The Miami Herald
March 26, 2000
AIDS epidemic ravages Honduras
This is the worst health epidemic' ever in Central America


 SAN PEDRO SULA, Honduras -- On the bright yellow wall inside a small
 orphanage here is an infant's handprint. It is Kenia's handprint. A nun traced her
 tiny hand there when she arrived at the Heart of Mercy House in 1998.

 Kenia is now two years old. She is so bubbly and enthusiastic the nuns call her
 the orphanage's ``social director.'' For visitors, she hops up and taps the picture of
 her hand, even though she cannot read her name above it.

 When Kenia dies, a nun will paint a tiny red cross beside the hand. Eleven
 crosses already adorn the wall. Mercy House is a sanctuary for babies and
 children with AIDS.

 ``We don't lose contact when they go to God,'' said Sister Diana Clyne. ``The kids
 here are a family. The little ones take care of each other. In almost every case,
 they lost their parents to AIDS too.''

 The orphanage is a mere footnote in an unfolding tragedy in northern Honduras.
 The HIV plague, some doctors fear, may soon approach the catastrophe of
 sub-Sahara Africa. Here AIDS is the second leading cause of death.

 Violence is first. The third is motorcycle accidents. To grasp that fully, one must
 understand that this is a country where gas station attendants sling AK-47's over
 their shoulders. The routine traffic safety technique for trucks passing on blind
 mountain curves at night is to turn off headlights to see if anyone is approaching.

 ``I believe that this is the worst health epidemic in the history of Central America,''
 said Dr. Carlos Lopez, the executive director of the largest and oldest private
 anti-AIDS organization in Honduras. ``Tuberculosis was bad, but its outbreaks
 were always controlled quickly. This is the big one, with no cure. And our people
 don't have the opportunity to survive. They cannot afford the medicines.''

 Honduras, a haven for sweatshops and prostitution, a region still reeling
 economically from Hurricane Mitch's epic fury 16 months ago, is pathetically
 poor. Eighty percent of its six million inhabitants live below the poverty line.

 Accurate AIDS statistics are hard to come by. Until this year, no one even kept
 score on reported AIDS patients. The government collected numbers from official
 labs, but didn't track what happened. Truer numbers come from hospitals and
 coroners. They count corpses.


 From fear of persecution, many Hondurans choose tests at private labs which do
 not report to the government. Officials and doctors disagree sharply about the

 Lopez, who is president of a coalition of non-government AIDS organizations,
 figures ``there are about 520,000 HIV-positive people in Honduras.'' Using the
 statistical models developed in Africa, that is conservative, he said.

 AIDS figures are like cockroaches: you multiply by some number for every one
 you actually see. In Africa they multiply by 60. Lopez thinks that in Honduras you
 should multiply by 40. ``We are finding new cases every single day. It is not

 Lopez belives that HIV infection in the city of San Pedro Sula alone could be as
 high a 240,000 - nearly half the residents. That's more than 10 times government
 estimates. He argued that Central American governments suppress the true
 figures because they are afraid of hurting tourism.


 Dr. Jerimias Soto, the director of the Health Ministry's AIDS program in
 Tegucigalpa, rejects Lopez's figures.

 ``It is not reasonable -- no way,'' Soto said. The African model to him is
 inappropriate because the epidemic has reached a maturity phase: growth is
 steady, but no longer accelerating. He calculates that roughly 40,000 people have
 the virus, more than three times the 13,000 confirmed and registered cases.

 Although government and private doctors argue about numbers, they work
 together on prevention programs for the most at-risk populations: prisoners,
 homosexuals, sailors, Caribbean blacks, high school students and prostitutes.

 Studies show that the virus is spread primarily through heterosexual sex.
 Women, the fastest-growing category, contract HIV from unfaithful partners who
 refuse to wear condoms. A few years ago HIV men outnumbered women
 three-to-one. Now half are female.


 In the Avenida Lempira, at the heart of San Pedro Sula's streetwalking district,
 prostitutes receive free condoms and medical exams at Proyecto La Sala, a
 storefront outreach center. It is open nightly to serve the illegal but widely
 tolerated sex workers.

 In cheap, tight clothing, prostitutes drift in during a lull in business -- between the
 evening rush hour, when men leaving work pick them up before going home, and
 the late night traffic. Most are teenagers and single mothers.

