BY CHARLES SAVAGE
SAN PEDRO SULA, Honduras -- On the bright yellow wall inside a
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
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
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
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
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
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
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
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
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,
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.''
CULTURE OF INFIDELITY
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.
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
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
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.
`YOU HAVE AIDS'
``I thought he was sick with the mumps or something,'' Karen Campos
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
Kimberly Campos, four, is free of HIV. But her two-year-old brother Andy tested
borderline. He will have to be monitored closely.
CHANCES NOT GOOD
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
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,
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
``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