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The Zombie Curse: A Doctor's 25-year Journey Into the Heart of the AIDS Epidemic in Haiti (2006)
Joseph Henry Press (JHP)

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299
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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti

Index

A

Access to health care

fear of AIDS and, 28, 37–38

HIV transmission and, 285–286

immigration policies and, 12, 25, 40, 41

poverty and, 4–5, 39, 74, 132

resource problems, 73–74

scope of AIDS pandemic and, 73

short-term vs. long-term programs, 164

Special Immunology Clinic and, 12

transportation issues, 25, 39

AIDS. See also Fear of AIDS;

HIV transmission

access to care, 73, 285–286

activists and activism, 72

and blindness, 47, 48, 50, 51, 53, 54, 55

common characteristics of patients, 11

confidentiality issue, 129

costs of treatment, 95, 284, 285–286

death and dying, 26, 28, 56, 57, 64, 66–67, 71, 73, 74–75, 80, 83–84, 85–86, 143–144

dementia/mental deterioration, 64–65, 78, 79–80

emergence, xvii, 71

emotional support for patients, 28, 37–38, 41–42, 51, 56

employment issues, 35, 41, 64, 70, 78, 83–84, 285–286

growth of epidemic, 16, 71, 73, 92–93

in Haiti, 117, 128–129, 130, 155, 171, 184, 195–196, 197, 211, 218, 220–221, 231, 233

Haitian refugees, 7–17, 24, 25–26, 35, 40, 44, 46, 50, 64, 74, 95

in homeless people, 74–75, 84, 87–97, 100–101, 129

homosexual transmission, xvii, xviii, 12, 16, 17, 24, 28, 30, 35, 38–39, 44–45, 50, 59, 64, 65–66, 69, 74–75, 76–86, 93, 100–101, 128, 143

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299

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Index A Access to health care fear of AIDS and, 28, 37–38 HIV transmission and, 285–286 immigration policies and, 12, 25, 40, 41 poverty and, 4–5, 39, 74, 132 resource problems, 73–74 scope of AIDS pandemic and, 73 short-term vs. long-term programs, 164 Special Immunology Clinic and, 12 transportation issues, 25, 39 AIDS. See also Fear of AIDS; HIV transmission access to care, 73, 285–286 activists and activism, 72 and blindness, 47, 48, 50, 51, 53, 54, 55 common characteristics of patients, 11 confidentiality issue, 129 costs of treatment, 95, 284, 285–286 death and dying, 26, 28, 56, 57, 64, 66–67, 71, 73, 74–75, 80, 83–84, 85–86, 143–144 dementia/mental deterioration, 64–65, 78, 79–80 emergence, xvii, 71 emotional support for patients, 28, 37–38, 41–42, 51, 56 employment issues, 35, 41, 64, 70, 78, 83–84, 285–286 growth of epidemic, 16, 71, 73, 92–93 in Haiti, 117, 128–129, 130, 155, 171, 184, 195–196, 197, 211, 218, 220–221, 231, 233 Haitian refugees, 7–17, 24, 25–26, 35, 40, 44, 46, 50, 64, 74, 95 in homeless people, 74–75, 84, 87–97, 100–101, 129 homosexual transmission, xvii, xviii, 12, 16, 17, 24, 28, 30, 35, 38–39, 44–45, 50, 59, 64, 65–66, 69, 74–75, 76–86, 93, 100–101, 128, 143

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti infants/children with, 45, 63–64, 73, 97, 257–258 insurance coverage, 285–286 intravenous drug users, xvii, 50, 58–59, 62–65 isolation of virus, 36, 69 long-term survivors, 100–101 media sensationalism, 24, 35, 36–37, 72 in Miami, xvii, xviii, 7–17, 100–101, 129 New York City, xviii, 24, 82, 258 occupation cases, 18, 22 opportunistic infections, 7–10, 11, 12, 14–15, 16, 18, 20, 26–28, 37, 38, 58, 62, 66, 73, 78; see also individual diseases and types of infections Petri dish theory, 128–129, 130, 131, 287 politicization, 36–37, 95 poverty and social issues and, ix–x, xiv–xv, xix, xx, 10, 26, 47, 64, 73–75, 89, 128–130, 132, 143–144; see also Prostitutes and prostitution projections, 72–73 religious views about, 28–30, 46–47, 48–49, 97 risk factors, xx, 17, 36, 50, 73–74, 129–130 San Francisco, xviii seroprevalence, 92–93, 284 sexual assault/exploitation victims, 93, 128 stigmatization and persecution of victims, xx–xxi, 28, 35, 50, 51, 54–55, 143, 184 T-cell counts, 20, 21–22, 25, 47, 97 testing and counseling, 71–72, 92, 93, 129, 193 treatments, 18, 19, 41, 48, 60, 69, 70, 72, 95, 284, 285–286 vaccine, 69 “worried well,” 58–59, 69 zombie curse theory, 129, 131 Affluence, health problems related to, 288–289 Akamil, 290, 291 American Association of Medical Colleges, 100, 148 Angelou, Maya, 297 Antiviral agents, 70 Aristide, Jean-Bertrand, 105–107, 124, 135–136, 140, 231, 232, 270, 280, 281, 286 Au Basse, Haiti, 151, 155, 156 AZT (zidovudine), 71, 95 B Bactrim, 18, 19, 62 Baille Touribe, Haiti, 183–184, 235 Baker Act, 99 Bassin Bleu, 207–208, 210, 211, 212 Bercail Bon Berger (Sheepfold of the Good Shepherd), 217–222 Black Caucus (U.S.), 106 Black Death, 73, 74, 129 Blindness, 47, 48, 50, 51, 53, 54, 55 Blood cryoprecipitate contamination, 95 experiments, 25–26, 31 Boucan Carrè, Haiti, 235 Boucantis, Haiti, 272 Breda plantation, 251 Brothers of the Good Shepherd, 88, 136, 137–139, 217–222, 244–245, 246 Buddhism, 34, 80

