JASL increases support for clients during COVID-19 Pandemic

Jamaica AIDS Support for Life (JASL) remained open to serve its clients during the COVID-19 pandemic. The organisation modified its treatment, care and support programme to respond to the needs of their clients and received assistance through soliciting donations and writing proposals for small grants to mitigate the impact of the pandemic.

COVID-19 resulted in clients losing their jobs and not being able to provide for themselves and their families. These clients needed money including a travel stipend to attend the clinic, nutritional support and care packages including sanitisation items. Loss of employment, lack of basic living support and depleting nutritional supplies are the main issues that undermined clients’ adherence to medication. To play its part and ensure that the gains made with adherence and viral suppression of its clients were not eroded, JASL quickly sprang into action and launched an initiative geared towards “Helping us to help People Living with HIV (PLHIV) during this time of crisis.” Specifically, it tried to assist clients by providing financial assistance, nutritional support and care packages.

JASL called local organisations and submitted proposals to international donor agencies to provide financial and other support. Executive Director of JASL, Kandasi Levermore expressed that “we cannot negate the importance of nutritional support in maintenance of optimal care and as such, JASL seeks to ensure that each of our clients is provided with holistic “love, action and support.” Many of these clients were not able to access the benefits from the Government of Jamaica’s CARE Programme.

Assisting JASL’s clients, including PLHIV has helped to address some of the clients’ socioeconomic challenges so that they were not distracted from continuing their ARV regime. PLHIV who are adherent to their ARVs will optimise their immune system and improve their chances to fight against the symptoms of COVID-19.

During the pandemic, JASL also engaged in other COVID-19 response efforts. The organisation developed its Infection Prevention and Control Protocol which was implemented to protect its staff and clients from COVID-19 and other infectious agents. Employees were adequately equipped with the requisite personal protective equipment (PPE) to protect themselves from contracting COVID-19 and clients were provided with masks, temperature checks and sprayed with hand sanitisers upon entering the treatment sites.

The organisation also suspended all community interventions and amplified one-on-one peer testing by appointments only at the organisation’s offices or at locations convenient to people who want to be tested.

JASL’s treatment, care and support programme remains grounded in the organisation’s strategic objective to improve the health outcomes of over 800 clients accessing services at three treatment sites in Kingston, St. Ann and Montego Bay.

JASL continues to provide relevant services for clients while the pandemic unfolds as the organisation is committed to improving their health outcomes.

The organisation is encouraging individuals and companies to support their work and the cause by calling its head office on 876-925-0021 or donating at NCB Knutsford Branch 351813768.

COVID-19 and its effect on vulnerable groups especially women and girls

The COVID-19 pandemic has disrupted lives globally, causing a significant struggle for vulnerable populations, particularly our women and girls.

This impact on our vulnerable groups only reinforces the inequity that exists, which we addressed during our United Nations General Assembly (UNGA) side event in September 2019. The inequalities were always present, COVID- 19 is only exposing them even more so now. Regardless of the situation, “women and girls are negatively and disproportionately impacted by disasters and conflict” (UNFPA and UN Women).

Moreover, COVID-19 has put the most vulnerable populations at higher risk due to the confinement measures and economic stresses that tend to reinforce abusive behaviour. According to UN Women, emerging data shows that since the outbreak of COVID-19, physical and sexual violence against women and girls (VAWG) has intensified.

Fortunately, despite challenges, there are immense opportunities: my experience as Belize’s Special Envoy for Women and Children and Chair of SCLAN has cemented my belief in the power of collaboration.

COVID-19 has shown us that there is still an urgent need for innovative targeted tools and comprehensive strategies to accelerate progress for our vulnerable populations. As we see positive efforts to fight COVID-19 in our region, we must use this dynamism to seek sustainable financing and reinforced partnerships that strengthen actions to protect women and girls.