 The attraction of this dangerous business is clear. Streetwalkers earn between $7
 and $21 depending on the act, while higher-class brothel and nightclub escorts
 can earn upwards of $100 for a night -- a fortune in a country whose minimum
 wage is $92 a month.

 While picking up condoms at La Sala on a recent night, Jenny, a plump
 22-year-old in tight black shorts and a see-through shirt, said, ``Some men offer
 you more money, double, to not use a condom. You can get 300 lempiras [about
 $21]. I don't do it though because my life is not worth 300 lempiras.''


 Alba Mendoza, a high school teacher and volunteer at La Sala since it opened in
 1995, said the spread is partially due to a culture of infidelity -- not limited to the
 husbands who visit brothels.

 ``There are probably 1,500 to 2,000 declared sex workers in San Pedro Sula. All
 classes of women go to bars and allow themselves to be picked up for money.''
 Mendoza said. ``They don't consider themselves prostitutes. They are not
 full-time. It happens at every level, with homemakers. The husbands don't know.''

 The inability to trust in monogamous relationships can be devastating. At Lopez's
 clinic, which serves about 300 HIV patients, Ruifino and Karen Campos recently
 came in for a checkup. They brought their children.

 Ruifino said he used to be a commercial sailor for an oil company until the
 company sent all its workers to a private lab for physicals four years ago. When
 he found out he had the AIDS virus, he got fired. ``I didn't tell anyone, not even my
 wife,'' Ruifino Campos said. ``She only realized a month ago.''

 That was in January, when the lymph nodes on his neck started swelling horribly.
 She pressed him to go to a doctor, but he refused. Instead, he rented a hotel
 room and put a gun to his head, then could not bring himself to pull the trigger.
 Defeated, he returned home.


 ``I thought he was sick with the mumps or something,'' Karen Campos said. ``I
 finally said to him, `Why don't you want to go to the doctor -- Is it because you
 have an incurable disease?' And he wouldn't tell me. I said, `You have AIDS,' and
 he started crying.''

 As she recounted their story, Ruifino Campos held his face in anguish. After his
 revelation, she went to a private lab. She, too, tested positive.

 The couple cannot afford the $2,000 a month it would cost to get them the drugs
 that would prolong their lives, although Karen is optimistic that relatives in the
 United States may help. They are bitter that the government will not pay for it.

 ``Nobody has the economic situation to be able to do anything about it,'' she said.
 ``Too many people here die because they can't buy the medicines.''

 In the four years since his diagnosis, Ruifino continued to have sex with his wife
 without a condom. ``I didn't reject him,'' Karen Campos said. ``I started crying. He
 said `don't be like that.' I told him afterward `it doesn't matter - what's important in
 this thing is to get better. Think of the children.' ''

 As they talked, their children squirmed on their laps, too young to understand.
 Kimberly Campos, four, is free of HIV. But her two-year-old brother Andy tested
 borderline. He will have to be monitored closely.


 After they left, Lopez said that their chances were not good. Because they cannot
 afford medicines, the odds are that both parents will die within five years. If
 relatives do not take them in, Kimberly and Andy Campos will be sent to an

 That scenario, played out uncounted times, places a heavy burden on facilities
 like the Heart of Mercy House. Originally founded in 1995 for ten HIV-positive
 children, the orphanage currently houses twice that number. Regularly it turns
 away new cases. Its space is so strained that when a child gets sick, the nuns
 cannot isolate him.

 Barely able to afford sufficient anti-viral medications at a cost of $5,000 a month,
 the nuns nevertheless are buying the house next door to expand. They feel they

 Besides funds, they need disposable diapers, tee shirts, socks, medications like
 Tylenol for children, basic antibiotics, children's books, children's videotapes.

 Mainly, though, they just want time: time to go to school like normal kids, even if
 they must take plastic gloves in their backpacks for their teachers in case of a
 skinned knee.

 ``Each child makes us realize that every moment is precious and that God has
 given us this moment to share with others and have joy,'' said Clyne, the nun.

 ``In explaining to the children the concept of living with an illness, we talk about
 living and dying. All of us will die. They will die from this illness.''

                     Copyright 2000 Miami Herald