International Trans Visibility Day

On 31 March, the world observed International Trans Visibility Day. As a Human rights advocate, I have observed that the social context for trans persons living in the Caribbean is harsher.

There is a growing and thriving trans population in the Caribbean. Due to the high degree of stigma and discrimination, transgender people are subject to the conditions of inequality and exclusion in the economic, social and legal environment.  Often, they are prevented from accessing basic human rights such as healthcare.

The police reports are treated as jokes or go missing when transpersons report acts of violence towards them.  The records of crimes against transgender people emerge now from civil society, then they have the difficult task of reporting these acts of violence and sometimes killings.

It is now evident that transgender persons are more visible in the Caribbean. There is a strong clear need for recognition and protection of their rights which have been violated historically. Self-perceived gender identity discrimination and violence are strong barriers to accessing healthcare, education, and employment. We must improve this with a clear implementation of decisive public policy to promote the human rights of this vulnerable population.

Because of the fear of discrimination, trans persons use healthcare facilities for critical situations only and often it is too late.  The education system has excluded them through discrimination, verbal and physical violence. Transgender persons have been denied access to work, even informal and badly paid jobs have been for most just a dream.

Gender Identity is real in the Caribbean.  To my trans persons in the Caribbean keep your faith in tack and continue to love who you are. I believe with education, and awareness, we can overcome our challenges.

Visibility is Empowerment.

Fantastic Learning Experience

My participation in the South South Learning Exchange was a stimulating and inspiring experience. I was enthused to learn of JASLs story – how they came to be in existence, their model of prevention, care and treatment and their governance processes. Throughout the week, it became evident that there is a high level of collaboration between the Ministry of Health team and the JASL leadership and team members.

The input that JASL leadership is also able to give at the governmental level is impressive. I was pleasantly surprised by the comprehensive range of services offered by JASL and our day long visit to the St Ann’s Chapter gave us the opportunity to hear the client’s stories and impressions of the excellent service that they receive at JASL. A similar South South Exchange would be beneficial for other countries and participants. I really commend PANCAP and the Knowledge for Health Project for facilitating such a fantastic learning experience.

The courageous fish of St. Anns Bay and their bowl of empowerment

After an hour and a half drive from Kingston, with scenic views of the valleys, peaks, and lush vegetation, we arrived at our destination: the St. Anns Bay chapter of Jamaica AIDS Support for Life (JASL). Excited for the opportunity to see the work this great civil society organization does, we all clamored out of our shuttle to a quaint unmarked building on a hill, with a stunning view of the bay. Met with warm smiles from the Chapter’s staff, and cute baby goats frolicking around a well-maintained yard, I marched up into the building and experienced something much different than I expected.

From hearing about the work of JASL regionally, and interacting with their well-informed and professional management team earlier in the week, I was expecting a state of the art facility with very formal, professionally-distant staff. Instead, I encountered a humble establishment with the friendliest, warmest and most inviting and passionate staff I have ever come across. I would be remiss to even call them mere staff as, from observation, they operated more as a tight knit family.

Throughout the day, there were several presentations and a tour of their facility, with a demonstration of processes, to showcase how they eagerly serve their community. The purpose of this learning exchange was to witness JASL’s service delivery, community engagement, and collaboration models. From the onset of the various presentations, of which many were very informative, it was clear that the team had an unwavering passion for the work that they do, and were very informed about their roles and how they aid in the fight against the HIV/AIDS epidemic.

However, the highlight of the chapter visit was the fishbowl exercise; where the JASL team invited a few of their clients so that we could experience their stories. Having never heard of a fishbowl exercise, I was very keen on seeing how it would work. For those who may not know what it is, it is where you have your clients, the ‘fish’, sit in a complete circle, the ‘bowl’, and everyone else, the ‘observers’, sit outside the circle. The goal was to replicate how one would observe fish in a fishbowl.

I was expecting the exercise to follow in the fashion of a support group. However, I was not prepared for the level of testimony these brave ‘fish’ put forth. They were courageous; it is not easy to stand before strangers and rehash your journey as an individual living with HIV. Hearing how instrumental JASL was in bringing them back from the depths of dark times in their lives, hearing how grateful they were to JASL for providing such a strong social support system, for re-empowering them, guiding them back to health, and to many of them, rekindling the sense of meaning and purpose, was an overwhelming experience that certainly left me, and others in the room, silent with emotion.

In the short 30 mins of the fish bowl exercise, it put in perspective how necessary it is for civil society organisations to not only provide direct services, but to foster an enabling environment where their community members are empowered to transform themselves and others that they know. As I prepared to make the journey back to Kingston, I felt a renewed passion setting in my bones. I looked up at the unmarked building overlooking the bay with a greater sense of appreciation and purpose.

Here it is, this family of professional and passionate individuals, with humble facilities, is guiding lost fish into their bowl of empowerment, and releasing courageous, thriving fish back into the tides of life.