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Over 10 000 persons benefit from PANCAP – PAHO Webinars

Since the beginning of the COVID-19 pandemic, the PAHO/WHO Sub-regional Office for the Caribbean collaborated with the Pan Caribbean Partnership against HIV and AIDS (PANCAP) on a series of webinars which aimed to provide effective, timely and relevant information to the Caribbean on a wide range of topics relating to COVID-19 and HIV. The webinars were aimed at diverse audiences and served to provide updates on new scientific evidence and to share evidence-based frameworks and strategies as well as successful and innovative implementation experiences for the prevention and management of COVID-19.

PANCAP and PAHO have been intentional in combining presenters who are experts in technical areas with regional presenters on successful Caribbean implementation experiences. This approach provided an understanding of evidence-based frameworks and how these can be applied to the local context.

The webinars conducted from March to May 2020 have reached over 10,000 persons.  Participants have the option of joining the live sessions or viewing the recording on the PANCAP and PAHO Facebook pages as well as the PANCAP website and YouTube Channel.  Participants’ engagement with the webinars has been high. Organisers have received positive feedback on the relevance of the knowledge shared and the expertise of the presenters. A recent post-webinar survey revealed that 98.5% of participants gained new knowledge, while 100% indicated that the information presented was useful to their work.  In addition, 95% of participants stated that they would utilise the new knowledge in the execution of their work programmes.

The two entities will continue this successful collaboration with the overarching aim of providing critical knowledge for the Region’s response to COVID-19.

The Caribbean’s Remarkable Response to COVID-19

The Caribbean has been commended globally by the World Health Organisation (WHO), CNN and BBC for its outstanding handling of the COVID-19 pandemic. How did the Caribbean do it? As with everything, it begins with leadership. At the helm was a woman who led with distinction.  The Hon. Mia Amor Mottley, Chair of the Caribbean Community (CARICOM) and the Prime Minister of Barbados, was proactive and impressive in her harnessing of the region’s technical expertise and resources to the region’s benefit as well as Barbados. This resulted in effective and timely communication buttressed by carefully crafted messages from reliable sources to the populations of the region.

The region’s containment of this unrelenting virus is due in large measure to the effective teamwork of our agencies and their expert staff. CARICOM, PANCAP, PAHO, CARPHA, CMLF all executed an excellent containment strategy. Their sterling efforts, combined with a poised approach by all of these tireless teams is nothing short of exemplary. Kudos to ALL concerned for sharing the critical information responsibly to save many lives and so avoid overwhelming our health care systems that proved to be more efficient and organised to cope with this pandemic than many larger more powerful nations.

This is not new to the region. The Caribbean and its resilient people have a track record of leading the world in their response to epidemics and pandemics: The Caribbean was the first area of the world to eliminate polio and measles; Cuba became the first country in the world to achieve the elimination of Mother-to-child Transmission of HIV and Syphilis and on World AIDS Day 1 December 2017, six Caribbean territories and states joined Cuba in that achievement.

Our leaders, medical professionals at all levels, labs and all frontline workers, have acted decisively, worked unselfishly and helped keep us safe across the Caribbean.

We salute you and thank you!

COVID-19 and Laboratories

An opportunity for strengthening laboratories and health systems in the region.

Diagnostics and Laboratory capacity are essential but often ignored pillars of both a responsive health system and effective global health security.

The Coronavirus pandemic has, more starkly than ever before, highlighted the critical importance of accurate, reliable and timely laboratory testing for diagnosis, patient care and management and understanding the scope of viral transmission, thereby protecting national, regional and global health security. For those of us that live in the Caribbean, as we watched the COVID-19 pandemic sweep through Asia, Europe and the United States, on its way to our shores, many lessons have been highlighted – the DOs and DON’Ts of how to manage this pandemic emerged and are emerging day by day!

Read the full article.

Fear of stigma and discrimination, a hindrance to HIV care

When we speak about HIV today, there still exists some element of fear and uncertainty by many individuals towards People Living with HIV (PLHIV). Even with the vast wealth of information and education, some persons continue to stigmatise and discriminate against PLHIV.  This poses a significant challenge for navigating and retaining persons in HIV care and treatment programmes.

