71, 82
substance abuse and, xvii, 50, 58–59, 63, 75, 89, 93–94, 96, 289
vectors in Haiti, 171, 211, 233, 286
violence and, 286–287
Homeless and street people
AIDS “Ninjas,” 74, 75, 84, 87–97, 100–101, 129
billing for health care, 100
Camillus Health Concern, 87, 88, 89–91, 98–102, 126
prostitution, 89
recovery and employment, 91, 94–95
substance abuse and mental health issues, 87, 88, 89, 98–99, 129
Homosexuals and homosexuality
AIDS, xvii, xviii, 12, 17, 24, 28, 30, 35, 38–39, 44–45, 46, 50, 59, 64, 65–66, 69, 81
attitudes toward, xvii, 28–30, 38–39, 52–53, 59, 70, 77, 81, 82, 86
Christian theology and, 29–30
Haitian men, 35–36, 44, 52–53, 54, 70, 82
opportunistic infections, 11–12, 28–29, 45, 69
physicians, 74–86
sexuality, 81–82
Honduras, 193
Hôpital Bienfaisance, 175, 178, 180, 186, 188
Hôpital Justinien au Cap, 196, 250, 251, 253–254
Hôpital St. Michel, 206
Human papilloma virus, 274–279
Humanitarian medicine. See also Health care workers;
Project Medishare;
other specific programs
abuses in, 268–270
as an anticurriculum, 267
cultural sensitivity and, xiii–xiv
deworming clinic, 152
in Haiti, x–xi, xii, 107, 109, 151–157, 163–164
house calls in rural areas, 151–157
malnutrition station, 153
Hurricane and tropical storms, 99, 142, 282, 283–284
I
Ibo Beach, Haiti, 233
Immigration and Naturalization Service, 40, 41, 42, 50, 54, 193
Immigration policy, xix, 3–4, 89
and access to health care, 40, 41
Haitian issues, 40, 41, 42, 44, 46, 47–48, 68
and HIV transmission, 285
Infants and children, Haitian
activities and attitudes, 166, 241, 250, 275
burns, 117
of Cité Soleil, 126–127, 130, 131, 240
education and schools, 146, 162, 166, 208, 291
handicapped, 240
health issues, 117, 118, 125, 127, 152, 153, 156, 160, 172, 173, 175, 177–178, 179, 180, 181–182, 194, 203–206, 218, 219–220, 240–241, 244, 245, 247, 257, 274
immigrants, 89
immunization, 240, 241, 290–291
malnutrition, 118, 153, 160, 170, 172, 181–182, 193, 218, 241, 273, 291
orphans and street children, 69, 73, 97, 112, 113, 114, 117–118, 119, 120, 121, 125, 126–127, 136, 138–139, 142, 147, 198, 199–206, 207, 217–222, 231, 240, 241, 257
Project Brossé-Dent, 219–220
sexual abuse and exploitation, 130, 144, 197, 274–279
Interferon, 41
International aid, xiv, 164, 189, 231, 233
International Red Cross, 118, 269, 281
Intravenous drug users, xvii, 50, 58–59, 62–65, 75, 93, 94
Islam, 34
J
Jackson Memorial Hospital, xvii, 4
equipment donations, 158
growth, 5
Haitian patients, 5–10, 12, 13–14
response to AIDS epidemic, 37–39, 45
Special Immunology Clinic, 57–60, 64, 68–69, 70, 72, 92, 97
Jacmel, Haiti, 199–200, 205, 207–212
Jimani, Haiti, 282
Joli Gilbert, Haiti, 153
K
Kaposi’s sarcoma, 12, 28, 38, 69
Kenscoff, Haiti, 141–142
L
La Plaine, Haiti, 162
Labadie, Haiti, 192–197, 243, 244, 246–247
Lac Cayman, Haiti, 162
Lac Péligre (Danger Lake), 162, 163, 164, 270, 284
Leishmaniasis, 17
Lewis, Stephen, xi–xii
Liberation theology, 106–107, 232
L’Ouverture, Toussaint, 251, 283
Louisiana territories, 250
M
Mackandal, 251
Malnutrition, 153, 160, 170, 172, 173, 179, 181–182, 184, 194, 218, 241
Media sensationalism
of AIDS epidemic, 24, 35, 36–37, 72
of Haitian political violence, 170, 234, 243–244, 248, 256, 273, 280
Medicine
dependence on technology, 196, 229
family practice, 185–191, 196–197, 229
liability and insurance issues, 157, 243, 256, 257, 267
professional values, 267
Medishare. See Project Medishare
Miami, 251.
