November 1-2 20128th BC Gay Men’s Health SummitReconsidering Social Determinants Vancouver Voices of the Most-At-Risk Populations (MARPs) of Jamaica By Jean Claude Louis, project consultant Vancouver Initiative
Jamaica• Jamaica is home to several tourist attractions.• 2.5 million Jamaicans and Jamaican descendants live abroad while 2,868,380 live in Jamaica(World Fact book 2011).• Jamaica is facing many challenges due to the deterioration of economic conditions.• Relies mostly on multilateral funding. Owes US$ 18 billion to IMF. 140% of its GDP(comparable to Greece.• Poverty and marginalization continue to affect large segments of the population
Public Health Challenges• HIV and AIDS stand as one of the biggest threats to the Jamaican & human development.• The first case of AIDS identified in 1982• By 2005 AIDS was the fourth leading cause of death among all Jamaicans• Between Jan. 1982 & June 2007: 12,063 cases of AIDS were diagnosed;6,848 people died as of AIDS-related illnesses. (National HIV/AIDS Control Programme, Ministry of Health/Panos Guide)
What is the actual situation?• Today, Jamaica has an estimated HIV prevalence rate of 1.7 percent. UNAIDS estimates that there are 32,000 Jamaicans living with HIV of which just over 6,000 are currently on treatment National HIV/AIDS Control Programme. (Call for Concept Papers - HIV/AIDS Prevention for Most-At-Risk Groups in Jamaica)• HIV remains a complex issue among the Most-At-Risk populations (MARP), Sex workers, vulnerable youth and particularly Gay men & Men having Sex with Men (MSM).
The situation of the MARPS• HIV prevalence is highest among MSM and among sex workers, compared to any other most-at-risk population• The HIV prevalence among MSM varied from 6.1% in the Dominican Republic to 32% in Jamaica and 18.1 % in Haiti. (SW:4.5%;homeless:8%• Jamaica has the highest HIV prevalence rate among MSM in the Caribbean and at number two in the world. Only Kenya with 43 percent has a higher prevalence rate.(UNAIDS,2010)
Issues affecting Gay men, MSM1. Being MSM/Gay men and HIV positive carries double stigma2. Stigma and discrimination, coupled with the legal issues pertaining to homosexuality and general homophobia prevent MSM/Gay men from accessing early needed health care3. Very difficult to provide information needed to prevent the spread of HIV4. High murder rates amongst the Lesbian, Gay, Bi-sexual and Trans-gendered (LGBT) community : 30 gay men were murdered between 1997 and 2000.5. Police do no compile statistics on attacks against gay men/MSM and lesbians. In 2010 alone, Jamaica Forum for Lesbians, All- Sexuals, and Gays (J-FLAG) received more than 40 reports of attacks on persons in Jamaica based on their sexual orientation.
Issues affecting MSM/Gay men.• The Charter of Rights passed by both Houses of Parliament (March 2011) guarantees certain fundamental rights which were never before protected in the Constitution, but Gay men/MSM ignored.• Both legislators or public defenders ignored argument from MSM advocacy groups for the repeal of legislation that bans gay adults from exercising their sexual preference .(Jamaica Gleaner)• Police continue to harass MSM for their sexual orientation. They raided many times the 2 existing gay bars. Victims (anonymously) have to search medical treatment for injuries sustained in the attacks. (http://therainbowpost.com/2011/03/01/jamaican-gay-bar-raided)
Responses• The response to HIV and AIDS in Jamaica is one of the strongest in the Caribbean, however• Stigma, discrimination, violence; generalized homophobia remain the greatest barriers for MSM to access to prevention and care.• Fear drives a great many MSM underground and into heterosexual relationships as a means of social and economic survival.• They are kept away from health services where their needs can be effectively met• As a result MSM, gay men, Sex Workers & their clients are becoming more and more vulnerable and form the MARPs.•
PK communication initiative• To strengthen the capacities of MSM/Gays to advocate and create awareness about the issues affecting them• Trigger real change and raise awareness among policy makers and stakeholders and the general society.• Fight discrimination and stigma against MSM and promote gay’s men health.• Promote, through the media, tolerance and accountability towards MSM in the response to HIV.Support and hold focused activities among journalists & MSM.