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti C Camillus Health Concern, 87, 88, 89–91, 98–102, 126 Camp Perrin, Haiti, 152 Cancer, 274 Cange, Haiti, 163, 164, 165, 171, 175, 183, 235, 258, 259, 260, 261, 281, 283, 291, 292 Cap Haitien, Haiti, 114, 161, 188, 230, 231, 244, 245, 246, 247, 251, 253, 259, 270, 280–281, 282, 286, 291 CARE, 283 Carrefour, 245, 246 Castro, Fidel, 3 Cataracts, 240–241, 245 Catholic Charities, 46, 55 Catholic Church, 33, 34, 125, 131, 217, 235 Cayémites, Haiti, 151, 155 Cellulitis, 261 Center for Haitian Studies, 243 Center for Humanitarian Medicine, 267 Centers for Disease Control, 18, 24, 34–35, 93 Central Intelligence Agency, 119, 270 Central nervous system infections, 8, 9, 11, 26–28 Children. See Infants and children, Haitian Chloroquine, 156 Christian fundamentalists, 28–29 Christian theology, homophilic origins theory, 29–30 Citadelle, 251 Cité Soleil, Haiti, 123–132, 133, 134, 144, 147, 151, 171, 217, 241 Clinton, Bill, 107 Clinton, Hilary, 185–186, 188, 189–190 Columbus, Christopher, 246 Communism, 232 Community health workers/accompagnateurs, 234–235, 249, 258, 262–264, 265, 281, 287–288 Congenital rubella, 240–241, 245, 257 Croix des Bouquets, Haiti, 161, 230, 232, 233 Croix Rondo, 271–279 Cuba, 232, 283 Cuban refugees, 3, 45, 74 D Death and dying, AIDS patients, 26, 28, 56, 57, 64, 66–67, 71, 73, 74–75, 80, 83–84, 85–86, 143–144 Decouze, Haiti, 199, 201, 207 Deforestation, 111, 165, 283–284 Dementia/mental deterioration, 64–65, 78, 79–80 Dentistry and dentists HIV transmission, 18, 22, 71 Project Brossé-Dent, 219–220 in Thomonde, 294–295 Diarrhea, 177–178 Doctor-patient relationships, 228 Dominican Republic, 163, 169, 171, 179, 278 Duvalier, François (“Papa Doc”), xviii, 124, 140, 164, 232, 233, 270 Duvalier, Jean-Claude (“Baby Doc”), 106, 140, 270 E Economic embargoes and, xiii, xiv, 106, 107, 109, 115, 123, 133, 136

