The Dominican Republic
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DISCUSSING THE IMPACT OF HISTORY, CULTURE AND ECONOMY ON THE ISSUE OF HIV/ AIDS.
The Dominican Republic is located on the Eastern two thirds of the Island of Hispania. The inhabitants of the Dominican Republic are a mixture and descendant members of the Spaniard, native Dominican, African slaves and European Lineages(1). Like most nations of the world, the Dominican Republic has had its social challenges that stem from the dynamics of the day – in spite of having risen from a generation of revolutions, the Dominican republic has had to extend with the impacts of war in the form of disabilities, orphans and destitution(2). There is one factor however, that has been felt across all social levels, the challenge of the infection and spread of HIV/AIDS.
HIV/AIDS IN DOMINICAN REPUBLIC
The spread of HIV/AIDS in the Latino community has been extensive, affecting thousands of individuals, families and communities. Approximately 80% of the Caribbean region HIV/AIDS cases are a combined nationals of Haiti and the Dominican Republic(3). Take the example of statistics by the Batey Relief Alliance that 8.8%of Dominican loan income women are HIV- positive. This accounts for 2 women in every eleven being positive. The domino effect of HIV/AIDS has left behind orphans and unstable social structures(4). There is significant spread of infections in the population complexed by the highly politicized and unregulated migration patterns. The number of female sex workers in this country is conservatively estimated at 60,000 women; (Kerigan et al 1997). Government statistics portion about 48,000of these women as more likely working out in pubs, brothels and discos. The remaining 12,000 work from public areas like piers, beaches and streets(5). The disease control priorities project report points out that there are racial, economic and social discriminative factors that have systematically increased HIV/AIDS spread and infection. The report estimates that by the end of 2006, the number of people with HIV/aids infection will soar to heights 1.95m count of 2004. More statistics, the prevalence rate of 1.2% for the Caribbean region, in 2005, is only second to that of sub-Saharan Africa according to a joint UNO and WHO report(6).
THE IMPACT OF HISTORY ON HIV AIDS IN THE DOMINICAN REPUBLIC
Originally the Island of Hispaniola, within which the Dominican Republic occupies two thirds, is home to the Dominican Republic occupies two thirds, is home to the Arawak people. These were the first people whom Christopher Colombus encountered(7).
History dealt them a cruel hand, however, when with successive colonizers this Taino population was reduced to a few thousands from a population of a million, and this created one of the most significant factors in the Dominican Republic; being the need for labour(8). The Spaniards bought in African slaves to the Island at the turn of the 16th century (1503). One of the most substansive roles of the African slaves was to work the plantations with subsequent years, political upheavals and change in colonial masters to self-governance. One thing that has had an outstanding impact on the lives of the inhabitants of this Island republic is the creation of social structures (classes)(9).
Whereas the society might appear tolerant to the diversity in culture and descent there is a catch(10). There is practically no recognition by the government or other sectors for people having Haitian descent or born outside the republic in spite of the fact that they might have one of the parents being Dominican(11). In addition most of these Haitan migrant workers whole role is sugarcane cutting and have had to face the challenge of the closure of the sugar mills especially in the Batay (villages). As such most of them have been left jobless without access to medical care, medicine, nutritious foods and proper access to educational facilities(12).
Batays is the large group in the aforementioned 48000 that works the pubs, discos and brothels in search of livelihoods(13). In addition with the advent of population pressure as terms of thousands are left unemployed, and living in destitution, the nutrition status of these Dominicans have changed. Malnutrition and related diseases are rampant and this has weakened both the psyche and immunologic responses(14). It is no wonder therefore that the people of the Dominican Republic earning low income are the ones highly infected with HIV Aids(15).
The Impact of Economics on HIV Aids in the Dominican Republic
The politics of any nation coupled to the history have a great impact on the economy and as such the social trends(16). The Dominican Republic is no different since 1861 when the Dominicans voluntarily returned to the Spaniard rule and later own in 1865 gained independence economic difficulties have plagued them(17). Couple this to the military coups of 1963, 1965 and the subsequent occupation by the united states military forces and it is so obvious that this nation has had its fair share of inflation and object poverty(18).
Take an example of 1988 – 1990 when the Dominican Republic went through a 2-year economic depression, unique to which were the high inflation rates and the devaluation of the (peso) currency(19). It has become hard over the years to recover from these economic challenges and this country has problems with the delivery of essential services like water, electricity and transportation. In spite of the economic reforms that have been instituted even with the IMF support, there has not been a very great change much as inflation is moderate(20). The Dominican Republic is largely on agricultural nation dependent on sugar, coffee, cocoa and tobacco cultivation on one hand and a tourism centre on the other hand. It is this second option of tourism that is responsible for a great number of clientele for frequent the republics brothels, pubs and discos where they mix the Dominicans and accentuate the spread of HIV Aids. Back in May 2003, there was a major banking group collapse ‘Banco Baninter’(21). This banks collapse caused a major economic crisis where losses went upto 2 billion us dollars equivalent to the Dominican’s Republic 15% GDP. In essence this represented 80% of the government’s budget then(22).
The impacts of this were felt by all and sundry who lived within the republic’s jurisdiction. Until today the republic courtesy of the IMF through the standby Agreement is a beneficiary of aid from international organizations, the inter-American Development Bank and the European Union(23). The significance of this cannot be overstressed, with the increase in poverty levels, tourism and a government that is largely under pressure to deliver to its citizenry, HIV Aids infection is possible out of the pursuit for livelihood(24).
In addition HIV spread is perpetuated on one hand out of the inability of the Dominican Republic to deliver on essential services.
The Impact of culture on HIV Aids in the Dominican Republic
There is a historical touch to the cultural beliefs and practices of the republics citizens. As mentioned earlier the workers in the Batays are of Haitian descent.
The main challenge for these Haiti born workers is the aspect of discrimination (if not xenophobia)(25). The Dominican Republic rulers center the fear in the Haitan population living in the Batanys on probable deportation(26). This discrimination and fear is a product of deep-rooted anti-Haitianism that has permeated the Dominican society for years. To shed more light on this Dominican children or offspring born of unregistered (therefore unrecognized) Haitian parents cannot obtain a birth certificate(27). This birth certificate is a ticket to access to essential services like education, health services and eventually jobs.
In essence the Dominican offspring of a non-registered Haitian parent is left ignorant, in utter poverty and consigned to working the sugar mills(28). The stratification of such a society and the poverty that permeates it leaves the Batany Dwellers short of access to health facilities located in communities other than their own. It is no surprise that the Batanys hold the largest group of HIV Aids carriers(29).
The Policy of the Dominican Republic and the USA in relation to HIV Aids.
The two nations have instituted a policy for free and voluntary counseling and Testing that is linked to medical and social services. There are attempts to strengthen the surveillance programs, which assist in developing and modifying HIV / STI and Tuberculosis spread(30). Primary health care approach is advocated to prevent HIV / Aids in Latin America; this is through health promotion and ensuring a strong community component.
1-7 Douglas A, The AIDS crisis, A Documentary History, Greenwood publishing Group, 1998, USA.
8Darrels E,The Amfar AIDS Handbook: complete guide to understanding HIV and AIDS, National Book Company Press, 1999, (USA)
9-12Shelley 9,Forgotten children of the AIDS Epidemic Yale University Press, 1995, (USA)
13-18Anne G, What everyone can do to fight AIDS, Jossey – Bass publishers, 1995, (USA)
19-30Roger C, Answering your questions about AIDS, American psychological Association, 1996, (USA)