Some Key activities•Baselines collection on media’s treatmentand coverage of MSM issues•Media training for print &broadcasters/editors involving stakeholdersand MSM•Media fellowships•Stakeholder consultations (health providers,legislators, media) & government on OT•A team of journalists & officials to exchangewith Vancouver around WAD(Nov. 26-Dec.1)
OT,a key tool in Panos work•Panos utilizes Oral Testimonies as a key value in itscommunity work to amplify the voices of those whoseeconomic, social and/or educational position hasexcluded and marginalized from the circles of influenceand power.•Panos has trained and supported several vulnerablegroups to HIV and AIDS, such as sex workers and youthinfected or affected by HIV, and youth living in areasprone to child trafficking, in using oral testimonies tocommunicate their concerns and perspective to mediaand policy makers. Their own voices encourage publicdialogue and debate
Oral Testimonies For MSM/Gaymen• To build and strengthen the capacity of MSM/ gay men in Jamaica to communicate their concerns through innovative communication technologies(photo voice, digital media, blogging, social media)• The OT collection will highlight issues affecting Gay men’s health through their own voices and provide first accounts to policy makers and stakeholders.
The process• Three workshops targeting thirty-six (36) MSM selected by the partners and through Panos screening are trained in 3 main cities• Every MSM/Gay man trained will collect a set (5-10) of testimonies
Why MSM collect the OT• In the best situation to do it as they are affected by the same issues.• Highlight the diversity and multiplicity of views and responses from various backgrounds• Provide firsthand accounts of the affected groups while ensuring complete anonymity.• Encourage public debate and dialogue• Produce powerful and realistic evidence of the less visible• Opportunity to convey their stories to a wider audience
Jona, 15 was expelled a year ago from school because he was too effeminate. Hedescribes reactions from school, community, families, and friends and how he accepts hislife like an effeminateDo you believe that the buggery law will ever be reviewed, as said by the present prime minister?“I think she’s joking. Any prime minister who comes and says that they also are going to do that, they could also be joking. Because there’s a face off into that. They could be looked upon, they might not win elections again. The mass in Jamaica are heterosexual. Anyone who comes and wants to change it, must be careful of what he or she is doing and has to do it slowly and gradually.”
Zuma is a 36 year old security guard. He is MSM and shared his views towards transactional sexwithin the MSM communityWhy many MSM conduct transactional sex, whether under cover or openly, Zuma views towards this issue stated…“Financial gains of course. Many of them have been turned out by their parents and they have bills to pay for example light water, rent etc…so therefore they have no other alternative but resort to this, they’re sort of limited.” About MSM being brutally murdered while conducting transactional sex… “It is not a good feeling for sure. Because they are human beings and whatever they are doing, I believe there’s a reason. Yes, they are human beings and the way in which they are treated…it is not right. As a MSM, I’m not comfortable seeing the abuse and disregard of our lives in that sort of way.”
“Teach” is a 31 year old gay teacher that shares his views on MSM behavior towards education. He said it’s very important to get an education Do you believe that the government is doing enough to help these MSM towards education?“Listen, remember the society we live in. Remember we live in Jamaica! Andthe government hands are tied, so to speak. You are asked….I know that youmust have a Joshua, you must have a Moses. You must have somebody who isgoing to stand out one day and be the different person in the group. But who‘sgoing to do that? Portia Simpson Miller tried it, but persons are pressuring her togo back on her word that she said about the buggery law. I don’t see thebuggery law changing for now. I wouldn’t say the government is not doinganything, but remember that we got a law of the country. And right now,homosexuality is illegal…...
Javed is among the fortunate and was very inspiring . He’s studied abroad and back to serve Jamaica. Advises to young MSM and how homophobia help him to excel in his studies .First of all, I think I would be lying if I say everybody oranybody can overcome the challenges that homophobiabrings and can excel. I think it really does take a toll on youwhen you are being ostracized by your peers andunfortunately unless there are structures put in place tosupport people and to encourage them, a lot of people willbe left behind, because of their gender identity. At the sametime I have been able to use homophobia as my motivation. If I wasn’t lucky enough to realize that through education Icould find a way to leave Jamaica and escape the trappingsof our conservative Christian culture that legitimizesdiscrimination, I would have never worked as hard……….
Expected results•Expanding local & international awareness andenhancing public debate through informationsharing•Stakeholder consultations (health providers,legislators, media) around government policy aboutthe Ots•Publication and distribution of 500 booklets of OralTestimonies region wide•Improved understanding of MSM situation by themedia and the society & policy change
Everyone should be able to livehis life with respect and dignity
REAL PEOPLE – REAL VOICESThe mission of PK is to amplify the voicesof the poor and marginalized and ensuretheir inclusion in public policy debate toenable Caribbean people, wherever theyare, to exercise their human rights andcommunicate their own developmentagenda.
Panos Caribbean is firmly headquartered in Haiti & Jamaica with satellite offices in theNetherlands and other caribbean countries Contact : haiti@ panoscaribbean.org email@example.com