Monday, June 11, 2007

Patricia Nell Warren on Puerto Rican AIDS Crisis

From A&U Magazine (June 1, 2007)

Puerto Rican Crisis


by Patricia Nell Warren

As I was writing this column, Cindy Sheehan quit the peace movement. Sheehan said she’d realized that her son “died for a country which cares more about who will be the next American Idol than how many people will be killed in the next few months while Democrats and Republicans play politics with human lives.”

Her bitter words echo other voices coming from Puerto Rico, where another war has been raging for over ten years—that of needy PWAs fighting bureaucratic ineptitude and corruption. Yet the mainland pays little attention—despite efforts at publicizing the war by veteran activists José Colón and Anselmo Fonseca.

In a recent IM interview with me, Colón said, “The situation regarding HIV/AIDS in PR is in a deep crisis, both in Title I and II. I feel like we are expensive for the government, and as such, disposable... I have found that neither the Health Department of Puerto Rico, nor the Health Department of the San Juan EMA, nor HRSA care for PLWHIV/AIDS at all. It just comes down to money and dirty politics.” Recently Colón made the dramatic announcement that he was stopping his own HIV treatment as a protest, and to show solidarity with Puerto Rican PWAs who are being denied treatment.

The problem is not lack of funding, but lack of proper administration. Puerto Rico is experiencing a complete collapse of HIV/AIDS service delivery—decrepit and unsanitary clinics, scarcity of doctors and other needed personnel, and meds simply not being bought and distributed. Indeed, according to one report, some HIV-positive
Puerto Ricans are fleeing to the U.S., in search of better services.

The crisis revolves around two agencies that administer over seventy-five percent— nearly $55 million—of the AIDS funds distributed to Puerto Rico. While the City of San Juan is supposed to administer Ryan White Title I funding and some HOPWA funds, Puerto Rico’s Department of Health is supposed to deliver Ryan White Title II funding, as well as ADAP, HOPWA and other related programs. Yet these agencies have shocking records of bungling, inefficiency and criminal corruption, harking back to a series of FBI arrests and trials a decade ago, with charges including outright embezzlement of funds. Yet problems continue to fester, and laws and regulations continue to be openly violated. Example: The mayor of San Juan’s action in axing the city’s required Community-Based Planning Council. In December 2006, the FBI launched a second round of raids on San Juan city offices that administer AIDS funds.

In May, Colón had had enough. He announced, “I will not take any medicines for my AIDS condition until the ADAP waiting list is totally eliminated…. I also believe that Law #349, the HIV/AIDS Patients Bill of Rights, is being violated. This has to stop.”

As I wrote this column, I asked Colón for a progress report on his protest. He said: “I just found out about ninety-six more cases on the ADAP waiting list today. Emotionally I am crushed. There is so much injustice! The government says that there is NO list, but we know of 477 cases.”
He added that he’d had to stop his protest after twelve days, at the request of his doctor, his family, and his partner Anselmo. “I’m just too frail to keep it up,” he said. “Nevertheless those twelve days have had a very strong impact.”

One Puerto Rican who moved to Florida to escape the crisis is asking, “Why is it that, unlike the public health challenges surrounding the aftermath of Hurricane Katrina and Walter Reed Veterans Hospital, the deepening HIV/AIDS crisis in Puerto Rico has not caught the attention of the national public? Am I less valuable a citizen in Puerto Rico than in Florida?”

In my opinion, this refugee’s question can be answered by asking other questions: Why have post-Katrina conditions along the Gulf Coast not been adequately addressed by government? Why have our wounded and disabled veterans been neglected by the very administration who demands that all Americans “support the troops in Iraq?” Why is the U.S. still mired in the Iraq war when most Americans want us to withdraw? Most important, why are more and more Americans like Cindy Sheehan and José Colón pointing fingers at both the Democrats and Republicans, in a deepening bipartisan crisis that reveals a collapse of government administration everywhere?

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