Category: all

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 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 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!

The PANCAP learning exchange provided the opportunity for sharing of best practices and knowledge exchange from the various Caribbean countries represented.  It also provided the opportunity for persons to improve their skills and replicate best practices highlighted by our colleagues from the Dominican Republic. With the information obtained during the learning exchange, I am now able to return to my island with my co-partner to start developing strategies to focus on critical areas where we were underperforming.  This includes implementing a system to better inform our sex worker population as we continue fighting for an HIV free Caribbean.

I was particularly impressed with the clinic at COIN.   A safe space has been strategically set up to ensure that persons who use the site clinic can access the services without their identity being compromised. Two access points have been identified to accommodate clients who do not want to be seen by other persons using the space.

Additionally, the clinic has been identified and labelled as a confidential room and unless requested by the client, only one person is allowed inside with the counsellor or tester at a time.

One of the ideas I noted from the learning exchange was modifying the hours of operation at the clinic to accommodate more persons who may not feel comfortable accessing the space during the day.  One clinic we visited indicated that their testing was conducted during the evening to assist persons who work and those who prefer not to be seen.

Since seeking sexual and reproductive health services is still considered a taboo, I think incorporating opening hours during the evening will ensure that more persons can access services.

Persons utilising the safe space also have an opportunity to receive sexual and reproductive health education and items to prevent the spread of Sexually Transmitted Infections (STIs) such as condoms (both male and female) and lubricants. To further facilitate and ensure confidentiality, agreements have been signed by members of the organisation which prohibit disclosure of any information about persons using the space.

Some of the strategies identified to enhance reducing HIV infections include continuous and periodic training sessions for testers in sexual and reproductive health education, including modes of transmission, various STIs, especially those that are prevalent within the population we serve. As such, we intend to replicate this best practice at home.  We also plan to continue building our partnership with the Ministry of Health and Wellness to allow for increased coordination during outreaches.  This approach has proven successful for our colleagues in the Dominican Republic.

What an awesome learning experience, seeing in action government, non-governmental organisations (NGOs), civil society organisations (CSOs) working in a harmonised partnership on an effective response to HIV and the provision of services needed and required by People Living with HIV (PLHIV).  This is one of the most important lessons that I am taking away from the South-South learning experience to the Dominican Republic arranged by PANCAP in collaboration with Integral Orientation and Research Centre/Centro de Orientacion e Investigacion Integral (COIN). The learning exchange was supported with funding from the United States Agency for International Development (USAID).

I was literally blown away when I visited the National AIDS Programme (NAP) and the Ministry of Public Health and Social Assistance. I was informed that the government had a mechanism in place for social contracting with CSOs. They can access part funding by writing a proposal and meeting specified requirements for the services they offer.

Additionally, the CSOs who are awarded a grant can work with other sub-recipients and sub-sub recipients to reach key populations where they are most comfortable accessing services.

Further, the CSOs are trained on project management, given guidance and are held accountable through yearly audits and have to report to the Ministry on the activities conducted.

The one-stop services offered to locals and migrants at COIN, and the Dominican Institute of Virological Studies (IDEV) were also impressive. In one visit, the client can have access to a multi-disciplinary team of specialists including medical doctors and laboratory tests such as HIV, VDRL, HB, Hepatitis B and C, liver and kidney functions, etc.

Clients also have access to Antiretrovirals, psychosocial services, gynaecological and urological examinations. Treatment for sexually transmitted infections (STIs) and other infections are also done. In addition, clients can access legal services. Other services include anal care, Tuberculosis (TB) prevention and control, syringe exchange programme, Haitian Migrant HIV and STIs services, migrant female sex workers support, and a support group for babies who were born HIV positive and are now parents of HIV negative babies.