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Electricity, 133, 146, 151, 152, 154, 159, 164, 166, 183, 193, 197, 253, 282 Elephantiasis, 274 Employment issues AIDS and, 35, 41, 64, 70, 78, 83–84 in Haiti, 171, 175, 179, 181, 191, 192, 216 homelessness and, 91, 94–95 F Family planning, 173, 261, 291 Farmer, Paul, 161, 163–164, 165, 171, 172, 175, 286, 287, 291–293 Fauci, Anthony, 70 Fear of AIDS and access to care, 28, 37–38 families of patients, 37–38 patients, 30–31 physicians and health care workers, 28, 37, 58–59, 60, 71–72 and violence, 47–48, 50 “worried well,” 58–59, 69 Fonds Verrettes, Haiti, 282 Fonkoze, 290 Fort Liberté, 252 Fungal infections, 11, 16 G Gallo, Robert, 36 Gates, Bill, Sr., 190 “Gay-Related Immunodeficiency Disease,” 12, 16, 28, 30 George Washington University, 292 Global Fund to Fight AIDS, Tuberculosis, and Malaria, 287 Gonaïves, Haiti, 282, 283, 284 Grande Plaine du Nord, 251 Grande Riviere du Sud, 208 Green Family Foundation, 233–234, 257, 259, 263 H HAART (Highly Active Anti-Retroviral Therapy), 182, 285–286 Haitian AIDS study blood experiments, 25–26, 31 limitations of, 35–36 opportunistic infections and, 10, 11–12 stigmatization of Haitians, x, xix, 131, 224 Haitian life and culture. See also Infants and children, Haitian; individual places affluence in, 121–122, 156, 200 African influence, 13, 33, 121, 220 agriculture, 162, 200, 209, 284 AIDS epidemic and, 117, 128–129, 130, 155, 171, 184, 195–196, 197, 211, 218, 220–221, 231, 233, 265, 286–287 alcohol and drug use, 92 artisans and artistry, 6, 114, 142, 149, 166 attitudes about life, 153, 157, 159, 236–237, 264, 293 Bassin Bleu, 207–208, 210, 211, 212 begging and beggars, 112, 113, 114, 119–120, 125, 126–127, 130, 134–135, 208 bicentennial, 280 black market, 123, 160 blood brothers, 26, 50 boats, boat building, and fishing, 6, 151, 154–155, 156, 210

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Carnival, 145, 209 charity, 121–122 Christian beliefs and practices, 21, 22, 33, 131, 134, 136–137, 143, 200–201, 202, 209, 235–236, 242 civil war, 120 climate and, 112–113, 142, 271, 273, 282, 283–284 Clinton (Hilary) visit, 185–191 coastal villages, 151–157, 192–197, 207–212 community health workers, 234–235, 249, 258, 262–264, 279 costs of health care, 206 crime and punishment, 34, 170–171 death rates, 111, 235 deforestation, 111, 165, 283–284 dress and undress, 6, 134, 136, 137, 153, 162, 188, 202–203, 206, 213 economic embargoes and, xiii, xiv, 106, 107, 109, 115, 123, 133, 136 economy, 282, 290 elections, 231, 282 electricity, 133, 146, 151, 152, 154, 159, 164, 166, 183, 193, 197, 253, 282 employment issues, 171, 175, 179, 181, 191, 192, 216 endemic diseases, 17, 111, 117, 155, 156, 160, 165, 170, 172, 175, 181–182, 184 family life, 92, 115, 117, 125–126, 135, 152, 153, 156, 163, 167–168, 171, 221, 239 French influence, xxi, 13, 33, 34, 111, 120, 121, 135, 166, 186, 207, 220 gangs, 170, 171 government and politics, xiii, xviii, 105–107, 111, 120, 123–124, 135–136, 140, 149, 152–153, 164, 170, 188, 213, 216, 217, 231–232, 233, 234, 243–244, 245, 247, 248, 251, 270, 272, 273, 280–284 health care system, xii, xiv–xv, 18, 22, 73, 107–108, 109, 112, 115–118, 123, 124, 125–126, 137, 142, 151, 156, 158, 159, 160, 165, 166, 171, 173, 175, 186, 197, 199, 252–253, 288 health fairs and, 169–184, 192–197, 203–206, 207, 214, 215–216 homelessness, 123–132, 142, 282, 287 housing and furnishings, 152, 153, 156, 163, 165–166 human rights, xiv–xv, 270 humanitarian medicine and, x–xi, xii, 107, 109, 112, 115, 118–119, 123, 124, 125, 133, 136, 151–157, 232; see also Project Medishare international aid, xiv, 164, 189, 231, 233, 281, 283, 286, 290 Lac Péligre (Danger Lake) project and, 162, 163, 164, 270, 284 land as birthright, 164, 231, 289 language, 5, 12–13, 15, 21, 51, 115, 121, 142, 169, 183 literacy, 111 malnutrition, 153, 160, 170, 172, 173, 179, 181–182, 184, 194, 218, 241, 273 markets and sidewalk industry, 114–115, 124–125, 135, 154, 162, 201, 219, 246, 251, 282 media portrayal of, 170, 234, 243–244, 248, 256, 273, 280, 281