How do we help PLHIV to deal with stigma and discrimination? We simply continue the fight with counselling, continuous education, and equipping persons with the correct tools such as information on civil society organisations that provide specific help and guidance on how to deal with discrimination.

From the beginning of the process, this fear of stigma poses a challenge to get persons to participate in free HIV testing. They fear being identified and discussed. For persons who have tested positive, the problem becomes more significant. They fear being identified with the HIV clinic, and the thought of family, friends and coworkers being made aware of their diagnosis can affect their enrolment in treatment. Because of this reality and their need for privacy coupled with their self-guilt and shame, we face high rates of non-adherence to treatment, dropouts and loss to follow-up.

We must understand the impact this situation has not only on the individual but on society. Only then can we fully grasp the extent of the damage that is created as a result of stigma and discrimination against PLHIV.

The fear of being stigmatised and discriminated against is real; we, therefore, have to continue to empower PLHIV to deal with it, and to know that there is hope and help beyond that situation hence equipping them to be physically and mentally healthy.

“My experience has energised me to improve my own programme”

PANCAP facilitated a South-South Learning Exchange in the Dominican Republic in February 2020.  With a history of success with two previous events, six OECS countries were selected to be part of this sharing of best practices and Saint Lucia is grateful to have been a willing participant in this exercise.

When I learnt about the learning exchange, I did not know what to expect.  The Integral Orientation and Research Center/Centro de Orientación e Investigación Integral (COIN) welcomed all twelve of us into their safe space for a week and the Executive Director of COIN, Santo Rosario, paved the way for us to visit many places.

We visited the Ministry of Health and met the Coordinator-General of the HIV and AIDS programme, Dr Luis Ernesto Feliz-Báez.  Dr Jose Ledesma, enthusiastically described the successes of their PrEP trial.  The visit to the National Council against HIV and AIDS (CONAVIHSIDA) was very illuminating.  It provided insight into the composition of the Council and how it works with representative member ministries as well as non-governmental organisations (NGOs).

COIN informed us about their programmes and activities as well as the linkages they have with other governmental agencies, non-governmental organisations and civil society.  We visited TRANSSA (Trans Siempre Amiga), CVC (Caribbean Vulnerable Communities Coalition), IDEV (Institute of Virological Studies) and REDOVIH (the network of People Living with HIV – PLHIV).  We had access to a wealth of information that highlighted best practices in the Dominican Republic.  It also highlighted areas where there is much work to be done.

I was very impressed with the variety of services offered at both COIN and IDEV and the fact that they can refer clients to other agencies when necessary.  TRANSSA, CVC, COIN and CONAVIHSIDA all highlighted incidents of stigma and discrimination involving PLHIV and LGBTQI persons.  Also, there are many unsolved homicides of transwomen and there is a need to address the basic needs and education of approximately 700 youth who are in detention centers.

My experience has energised me to address some issues within my programme. I hope that the programme will be able to establish a relationship with sex workers.  They are a “hidden” population in Saint Lucia.  This task must be accomplished in conjunction with the island’s only LGBTQI organisation, “United and Strong Inc.”  There has to be a Pre-Exposure Prophylaxis (PrEP) sensitisation exercise before there can be a decision on a trial roll-out of PrEP.

I would like to thank PANCAP for the opportunity to have been a participant in this exercise.  I am grateful for the warm welcomes extended to all of us by all the institutions we visited, as well as the willingness to speak freely about their organisations and the work that they do.  Thank you to Timothy and Shanti for your support throughout the trip.  Thank you to my colleagues for having made the experience memorable and enjoyable.

A special thank you to Santo Rosario and Vanessa Rosario and all the COIN staff who opened their space to us and made us all feel very welcome.