See also Haitian refugees and Haitian Americans;
Jackson Memorial Hospital;
University of Miami School of Medicine
AIDS epidemic, xvii, xviii, 7–17, 100–101, 129
Arena, 89–90
city life, 4
Freedom Tower, 3
Genesis House, 84
health care system, 288
homeless and street people, 74, 84, 87–102
Krome Avenue Detention Center, 4, 43, 68
Little Haiti and Haitian
community, xvii, 3–6, 35, 92, 106, 131, 134, 148, 158–159
Miami Project to Cure Paralysis, 107–108, 149
Mirebalais, Haiti, 162, 166, 171
Missionaries and missionary work, 21, 107, 108–109, 117, 119, 137–139, 141–143, 152, 181, 217–222
Mosquito control, 261
Muslims, 30
N
Napoleon, 250
National Health Service Corps, 5
National Institutes of Health, 69–70
Neptune ferry boat disaster, 119, 218
New Orleans French Quarter, 207
New York City
AIDS epidemic, xviii, 24, 82, 258
Northwestern University, 292
O
Obas, Beethoven, 132
Obas, Mozart, 132
Ogé, 251
Open Society Institute, 185, 186–187, 244, 252–253, 254, 257, 267
Opportunistic infections, 18, 20, 26–28, 37, 38, 58, 62, 66, 73, 78;
see also individual diseases and types of infections
in Haitian refugees, 7–10, 11, 12, 14–15, 16
in homosexual men, 11–12, 28–29, 45, 69
Oral rehydration therapy, 173, 177–178
Orphanages
Bercail Bon Berger (Sheepfold of the Good Shepherd), 217–222, 295
caregivers (matant), 240
handicapped and abandoned children, 239–240
health fairs, 198, 199–206, 207, 218, 230, 231, 234, 239, 244, 255
Orphelinat Bon Secours, 201–206, 207
in Post Cazeau, 117–118
resources, 239
tuberculosis screening in, 244, 257
Orwell, George, 73
P
Pape, Bill, 286
Parasitic infections, 10, 11, 15, 155, 170, 172, 181–182, 194, 241
Partners in Health, x–xi, xii, 164, 258, 260, 270, 292
Peace Corps, 182, 216, 236, 257
Pestel, Haiti, 117, 151, 152, 153, 154, 156
Petionville, Haiti, 119–121, 133, 134, 135, 188, 272
Petit Goave, Haiti, 272
Pignon, Haiti, 175, 178, 180, 186, 188, 190, 191, 230, 231, 250
Piperazine, 153
Place D’Armes, 251
Pneumocystis carinii pneumonia, 10, 11, 12, 18, 21, 40, 45, 62, 64–65, 89, 285
Pointe Honoré, Haiti, 246
Port-au-Prince, Haiti, 105, 111–122, 124–125, 135, 136, 142, 151, 158, 160, 161, 162, 164, 170–171, 182, 186, 187, 199, 217, 230, 233, 245, 246, 247, 251, 259, 273, 281, 282, 286–287
Post Cazeau, Haiti, 117, 118, 198
Post-streptococcal glomerulonephritis, 261
Poverty
and access to health care, 4–5, 39, 74, 132
“decent” vs. “indecent,” 171, 284
environmental impacts of, 284
and family collapse, 239
in Haiti, 6, 111, 112, 113, 119–120, 121, 123–132, 144–145, 151, 153, 155–156, 164, 171, 191, 239
in Haitian-American communities, 7, 9, 10, 26, 40
and HIV transmission, ix–x, xiv–xv, xix, xx, 10, 26, 47, 64, 73–75, 128–130, 132, 143–144, 284
reduction strategies, 191, 290
stereotypes about, 289
women’s status and, 284–285, 290
Preval, Rene, 188
Project Brossé-Dent, 219–220
Project Medishare, xii, 109, 117, 157.