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti medical education system, 185–191, 254 midwives (fanm saj), 190, 263, 276 missionaries and missionary work, 21, 107, 108–109, 117, 119, 137–139, 141–143, 152, 181, 217–222, 283 museum, 142 music and dancing, 132, 133, 139, 166, 179, 180, 220, 236, 238 Neptune ferry boat disaster, 119, 218 old people (granmoun), 173–174 plantation economy, 232 police, 171, 276 politeness and hospitality in, 137–139, 157, 160, 166, 209, 218–219, 265, 293 poverty, 6, 111, 112, 113, 119–120, 121, 123–132, 144–145, 151, 153, 155–156, 164, 171, 191, 218, 239, 284 prostitution, 171, 197, 210–211 richness and contrasts, xxi, 134, 136, 145, 246–247, 261, 266 in rural areas, 141–144, 151–157, 159, 162 sanitation issues, 113, 114, 116, 117, 124–125, 128–129, 134, 151, 152, 193, 282 sexual practices and taboos, 14, 35–36, 44, 52–53, 54, 70, 82 slavery and slave revolt, xiii, xvii, 33, 34, 120, 121, 124, 135, 166, 203, 232, 250, 251 social class structure, x, 51–52, 120–122, 135–136, 252, 254 Spanish influence, 166 sports, 149 squatters’ settlements, 208–209, 251 stigma and shame of disease, 181, 184 symbolism, 200–201, 235 Ton Ton Macoutes, xviii, 161 tourism and, 120, 192, 197, 200, 208, 211, 233, 246 trade, 152 transportation and roads, 113–114, 118, 151, 152, 153–154, 160–162, 163, 169, 171, 183, 188, 199–200, 230, 232, 246, 272–273 twins (marasa), 195–196 United Nations intervention, 107, 133, 211, 231, 272, 278, 282, 283 U.S. foreign policy, xiii–xiv, xxi, 105–107, 119, 164, 232 U.S. military in, 105, 107, 112, 116, 123, 281 violence, x, 170, 217, 243–244, 245, 247, 248, 270, 272, 273, 278, 280–284, 286–287 Voodoo practices and beliefs, xiii, 6, 7, 16, 32–34, 35, 119, 134, 165, 166, 178, 184, 199–206, 242, 250, 263–264, 266, 275, 277, 280, 283 water supply, 133–134, 146, 151, 152, 154, 156, 180, 193, 197, 279 weddings, 153 women’s status and roles, 133–134, 137, 141, 152, 162, 171, 182, 190, 201–202, 210–211, 219, 234, 283, 287 Haitian refugees and Haitian Americans access to health care, 12, 25 AIDS epidemic, x, xvii, xix, 7–17, 24, 25–26, 31, 35–36, 40, 44, 46, 50, 64, 74, 95, 131, 224 Americanization of, 131, 171 blood donation, 95

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti communication problems, 12–13, 15, 21 education of medical personnel about, 32–33 homelessness, 92 immigration issues, 40, 41, 42, 44, 46, 47–48, 68 Miami community, xvii, 3–6, 35, 92, 106, 131, 134, 148, 158–159 New York City community, 24, 171 ocean crossings and interdictions, 3–4, 6–7, 43–44, 68, 154, 231, 233 opportunistic infections, 7–10, 11, 12, 14–15, 16 personal characteristics, 5–6, 12–13, 19–20, 21, 92 poem, 297 poverty and health issues, 7, 9, 10, 26, 40 prostitution, 44 stigmatization and discrimination, xix, xxi, 13–14, 26, 110 violence against, 47–48 volunteering in Haiti, 108, 109, 112, 123, 131, 132, 135, 139, 140, 142, 145, 147–148, 149, 193–194, 224 Harvard University, 260 Center for Health and Social Justice, 269 Health care workers with AIDS, 18, 22, 71, 74–86, 143–144 availability for treating patients, 73 barefoot doctors of China, 249 community accompagnateurs, 234–235, 249, 258, 262–264, 265, 279, 281, 287–288 criticisms of, 30, 36, 72 and cultural sensitivity, 35, 36, 52–53 emotional toll on, 28, 41, 56, 60–61, 77, 110, 143–144, 146–147 fear of AIDS, 28, 37, 58, 60, 71–72 and gay patients, xvii, 38, 52–53, 70, 77 midwives (fanm saj), 190, 263, 276 stereotyping and labeling, xvii, 35, 36, 223–229 testing for AIDS, 71–72 violence against, 72 Health fairs in Haiti, 169–184, 192–197, 203–206, 207, 214, 215–216 Heart murmurs, 244 Hemophiliacs, 50, 95 Hepatitis, 11, 22 Herpes virus, 11, 58 Heterosexual transmission, xvii, 11–12, 50, 58–59, 62–65, 72, 82–83 Hinche, Haiti, 166, 170 HIV transmission access to care and, 285–286 blaming/scapegoating, xvii, 12, 24, 28, 35, 36, 52–53, 128, 143 hemophiliacs, 50 heterosexual, xvii, 11–12, 35, 50, 58–59, 62–65, 72, 82–83, 93 homosexual, xvii, 12, 17, 24, 28, 35, 44–45, 50, 69 immigration policies and, 285 maternal–infant, 45, 63–64, 65, 254 myths about, x, 35, 44–45, 83, 128, 143 occupational, 18, 22 poverty and, ix–x, xiv–xv, xix, xx, 10, 26, 47, 64, 73–75, 128–130, 132, 143–144, 284–285

