Guatemala: Confronting a growing AIDS crisis

An MSF doctor, nurse and health educator travel to various departments near the Mexican border to teach and offer informational sessions on HIV/AIDS to health staff working in public health facilities.

Gaining access to HIV/AIDS medicines was a crucial issue in Guatemala during 2004 and 2005. Following the 9 March 2005 national passage of Decree 31-88 and the July 2004 signing of the US-Dominican Republic-Central American Free Trade Agreement (CAFTA), the region now grants excessive levels of intellectual property protection that can restrict access to essential medicines and make drug prices unaffordable for the vast majority of Guatemalans.

In addition to its direct work with patients, MSF is urging national officials to find ways to ensure greater access to needed treatment and care.

For those who live outside of Guatemala City, HIV/AIDS care is difficult to obtain due to the centralization of care in the capital. To counter this, MSF runs projects in Puerto Barrios and Coatepeque. These are the only two locations outside of Guatemala City where HIV-positive people can receive needed care and treatment. MSF is pushing the government to extend the country's HIV/AIDS program to reach people living in more remote areas of the country.

Today, MSF staff provide HIV/AIDS care at the Yaloc clinic in Guatemala City for approximately 1,800 patients, of whom 740 people were receiving antiretroviral (ARV) medications by August 2005.

In Puerto Barrios, a town in the Izabal department, MSF was providing care to 519 patients as of August 2005, with 219 receiving ARVs. At MSF's HIV project in the town of Coatepeque, near the border with Mexico, MSF staff provide comprehensive care to more than 1,500 people, including 371 who were using ARVs by the end of July 2005.

Prevention efforts are another priority. MSF has trained teachers and has developed sexual-education materials, including information on preventing HIV transmission, which are now being used with more than 3,500 students at 14 schools in Coatepeque. The ministry of education plans to incorporate the teaching material into its regular curriculum at the end of 2005.

An MSF doctor, nurse and health educator travel to various departments near the Mexican border to teach and offer informational sessions on HIV/AIDS to health staff working in public health facilities. The area has a high prevalence of HIV (65 cases per 100,000 people) because a Pan-American transportation route passes through it. MSF is informing communities about the disease to help avoid discrimination against people living with it and to help those in need of care to obtain it.

In June 2005, MSF transferred responsibility for its HIV/AIDS project in Guatemala City's Roosevelt Hospital to the ministry of health. In 2001, the project was the first in the capital to provide comprehensive care for HIV-positive patients.

At the time of the handover, 625 patients were receiving ARVs and more than 2,000 were being followed by the medical staff. MSF will follow the transfer process closely to ensure high-quality treatment and the continuous flow of ARV stocks.

Helping those with Chagas disease and street children

MSF is providing primary health care to people living in Chiquimula department. To ease access to care, the team has rebuilt three area clinics, supports an existing health center and has trained staff members who now work for the ministry of health.

Because Chagas disease is endemic in the area, the team is screening children who may have been infected with the parasitic disease to locate those who are within the early phase of the illness, which is still treatable (see page 75). By August 2005, almost 9,000 children in the Olopa municipality - approximately 46 percent of the target population - had been screened.

For most of 2004, MSF also provided medical and psychological care for children affected by domestic violence or neglect at a therapeutic day care center in Lomas de Santa Faz, a slum on the outskirts of Guatemala City. The project's activities were handed over to a local organization in September 2004.

During 2004, MSF hosted 82 children at the day center, performed 729 psychological consultations for 399 children, and conducted 1,053 medical consultations. In addition, MSF runs a project in Guatemala City that provides free health care and psychological counseling to more than 700 street children and young adults.

MSF has worked in Guatemala since 1988.