See also Thomonde
academic credibility, 257
community health project, 234–235, 249, 258, 262–264, 279, 289, 290, 292
debriefings, 239–240
education and training component, 148, 149–150
equipment donations, 158
family medicine residency program, 185–191, 196–197, 230, 231, 244, 249–255, 257, 267, 272, 280–281, 286, 291
funding, 149, 185, 188, 192, 230, 233–234, 236, 244, 249, 252– 253, 254–255, 257, 272
guesthouse in Thomonde (Kay Medishare), 213–216, 235–236, 262, 265, 281, 292
health fairs in Haiti, 147, 166–184, 192–197, 199, 207, 214, 215–216, 244, 271–279, 292
honors and awards, 244
hospital in Thomonde, 167, 236, 261, 262, 265, 272, 281
and Klinik Bon Saveur, 163–164
Komite Zamni Thomonde generator request, 158–160, 166
in Labadie, 192–197, 243, 244, 246–247
mission, 249
nutrition programs, 181, 272, 289, 290, 291
orphanage health fairs, 198, 199–206, 207, 218, 230, 231, 234, 239, 244, 255
Pap smear screening, 184
prenatal care, 182, 195, 234, 261, 271, 273, 291
“Président à Vie,” 149
screening for problems, 170, 174, 182, 184, 261
in Thomonde, 160, 166–184, 213–216, 230, 231, 234–235
University of Florida School of Medicine and, 198–199
University of Miami School of Medicine and, 147–150, 170, 234–235, 243–248, 249, 256–266, 291
volunteers, 108, 109, 112, 123, 131, 132, 135, 139, 140, 142, 145, 147–148, 149, 166–184, 192–197, 199, 207, 214, 215–216, 224, 231, 236, 240, 244, 267, 272, 292, 294–295
Zanmi Lasante partnership, 164
Prostitutes and prostitution, 44, 72, 75, 89, 93–94, 96, 101, 132, 144, 171, 197, 210–211, 284–285
R
Raymond-le-Bain, Haiti, 207
Reiff, David, 268–269
Religion, and views about AIDS, 28–30, 46–47, 48–49, 97
Roi Henri Christophe Hotel, 251
Royal Caribbean Cruise Line, 192, 197, 244
S
St. Catherine’s Hospital (Haiti), 124
Saint Dominique, 250–251
Sanitation issues, 113, 114, 116, 117, 124–125, 128–129, 134, 151, 152, 193, 282
Santa Maria, wreck of, 246
Savanette, Haiti, 183, 235, 237
Scabies, 194
Schistosomiasis, 17
Sepsis, 117
Sexual assault/exploitation, 93, 128
Shalala, Donna, 257, 258, 259, 260, 291
Sickle-cell anemia, 234
Sisters of Charity, 221
Skin disorders, 15, 25, 40, 175
Slavery and slave revolt, xiii, xvii, 33, 34, 120, 121, 124, 135, 166, 203, 232, 250, 251
Socialism, 232
Stigmatization and stereotyping of AIDS patients, xvii, xx–xxi, 12, 24, 28, 35, 36, 50, 51, 52–53, 54–55, 128, 143, 184
of Haitians, x, xix, xxi, 13–14, 26, 28, 51, 110, 181, 184
of homosexuals, xvii, 28–30, 38–39, 51, 52–53, 59, 70, 77, 81, 82, 86
by medical personnel, 50, 51, 110
of medical personnel by colleagues, xvii, 35, 36, 39, 223–229
Strongyloidiasis, 17
Substance abuse, xvii, 50, 58–59, 62–65, 75, 87, 88, 89, 93–94, 96, 98–99, 129, 289.