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti prevention, xii, 79, 129, 254, 286 prostitution and, 72, 75, 89, 93–94, 96, 132, 144, 284–285 risk factors, 17, 50 routes, xx, 22, 35, 54–55, 63–64, 71, 82 substance abuse and, xvii, 50, 58–59, 63, 75, 89, 93–94, 96, 289 vectors in Haiti, 171, 211, 233, 286 violence and, 286–287 Homeless and street people AIDS “Ninjas,” 74, 75, 84, 87–97, 100–101, 129 billing for health care, 100 Camillus Health Concern, 87, 88, 89–91, 98–102, 126 in Haiti, 123–132, 142, 282 immigrants, 89, 92 prostitution, 89 recovery and employment, 91, 94–95 shelter, 87, 88, 90 substance abuse and mental health issues, 87, 88, 89, 98–99, 129 Homosexuals and homosexuality AIDS, xvii, xviii, 12, 17, 24, 28, 30, 35, 38–39, 44–45, 46, 50, 59, 64, 65–66, 69, 81 attitudes toward, xvii, 28–30, 38–39, 52–53, 59, 70, 77, 81, 82, 86 Christian theology and, 29–30 “gay plague,” 12, 16, 28, 30 Haitian men, 35–36, 44, 52–53, 54, 70, 82 opportunistic infections, 11–12, 28–29, 45, 69 physicians, 74–86 sexuality, 81–82 Honduras, 193 Hôpital Bienfaisance, 175, 178, 180, 186, 188 Hôpital Justinien au Cap, 196, 250, 251, 253–254 Hôpital St. Michel, 206 Human papilloma virus, 274–279 Human rights, xiv–xv, 270 Humanitarian medicine. See also Health care workers; Project Medishare; other specific programs abuses in, 268–270 as an anticurriculum, 267 cultural sensitivity and, xiii–xiv deworming clinic, 152 in Haiti, x–xi, xii, 107, 109, 151–157, 163–164 house calls in rural areas, 151–157 malnutrition station, 153 short-term missions, xii, 164 Hurricane and tropical storms, 99, 142, 282, 283–284 I Ibo Beach, Haiti, 233 Immigration and Naturalization Service, 40, 41, 42, 50, 54, 193 Immigration policy, xix, 3–4, 89 and access to health care, 40, 41 Haitian issues, 40, 41, 42, 44, 46, 47–48, 68 and HIV transmission, 285 Impetigo, 172, 261 Infants and children, Haitian activities and attitudes, 166, 241, 250, 275 with AIDS, 45, 63–64, 73, 97, 257–258 begging, 112, 113, 114, 125, 126–127, 130, 208

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti burns, 117 of Cité Soleil, 126–127, 130, 131, 240 education and schools, 146, 162, 166, 208, 291 handicapped, 240 health issues, 117, 118, 125, 127, 152, 153, 156, 160, 172, 173, 175, 177–178, 179, 180, 181–182, 194, 203–206, 218, 219–220, 240–241, 244, 245, 247, 257, 274 immigrants, 89 immunization, 240, 241, 290–291 malnutrition, 118, 153, 160, 170, 172, 181–182, 193, 218, 241, 273, 291 orphans and street children, 69, 73, 97, 112, 113, 114, 117–118, 119, 120, 121, 125, 126–127, 136, 138–139, 142, 147, 198, 199–206, 207, 217–222, 231, 240, 241, 257 Project Brossé-Dent, 219–220 sexual abuse and exploitation, 130, 144, 197, 274–279 Interferon, 41 International aid, xiv, 164, 189, 231, 233 International Red Cross, 118, 269, 281 Intravenous drug users, xvii, 50, 58–59, 62–65, 75, 93, 94 Islam, 34 J Jackson Memorial Hospital, xvii, 4 equipment donations, 158 gallows humor, 13–14, 39 growth, 5 Haitian patients, 5–10, 12, 13–14 response to AIDS epidemic, 37–39, 45 Special Immunology Clinic, 57–60, 64, 68–69, 70, 72, 92, 97 Jacmel, Haiti, 199–200, 205, 207–212 Jérémie, Haiti, 114, 119 Jimani, Haiti, 282 Joli Gilbert, Haiti, 153 K Kaposi’s sarcoma, 12, 28, 38, 69 Kenscoff, Haiti, 141–142 Klinik Bon Saveur, 163, 164 L La Plaine, Haiti, 162 Labadie, Haiti, 192–197, 243, 244, 246–247 Lac Cayman, Haiti, 162 Lac Péligre (Danger Lake), 162, 163, 164, 270, 284 Leishmaniasis, 17 Leogane, Haiti, 244–245, 246 Les Cayes, Haiti, 151, 152 Lewis, Stephen, xi–xii Liberation theology, 106–107, 232 L’Ouverture, Toussaint, 251, 283 Louisiana territories, 250 M Mackandal, 251 Malaria, 118, 155, 156, 175 Malnutrition, 153, 160, 170, 172, 173, 179, 181–182, 184, 194, 218, 241 Mariel boatlift, 3, 74