Further, there was a presentation done by Dr Robert Paulino, Director del Instituto de Medicina Tropical and Salud Global Universidad Iberoamericana,  on the care and treatment given to persons at risk for contracting HIV and the Pre-Exposure Prophylaxis (PrEP) services offered. This system is based on referral. The individual will be interviewed and a risk assessment conducted. They are then sent for the relevant laboratory investigations such as HIV, Hepatitis, VDRL, liver and kidney functions tests. If the HIV test is negative, then PrEP will be initiated. There will be a “follow up” with the patient 15 days after commencement of treatment then every three months.

There were some challenges experienced by PrEP implementers in the Dominican Republic, which I would need to consider when implementing my programme. These are ensuring that the clients understand the importance of condom use during PrEP in preventing the transmission of other STIs and the importance of immunising against Hepatitis B.

The Dominican Republic HIV response also had agencies which enabled key populations to report on issues affecting their human rights and to seek redress when their rights are abused. Two of the agencies visited were Caribbean Vulnerable Communities Coalition (CVC) where I learnt about the Shared Incident Database (SID) which facilitates the reporting of human rights abuses by key populations and Transsa, a CSO group, which provides services for transwomen.

Throughout the five days, we also learnt about the progress of each OECS country in achieving the 90-90-90 Targets. We realised that we share similar strengths, weaknesses and challenges, but we are resolute in making sure that our countries reach the 90-90-90 Targets by 2025.

The South-South learning exchange gave me a clear view as to where my country’s programme needs to go and clear steps on how to get there through the forming of strong linkages and alliances with NGOs and CSOs.

I am leaving the Dominican Republic motivated to continue to work towards an HIV programme which will meet the needs of the various populations who are in need of HIV prevention, care, treatment and support services to reduce the negative impact of HIV in Antigua and Barbuda.

The PANCAP South-South Learning Exchange promised to be an interesting event, and I cannot say that I was disappointed. HIV education and programming has been part of my work at GrenCHAP since 2018 and I have been especially interested in this and other sexually transmitted infections (STIs) for quite some time.

Though HIV is a big part of the work that I do the other STIs have always been of great interest to me. It is notable that because of increased HIV awareness the transmission of the virus has decreased across the globe. However, this focus has made education for other STIs less available and has resulted in an increase in the rates of these STIs.

Our trip to the Dominican Institute for Virological Studies (IDEV) was a fascinating experience, particularly regarding the information we received on Human Papillomavirus contraction in the anal cavity that can lead to cancers in that part of the body. HPV, though very common, is a less talked about infection but has that detrimental effect of causing cancer.  Witnessing how it is treated within the facility and how these services have been made available for individuals who experience these issues was one of the best things I have seen on this learning journey. The priority placed on other STIs allows for a better understanding of the risks associated with them and helps individuals be more proactive with protecting themselves.

Overall the experience was an enlightening one. Though I am not a clinician, I am excited to see what can be done in terms of anal health services within the OECS as we try to make other STIs a priority.

It was an intimate gathering on 24 February 2020, as staff of the PANCAP Coordinating Unit and a few members of the wider CARICOM Secretariat celebrated soon to be former Director, Mr Dereck Anthony Springer, at Parc Rayne, East Bank Demerara, Guyana.

The tributes were many.  In speeches and statements that were candid reflections of the man, his measure and message.  In songs and serenades by his staff led by Nickosha DeNobrega and later the great Mariah Carey, the lyrics so profound and beautiful that even the discordant chords, the contribution of the gathering, were not a distraction.

Tributes came from all levels of staff of the PCU and from the wider Secretariat with whom he has worked closely. They included the CARICOM Deputy Secretary-General, Dr Manorma Soeknandan and Dr Douglas Slater, Assistant Secretary-General.

They came also from those he continues to work with in a commitment to turn back the tide of the epidemic and to ensure it does not stay on shore. Among them, Dr Edward Greene, former Assistant Secretary-General for Human and Social Development, CARICOM Secretariat and UN Secretary-General Special Envoy for HIV and AIDS in the Caribbean.