See also Intravenous drug users
T
Terrier Rouge, Haiti, 272
Tetratotoxin, 33
Thomonde, Haiti
accessibility, 161–162, 164, 165, 169, 272
AIDS in, 287–288
blessing of guesthouse, 235–236
boundaries of, 272–273
children of, 172–173, 177–178, 179, 181–182, 236–237
community health workers/accompagnateurs, 234–235, 249, 258, 262–264, 265, 281, 287–288
dental care in, 294–295
disaster relief work by, 283
economic and community development, 289–290
eye care program, 291
guest house (Kay Medishare), 213–216, 235–236, 262, 265, 281, 292
health census, 262–263
health fairs and house calls, 166–184, 214, 215–216, 261
health statistics in, 160, 165, 172, 265
hospital/clinic, 167, 236, 261, 262, 265, 272, 281
immunization campaign, 290–291
Komite Zamni Thomonde generator request, 158–160, 166
population, 164
poverty level, 171
secrets of success in, 287–288
University of Miami administrators’ visit, 260–261
village design, 165–166
Tierre Muscadet, Haiti, 183, 235, 237
Tourism and, 120, 192, 197, 200, 208, 211, 233, 246
Toxoplasmosis, 10, 11, 12, 14, 16, 58
Trade embargoes. See Economic embargoes
Tuberculosis
atypical, 78
control worker, 234
disseminated, 7–10, 11, 12, 14–15, 20, 58
drug-resistant, 73
in Haiti, 118, 155, 156, 165, 172, 175, 184, 204, 218, 220, 230, 234, 264, 273, 287–288
in orphanages, 218, 220, 230, 234, 241, 257
scrofula, 274
treatment, 17, 264, 265, 287–288
Typhoid fever, 118, 193, 204–205
U
UNICEF, 283
United Nations
Children’s Education Fund, 254
military intervention in Haiti, 107, 133, 211, 231, 272, 282, 283
United States
Haitian foreign policy, xiii–xiv, xxi, 105–107, 112, 116, 119, 123, 164, 232, 281
humanitarian relief to Haiti, 283
immigration policy, 40, 41, 42, 44, 46, 47–48, 68
University of Florida School of Medicine, 198–199
University of Miami School of Medicine, xvii, xviii, 4–5
administration trip to Haiti, 258–266
Camillus Health Concern, 87, 88, 89–91, 98–102, 126
Community Service Award, 99, 148
family medicine program, 187, 229
grading system, 227–228
international pediatric infectious diseases program, 234, 258
Jay W. Weiss Center for Social Medicine and Health Inequality, 291
Key West project, 77, 79–80, 84–85, 147
liability and insurance issues, 157, 243, 256, 257, 267
medical assistance in Haiti, 109–110, 112, 118–119, 256–266, 291
minority problems, 223–229
and Project Medishare, 147–150, 170, 234–235, 243–248, 249, 256–266, 291
Project to Cure Paralysis, 107–108, 149, 236
volunteerism and culture of compassion, 77, 79–80, 84–85, 87, 88, 89–91, 98–102, 126, 147, 148
U.S. Agency for International Development, 164, 189, 254, 286, 291
V
Val Artibonite, Haiti, 162
Venezuela, 283
Vertierres, Haiti, 251
Vétivert, 152
Violence
against Haitian refugees, 47–48
against health care workers, 72, 270, 281
political, in Haiti, x, 170, 217, 243–244, 245, 247, 248, 270, 272, 273, 278, 280–284
sexual coercion, 284–285, 286–287
acceptance of Western medicine, 202, 263–264
amulets, 241
attitudes of outsiders about, 119, 237–238
and black magic, 242
bokar (male priest), 33, 157, 237, 263
cultural voyeurism, 237–238
Damballah, 266
dokte fè (leaf doctor), 33, 34, 263
ecstasy and possession, 241–242
Erzilie Freda/Virgin Mary, 202, 204, 242
hexes and spells, 7, 16–17, 33, 263, 264, 275, 277, 283–284
hougan (spell giver), 33
La Sirène, 56
mambo (priestess), 33, 201–206, 263
mojo (love potion), 33
orphanage, 199–206
ounmfò (temple), 201, 202, 204, 206
saints, 242
and slave revolt, 250
spirits and spirit world, 11, 33, 56, 203, 241
symbolism, 200–201
tombs, 200
zombies and zombie curse, xiii, xx, 32–34, 129, 131, 144–145, 170, 226, 233, 260, 264, 280, 283–284
W
Water supply, 133–134, 146, 151, 152, 154, 156, 180, 193, 197, 279
Women’s status and roles, 133–134, 137, 141, 152, 162, 171, 182, 190, 201–202, 210–211, 219, 234
World Bank, 231
World Harvest, 118
World Health Organization, 72
Y
Yeast infections, 11, 14, 20, 40, 58, 69
Z