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Media sensationalism of AIDS epidemic, 24, 35, 36–37, 72 of Haitian political violence, 170, 234, 243–244, 248, 256, 273, 280 Medicine corporatization, 228, 267 dependence on technology, 196, 229 family practice, 185–191, 196–197, 229 liability and insurance issues, 157, 243, 256, 257, 267 professional values, 267 Medishare. See Project Medishare Miami, 251. See also Haitian refugees and Haitian Americans; Jackson Memorial Hospital; University of Miami School of Medicine AIDS epidemic, xvii, xviii, 7–17, 100–101, 129 Arena, 89–90 city life, 4 Cuban refugees, 3, 74 diversity, 4, 92 Freedom Tower, 3 Genesis House, 84 health care system, 288 homeless and street people, 74, 84, 87–102 Krome Avenue Detention Center, 4, 43, 68 Little Haiti and Haitian community, xvii, 3–6, 35, 92, 106, 131, 134, 148, 158–159 Miami Project to Cure Paralysis, 107–108, 149 Mirebalais, Haiti, 162, 166, 171 Missionaries and missionary work, 21, 107, 108–109, 117, 119, 137–139, 141–143, 152, 181, 217–222 Mosquito control, 261 Muslims, 30 N Napoleon, 250 National Health Service Corps, 5 National Institutes of Health, 69–70 Neptune ferry boat disaster, 119, 218 New Orleans French Quarter, 207 New York City AIDS epidemic, xviii, 24, 82, 258 Haitian community, 24, 171 Northwestern University, 292 O Obas, Beethoven, 132 Obas, Mozart, 132 Ogé, 251 Open Society Institute, 185, 186–187, 244, 252–253, 254, 257, 267 Opportunistic infections, 18, 20, 26–28, 37, 38, 58, 62, 66, 73, 78; see also individual diseases and types of infections in Haitian refugees, 7–10, 11, 12, 14–15, 16 in homosexual men, 11–12, 28–29, 45, 69 Oral rehydration therapy, 173, 177–178 Orphanages Bercail Bon Berger (Sheepfold of the Good Shepherd), 217–222, 295 caregivers (matant), 240 handicapped and abandoned children, 239–240 health fairs, 198, 199–206, 207, 218, 230, 231, 234, 239, 244, 255

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti in Leogane, 244–245, 246 Orphelinat Bon Secours, 201–206, 207 in Post Cazeau, 117–118 resources, 239 tuberculosis screening in, 244, 257 Orwell, George, 73 P Pape, Bill, 286 Parasitic infections, 10, 11, 15, 155, 170, 172, 181–182, 194, 241 Partners in Health, x–xi, xii, 164, 258, 260, 270, 292 Peace Corps, 182, 216, 236, 257 Pentamidine, 18, 19 Pestel, Haiti, 117, 151, 152, 153, 154, 156 Petionville, Haiti, 119–121, 133, 134, 135, 188, 272 Petit Goave, Haiti, 272 Pignon, Haiti, 175, 178, 180, 186, 188, 190, 191, 230, 231, 250 Piperazine, 153 Place D’Armes, 251 Pneumocystis carinii pneumonia, 10, 11, 12, 18, 21, 40, 45, 62, 64–65, 89, 285 Pointe Honoré, Haiti, 246 Port-au-Prince, Haiti, 105, 111–122, 124–125, 135, 136, 142, 151, 158, 160, 161, 162, 164, 170–171, 182, 186, 187, 199, 217, 230, 233, 245, 246, 247, 251, 259, 273, 281, 282, 286–287 Post Cazeau, Haiti, 117, 118, 198 Post-streptococcal glomerulonephritis, 261 Poverty and access to health care, 4–5, 39, 74, 132 “decent” vs. “indecent,” 171, 284 environmental impacts of, 284 and family collapse, 239 in Haiti, 6, 111, 112, 113, 119–120, 121, 123–132, 144–145, 151, 153, 155–156, 164, 171, 191, 239 in Haitian-American communities, 7, 9, 10, 26, 40 and HIV transmission, ix–x, xiv–xv, xix, xx, 10, 26, 47, 64, 73–75, 128–130, 132, 143–144, 284 reduction strategies, 191, 290 stereotypes about, 289 women’s status and, 284–285, 290 Preval, Rene, 188 Project Brossé-Dent, 219–220 Project Medishare, xii, 109, 117, 157. See also Thomonde academic credibility, 257 community health project, 234–235, 249, 258, 262–264, 279, 289, 290, 292 debriefings, 239–240 education and training component, 148, 149–150 equipment donations, 158 family medicine residency program, 185–191, 196–197, 230, 231, 244, 249–255, 257, 267, 272, 280–281, 286, 291 funding, 149, 185, 188, 192, 230, 233–234, 236, 244, 249, 252– 253, 254–255, 257, 272 growth of, 230, 249, 293 guesthouse in Thomonde (Kay Medishare), 213–216, 235–236, 262, 265, 281, 292 health fairs in Haiti, 147, 166–184, 192–197, 199, 207, 214, 215–216, 244, 271–279, 292