“If we all stand separated, we will fall separated, but if we stand together, we will thrive together”

The Learning Exchange allowed me to explore the possibility of replicating best practices and evidence-based interventions from the Dominican Republic in the OECS countries.  Particularly strategies related to HIV prevention, PrEP, systems for dealing with intravenous drug use habits and changing legislation to allow key populations to access health.  It was evident that these changes and approaches are propelling a new and dynamic approach to HIV prevention in the Dominican Republic.  It is worth exploring whether these approaches can be utilised effectively in smaller Caribbean islands.

During the learning exchange, I noted that tackling vulnerable populations with capacity building, advocacy, and social and behavioural change communication is making headway in controlling the epidemic.

I was particularly impressed with the provision of HIV and other health services for migrants.  This is an approach that OECS countries should consider implementing.  The Caribbean landscape as it relates to migration is slowly changing, and there is the need to establish similar practices and prevention strategies for the region. We are slowly shifting from being isolated territories, but one cultural, social and economic region.  The evidence of movement of people from one country to the other signifies a changing paradigm in the region. If we all stand separated, we will fall separated, but if we stand together, we will thrive together.

“The learning exchange was nothing short of eye-opening”

The learning exchange brought to mind a quote I have heard time and time again, “everything in its own awesome timing”. I have had the desire to further my involvement in Civil Society. Still, I feared the unknown; I was somewhat intimidated by the extra work it involves but this experience has given me the motivation to get it done. My attendance at the learning exchange has been nothing short of eye-opening.

The capacity building was outstanding, the networking timely, and the overall experience was a humbling one. The field visits which showcased the work being done in the Dominican Republic were outstanding and I am grateful to the staff and volunteers who work with the clients.

I especially enjoyed visiting the Dominican Institute of Virological Studies (IDEV) clinic where they have a massive operation. The presenters’ strategies and methods of work were clearly illustrated.

It is my hope that each member of the visiting team observed at least one best practice that we can adapt and improve the services to our clients. If we continue to work together and use these practices, I see us moving closer to achieving the 90-90-90 Targets in the OECS!

“The lesson learnt from the exchange is that CSOs should be integrally involved in the HIV response”

The South-South Knowledge Exchange was truly an exchange.  The experience provided a different view of the robust efforts of civil society organisations (CSOs) that advocate for the rights of their communities and support vulnerable populations.

I love the Dominican Republic’s civil society organisations’ contribution to the HIV response.  I admire how visible and open they are about their issues and provide solutions to help fight HIV and stigma in their communities. Their commitment to work and the communities they serve is something to be emulated.   

The collaboration between Integral Orientation and Research Center/Centro de Orientación e Investigación Integral (COIN), CONAVIHSIDA, CSOs and other partners showed the strength and commitment of the people of this country.

It was evident that COIN, Ministry of Public Health and the other institutions that we visited were happy to share their best practices and to highlight the areas where more work needs to be done.

At times, seeing all the strengths of their HIV response made the work at home that we will have to do seem like a mammoth task.  However, as strong Caribbean people, we must keep on building and learning from each other.  We will find ways to adjust our approach to achieve the success of building the voices of our CSOs and achieving the 90-90-90 Targets.

The lesson learnt from the exchange is that CSOs should be integrally involved in the HIV response.  We must ensure that their voices are heard. I say KUDOS to all including COIN, especially the staff of the COIN Clinic and COIN Observatory, Ministry of Public Health and Social Assistance, Transsa, Caribbean Vulnerable Communities Coalition (CVC),  Institute of Tropical Medicine, Institute of Virological Studies – IDEV and REDOVIH.

The experience was as holistic like the services provided at the Instituto Dominicano de Estudios Virológicos (IDEV) and COIN, which included PrEP, HIV rapid testing and approaches to deal with human trafficking.

Finally, the people are very friendly and the black beans and rice (muy deliciosa).

Thank you PANCAP and to the Ministry of Health in my country, Saint Kitts and Nevis for the beneficial opportunity.  My fellow OECS colleagues (colegas), you were a great bunch!