In a short week, JASL has shown me how they form the bowl that transforms their fish. And now, I will go home to form the bowl that will transform our fish in the Bahamas.

Fabulous example of a strong collaboration – South-South Learning Exchange in Jamaica

HIV and AIDS continues to be a huge challenge in the Caribbean region 30 years into the epidemic. We’ve made great strides in reducing new infections and supporting people living with HIV (PLHIV) all across the continuum of care. To have an even greater impact and to reach the UN 90-90-90 goals, we have to strategize and strengthen our partnerships across the Caribbean region.

The JASL study tour held in Jamaica August 8-11th was a fabulous example of a strong South to South Collaboration. We had an opportunity to visit the entire Jamaica AIDS Support for Life operations, benefit from presentations from the talented JASL team members and hear all about the way JASL has partnered with the Jamaican Ministry of Health and other civil society partners. JASL really supports PLHIV from the time of the first HIV test, linkage to care, nutritional support, navigating the health care system and obtaining psychosocial support. Quite a few clients shared with us that JASL enabled them to live healthy lives with HIV and overcome challenges and obstacles. The stories they shared with us were really touching and we even were treated to a poem about HIV, love and support.

We need more strong partnerships like this! Strong partnerships to end AIDS! Congratulations to JASL on the great work you are doing! Cheers and thank you for PANCAP/Knowledge for Health and USAID for supporting The Bahamas, Barbados and Guyana’s participation in this valuable exchange. There is definitely strength in unity! Here’s to our partnerships to end AIDS!

South to South Learning Exchange: the Google for Understanding How to Decrease Prevalence in Key Populations.

As I traveled to Jamaica for a South to South Learning Exchange, my head was full of all the numbers- HIV prevalence of 1.6%, 29,000 persons living with the disease, 81% of these know their HIV status, 43% of those on treatment and amongst those with 61% with viral suppression. I paid particular attention to the data on key populations and noted that Jamaica has one of the lowest HIV prevalence among the sex worker population in the region. In 2014, HIV prevalence among sex workers is 8.7% in Haiti, 5.5% in Guyana and comparatively low, 2.9% in Jamaica. Additionally, Jamaica’s data is suggesting that the prevalence among the population is declining, from 4.9% in 2008 to 2.9% in 2014. I was intrigued- what is different in Jamaica? What is contributing to this success? I had many questions and I was looking for some answers.

We spent the first two days of our four-day South to South Learning Exchange understanding the principles that guide Jamaica AIDS Support for Life (JASL) prevention programmes with a focus on key populations, defined as those having the highest risk of contracting and transmitting HIV. Having received a solid foundation and armed with the theoretical concepts, it was time to see their work in action. With much excitement, we “hit the road”. The teams coming from Guyana, Barbados and The Bahamas were eager to experience first-hand the uniqueness of JASL’s sex worker intervention and I was anxious to get some answers to my questions.

After a long journey, we arrived at “Back Road”. The long stretch of road was dark, with a constant flow of traffic both ways. Loud Jamaican music emanated from well-lit nearby bars. Numerous male patrons were seen hanging around with beer bottles in their hands, but only a few sex workers were standing along the roadside. The experienced JASL team quickly concluded that it was a “slow night” because it was mid-week. Nevertheless, we stopped at a point where there were a few commercial sex workers. JASLs team comprising of their peer navigator and HIV counselor/ tester approached them with ease and confidence. The sex workers willingly engaged the team and shared personal experiences on strategies they have used to protect themselves, including having the lights on. A lot of the discussion was on condom use, focusing on the size of the condoms and use of water based versus oil based lubricants. The peer educators were ready with their responses and once again I saw a condom blown as a balloon demystifying “small condoms”. We stayed for about an hour and a half, spoke with five-seven sex workers and tested four. As we concluded, it was clear to me that the sex workers were well educated on HIV and STI risk reduction and JASLs team has the expertise and experience for this type of work.

We departed “Back Road” at around 11 pm. It had been a long day for us and we were all tired. The bus was quiet – the music low and everyone deep in thought. I felt a renewed sense of commitment to serve the people who need our services most. I acknowledged the challenges of outreach work and had a greater appreciation and admiration for the work of civil society organisations. I applauded the field workers who spend many hours in the evenings combing the venues, seeking out persons to share techniques on the correct and consistent use of condoms, discuss HIV and STI risk reduction and test for HIV.

I drew from my experience as a former National AIDS Programme Manager and thought about a similar sex worker intervention in Guyana. I realized that there were as many commonalities as there were differences. I acknowledge that we are one Caribbean with similar cultures, but when it comes to HIV, the uniqueness of our specific context plays an important role in designing indigenous interventions that will change lives.

As I reflected on my questions, I realized that there is still more that I need to know. A little rest and I will be ready for the Day 3!