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti honors and awards, 244 hospital in Thomonde, 167, 236, 261, 262, 265, 272, 281 and Klinik Bon Saveur, 163–164 Komite Zamni Thomonde generator request, 158–160, 166 in Labadie, 192–197, 243, 244, 246–247 mission, 249 nutrition programs, 181, 272, 289, 290, 291 orphanage health fairs, 198, 199–206, 207, 218, 230, 231, 234, 239, 244, 255 Pap smear screening, 184 prenatal care, 182, 195, 234, 261, 271, 273, 291 “Président à Vie,” 149 screening for problems, 170, 174, 182, 184, 261 in Thomonde, 160, 166–184, 213–216, 230, 231, 234–235 University of Florida School of Medicine and, 198–199 University of Miami School of Medicine and, 147–150, 170, 234–235, 243–248, 249, 256–266, 291 volunteers, 108, 109, 112, 123, 131, 132, 135, 139, 140, 142, 145, 147–148, 149, 166–184, 192–197, 199, 207, 214, 215–216, 224, 231, 236, 240, 244, 267, 272, 292, 294–295 Zanmi Lasante partnership, 164 Prostitutes and prostitution, 44, 72, 75, 89, 93–94, 96, 101, 132, 144, 171, 197, 210–211, 284–285 R Raymond-le-Bain, Haiti, 207 Reiff, David, 268–269 Religion, and views about AIDS, 28–30, 46–47, 48–49, 97 Roi Henri Christophe Hotel, 251 Royal Caribbean Cruise Line, 192, 197, 244 Ryan White program, 95, 101 S St. Catherine’s Hospital (Haiti), 124 Saint Dominique, 250–251 St. Marc, Haiti, 194, 272 Sanitation issues, 113, 114, 116, 117, 124–125, 128–129, 134, 151, 152, 193, 282 Santa Maria, wreck of, 246 Savanette, Haiti, 183, 235, 237 Scabies, 194 Schistosomiasis, 17 Sepsis, 117 Sexual assault/exploitation, 93, 128 Shalala, Donna, 257, 258, 259, 260, 291 Sickle-cell anemia, 234 Sisters of Charity, 221 Skin disorders, 15, 25, 40, 175 Slavery and slave revolt, xiii, xvii, 33, 34, 120, 121, 124, 135, 166, 203, 232, 250, 251 Socialism, 232 Soros, George, 186–187, 188, 189, 190, 244, 257 Squatters’ settlements, 208–209, 251

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Stigmatization and stereotyping of AIDS patients, xvii, xx–xxi, 12, 24, 28, 35, 36, 50, 51, 52–53, 54–55, 128, 143, 184 of Haitians, x, xix, xxi, 13–14, 26, 28, 51, 110, 181, 184 of homosexuals, xvii, 28–30, 38–39, 51, 52–53, 59, 70, 77, 81, 82, 86 by medical personnel, 50, 51, 110 of medical personnel by colleagues, xvii, 35, 36, 39, 223–229 Strada, Gino, xi, xiv Strongyloidiasis, 17 Substance abuse, xvii, 50, 58–59, 62–65, 75, 87, 88, 89, 93–94, 96, 98–99, 129, 289. See also Intravenous drug users Syphilis, 11, 20, 52 T Terrier Rouge, Haiti, 272 Tetratotoxin, 33 Thomonde, Haiti accessibility, 161–162, 164, 165, 169, 272 AIDS in, 287–288 blessing of guesthouse, 235–236 boundaries of, 272–273 children of, 172–173, 177–178, 179, 181–182, 236–237 community health workers/accompagnateurs, 234–235, 249, 258, 262–264, 265, 281, 287–288 dental care in, 294–295 disaster relief work by, 283 economic and community development, 289–290 elections, 213, 280 eye care program, 291 guest house (Kay Medishare), 213–216, 235–236, 262, 265, 281, 292 health census, 262–263 health fairs and house calls, 166–184, 214, 215–216, 261 health statistics in, 160, 165, 172, 265 hospital/clinic, 167, 236, 261, 262, 265, 272, 281 immunization campaign, 290–291 Komite Zamni Thomonde generator request, 158–160, 166 population, 164 poverty level, 171 rebels in, 270, 281 secrets of success in, 287–288 University of Miami administrators’ visit, 260–261 village design, 165–166 Tierre Muscadet, Haiti, 183, 235, 237 Ton Ton Macoutes, xviii, 161 Tourism and, 120, 192, 197, 200, 208, 211, 233, 246 Toxoplasmosis, 10, 11, 12, 14, 16, 58 Trade embargoes. See Economic embargoes Transsexuals, 94, 95–96 Tuberculosis atypical, 78 control worker, 234 disseminated, 7–10, 11, 12, 14–15, 20, 58 drug-resistant, 73 in Haiti, 118, 155, 156, 165, 172, 175, 184, 204, 218, 220, 230, 234, 264, 273, 287–288

