What's Behind The Alarming Rise In HIV Infections Among The Indigenous People Of Panama : Goats and Soda In many parts of the world, the rate of HIV infection is declining. But not among the indigenous peoples of this Central American country.
NPR logo

What's Behind The Alarming Spike In HIV Infections In Panama?

  • Download
  • <iframe src="https://www.npr.org/player/embed/607551772/629703810" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript
What's Behind The Alarming Spike In HIV Infections In Panama?

What's Behind The Alarming Spike In HIV Infections In Panama?

  • Download
  • <iframe src="https://www.npr.org/player/embed/607551772/629703810" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript

NOEL KING, HOST:

In a rugged corner of Panama, a disease that is under control in much of the world is spreading at a troubling rate. AIDS is now the second-leading cause of death among the country's biggest indigenous community, and the spike in HIV is being seen across indigenous populations in Central America. Jacob McCleland of member station KGOU explains what's going on.

JACOB MCCLELAND, BYLINE: A short man with a ponytail peaks through a crack in a sheet metal fence, calling out to see if anybody's home.

DARIO GARCIA: (Speaking Spanish).

MCCLELAND: His name is Dario Garcia, and he's checking on some HIV patients to make sure they're taking their meds.

UNIDENTIFIED PERSON: (Speaking Spanish).

GARCIA: (Speaking Spanish).

MCCLELAND: Garcia walks through the muddy yard past chickens and scrawny dogs to the cinderblock house.

GARCIA: (Speaking Spanish).

MCCLELAND: Two men, both indigenous and HIV positive, live here. At first, they want to talk to Garcia until they spot somebody outside. They clam up. One man backs into the corner of the room. If he could dissolve into the wall, he would. Nobody else in the household knows they have HIV, and the men are afraid to be overheard. Garcia quickly changes the subject. A few minutes later, we leave.

GARCIA: (Speaking Spanish).

MCCLELAND: Garcia is a volunteer who checks the well-being of patients. He says he still finds people who are afraid to be around any talk of HIV. They'll automatically shut down. That's how strong the stigma is. He knows this firsthand. He, too, is HIV positive.

GARCIA: (Speaking Spanish).

MCCLELAND: He says the greatest discrimination for somebody with HIV can come from their own family. Garcia is an ethnic Ngabe, the largest indigenous group in Panama, and he's heartsick about the crisis his people are facing. In other parts of the world, the rate of HIV infection is on the decline. Here, it's spiking. About 150,000 people live in the Comarca Comarca Ngabe-Bugle territory. And HIV/AIDS is now the second-leading cause of death here. Arlene Calvo is a research professor at the University of South Florida's Panama City campus. She says HIV was unheard of in the Ngabe's territory until recently. The first case wasn't identified until 2001, decades after the virus first ravaged other parts of the world. And now that it's here, it's entrenched.

ARLENE CALVO: It went from having just a few cases to after a few months having a hundred identified cases and probably a year after that having over 500 cases.

MCCLELAND: Calvo says there are many more who haven't been detected, and others are so sick when they're first diagnosed that there's no way to treat them.

CALVO: You have to understand that this is a very rural area, not comparable to rural U.S.

MCCLELAND: The terrain is mountainous, and many communities aren't connected by roads. Blood tests must be administered in a hospital by a lab technician, which can mean an eight to 10-hour trip, much of it on foot. Calvo says this is one of the biggest barriers to controlling the outbreak.

CALVO: Even if you're healthy, it is very difficult. Imagine being sick and trying to do this.

MCCLELAND: Many Ngabes with HIV get treatment at the clinic in the little town of San Felix. The doctor here is Cesar Gantes.

CESAR GANTES: (Speaking Spanish).

MCCLELAND: He says the region is a breeding ground for HIV because there are no places to buy condoms. And while treatment's free, only about half of Gantes' patients continue with it largely because they don't have money for transportation.

GANTES: (Speaking Spanish).

MCCLELAND: Another barrier - sex education in Panama is banned. Indigenous communities across Latin America are seeing a similar spike. And in Panama and Honduras, the prevalence of HIV is as much as six times greater than among the general population. Anthropologist Patricia Ponce says indigenous people in these countries are at a higher risk for infection because they often migrate to find work.

PATRICIA PONCE: (Speaking Spanish).

MCCLELAND: She says when men travel for work, they sometimes diversify their sex practices, including sex with other men.

PONCE: (Speaking Spanish).

MCCLELAND: And women who leave their communities can often end up in the sex trade.

MENDOZA: (Speaking Spanish).

MCCLELAND: Thirty-one-year-old Mendoza is sitting on a bench underneath a mango tree in a park in the town of Tole. He knows that people with HIV can be shunned, so he doesn't want to use his full name.

MENDOZA: (Speaking Spanish).

MCCLELAND: He doesn't want another person to live through what he has. He's studying to be a teacher so he can help younger generations of Ngabe. At the same time, Mendoza is more fortunate than many HIV patients here. He still lives in his village, and his family, especially his mother, is supportive.

MENDOZA: (Speaking Spanish).

MCCLELAND: "She has supported me in everything," he says. Others aren't as fortunate. Dario Garcia, the young man we met earlier, says he doesn't have the support of his parents because he's also gay.

GARCIA: (Speaking Spanish).

MCCLELAND: He feels alone, he says.

GARCIA: (Speaking Spanish).

MCCLELAND: The people he helps, those who have been diagnosed with HIV, they are his real family now. And he dreams they won't have to live through the same pain. For NPR News, I'm Jacob McCleland in Santiago, Panama.

Copyright © 2018 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.