All contributions highlighted who Dereck Springer was and is, in both professional and personal capacities They all proclaimed him an exemplary leader who led by example; a dedicated, disciplined and decisive leader; and “a man of the time, in the time and for the time” a fitting title of a booklet with glowing tributes from a wide cross-section of PANCAP partners that was presented to him.

A stunning portrait in the true likeness of Dereck was presented to him and it was fitting that the artist, Compton Babb, was a special guest, and witnessed the adulation for his work from Dereck and all those in attendance. It was indeed a wow! factor.   It preceded Dereck’s eloquently comprehensive “thank you” to every member of his staff and all those present.

This memorable event basked in an atmosphere consumed with appreciation, camaraderie, jolly banter, great cuisine and a joie de vivre. It was tinged with a bit of raw emotion, the reality that after all, this was a farewell. It was a beautiful morning. The photos attempt to tell part of the story; the whole story, forever hidden in the hearts of all who were a part.

I question numerous life decisions I make but attending this congress is not one of them. The entire experience was high energy, building momentum from day one. Sharing the same space with so many influential and dynamic young and “youngish” leaders across the Caribbean really made me more receptive to differences in ideas, opinions and circumstances.

The youth congress facilitated communication between the youth and the policymakers. The forum pioneered a new dynamic for discussions about youth health involving youth at every stage. It was a catalyst to drive the change in the Caribbean’s approach to youth and adolescent health issues. The congress was extremely productive with the creation of a roadmap for youth health, detailing its goals and objectives.

Being the first of its kind there were a few hiccups but the content, engagement and networking made up for it. The plenary sessions captured my attention the most since it was an early morning session, and my mind was still fresh. It allowed for a holistic discussion with all of the participants, and this invoked a sense of inclusivity at every level.

This congress was a great experience to not only share my ideas and learn from others but to ensure the information gathered would be disseminated to our respective peer groups and organisations.

On 15 October 2019, the first-ever Caribbean Council on Adolescence and Youth Health was held. It lasted for three days and was filled with individuals of various Caribbean countries and well-known organisations. It was a launch-pad where advocates, health and social workers, policy-makers, academia, clinicians and young people heeded the call for improved health and well-being of adolescents and young people for the future development of the Region.

Over the three days, I attended several sessions from different tracks and thematic focus. The sessions were excellent, the content was relevant and addressed issues affecting adolescents and young people in an honest, transparent and meaningful way. I particularly liked the smaller, more intimate sessions that ran concurrently and I wish that I could have attended them all. I was most interested in the session that dealt with mental health. As I listened to the presentations and experiences, the challenges of being an adolescent in a time where bullying is pervasive, academic competition is fierce, and support systems are lacking, resonated with me. As adolescents, we are indeed living in a time that requires careful navigation to protect our mental health.

All of the sessions were interactive, and I gained a lot of knowledge.

I am extremely grateful that I had the opportunity to attend such an important event, and I hope that I can participate in many more in the future.

I enjoyed the conference. It was my first, and I am incredibly grateful to the Pan- American Health Organisation (PAHO) for granting me this unique opportunity. I appreciated the idea of creating a conference that focused on adolescent health, and including adolescents in the decision-making when it comes to their health.

The Caribbean Congress on Adolescent and Youth Health (CCAYH) was a great initiative, as it was a different approach to resolving the issues affecting this demographic.  This was my first experience at such an event, and I was excited to be part of it.

The Congress was well organised, and a lot of pertinent information was presented. I liked the parallel sessions as these were smaller activities that allowed presenters to share more in-depth experiences, research and studies.

I enjoyed the sessions dealing with substance abuse and mental health. They were most interesting to me. The information remained with me, as the statistics put a lot into perspective in relation to what is really happening with young people and adolescents in the Caribbean. I was impressed with a presenter during the mental health session who was very courageous to speak about her struggles with mental health. I think this was an excellent way to educate and help us understand the complexity and hardships of mental health.

This congress gave me exposure and a wealth of knowledge. I am very thankful for the opportunity to experience and network with my Caribbean counterparts.