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti in orphanages, 218, 220, 230, 234, 241, 257 scrofula, 274 skin tests, 207, 220, 230 treatment, 17, 264, 265, 287–288 Typhoid fever, 118, 193, 204–205 U UNICEF, 283 United Nations Children’s Education Fund, 254 military intervention in Haiti, 107, 133, 211, 231, 272, 282, 283 United States Haitian foreign policy, xiii–xiv, xxi, 105–107, 112, 116, 119, 123, 164, 232, 281 humanitarian relief to Haiti, 283 immigration policy, 40, 41, 42, 44, 46, 47–48, 68 University of Florida School of Medicine, 198–199 University of Miami School of Medicine, xvii, xviii, 4–5 administration trip to Haiti, 258–266 Camillus Health Concern, 87, 88, 89–91, 98–102, 126 Community Service Award, 99, 148 family medicine program, 187, 229 grading system, 227–228 international pediatric infectious diseases program, 234, 258 Jay W. Weiss Center for Social Medicine and Health Inequality, 291 Key West project, 77, 79–80, 84–85, 147 liability and insurance issues, 157, 243, 256, 257, 267 medical assistance in Haiti, 109–110, 112, 118–119, 256–266, 291 minority problems, 223–229 and Project Medishare, 147–150, 170, 234–235, 243–248, 249, 256–266, 291 Project to Cure Paralysis, 107–108, 149, 236 volunteerism and culture of compassion, 77, 79–80, 84–85, 87, 88, 89–91, 98–102, 126, 147, 148 U.S. Agency for International Development, 164, 189, 254, 286, 291 V Val Artibonite, Haiti, 162 Venezuela, 283 Vertierres, Haiti, 251 Vétivert, 152 Violence against Haitian refugees, 47–48 against health care workers, 72, 270, 281 political, in Haiti, x, 170, 217, 243–244, 245, 247, 248, 270, 272, 273, 278, 280–284 sexual coercion, 284–285, 286–287 Voodoo, 6, 7, 11 acceptance of Western medicine, 202, 263–264 afterlife, 56, 200 and AIDS myth, 35, 83 amulets, 241

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti attitudes of outsiders about, 119, 237–238 and black magic, 242 bokar (male priest), 33, 157, 237, 263 cultural voyeurism, 237–238 Damballah, 266 dokte fè (leaf doctor), 33, 34, 263 ecstasy and possession, 241–242 Erzilie Freda/Virgin Mary, 202, 204, 242 hexes and spells, 7, 16–17, 33, 263, 264, 275, 277, 283–284 hougan (spell giver), 33 La Sirène, 56 Lwa, 33, 241, 266, 283 mambo (priestess), 33, 201–206, 263 mojo (love potion), 33 orphanage, 199–206 ounmfò (temple), 201, 202, 204, 206 saints, 242 and slave revolt, 250 spirits and spirit world, 11, 33, 56, 203, 241 symbolism, 200–201 tombs, 200 zombies and zombie curse, xiii, xx, 32–34, 129, 131, 144–145, 170, 226, 233, 260, 264, 280, 283–284 W Water supply, 133–134, 146, 151, 152, 154, 156, 180, 193, 197, 279 Women’s status and roles, 133–134, 137, 141, 152, 162, 171, 182, 190, 201–202, 210–211, 219, 234 World Bank, 231 World Harvest, 118 World Health Organization, 72 Y Yeast infections, 11, 14, 20, 40, 58, 69 Z Zanmi Lasante, x–xi, xii, 164, 258, 260, 270, 292 Zetoit, Haiti, 151, 155, 156–157, 241

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti

Representative terms from entire chapter:

aids epidemic