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Story Publication logo March 25, 2013

In Honduras, Drums Join the Battle Against AIDS


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The Garifuna have historically been forgotten in Honduras and currently face one of the highest HIV...

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Lesbia Martinez, 33, with her daughter Asly Carolina Cordaba, 8. Lesbia was ostracized by her family when she told them about her HIV diagnosis and once tried to kill herself. Now she says that she wants to be an example in her community and 'keep her head high and continue moving forward.' Image by David Rochkind. Honduras, 2013.

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On a recent afternoon in the village of Corozal on Honduras' northern coast, men readied boats for fishing excursions, women sold coconut bread and boys played soccer on a beach lined with thatched huts. Suddenly, they heard the sound of drums emanating from a sandy lot near the beach, and some stopped what they were doing. Two teenage boys were slapping their palms on the tops of hollowed-out tree trunks, one a lower-pitched segunda drum and the other a higher-pitched primera. The two layers of pounding percussion created a magnetizing rhythm, and, as if captivating the community, a crowd arrived within minutes.

For centuries, the drumming has been the signature sound of celebration for the Garifuna, an Afro-Caribbean people on the Atlantic coast of Central America. Now this music has found an additional purpose—to prevent the spread of HIV. As people came to hear the drumming, the musicians turned into actors in a street theatre performance, and more performers soon joined. The plot centered around a court case: the Garifuna were putting HIV itself on trial. Eduardo Marcial Garcia, who played the prosecutor, gave his argument. "We're here to bring suit against HIV, the main cause of death in our communities," Garcia said. "It's orphaning children and tearing apart families. We want swift justice against HIV."

Garcia wasn't just acting. He was educating the audience about an epidemic. According to the Honduran government and the U.S. Centers for Disease Control and Prevention, 4.5% of the Garifuna population in the country is HIV positive, a proportion more than five times as high as in the nation as a whole. To put that in perspective, no country in the Western Hemisphere has a rate nearly that high, and it's twice as high as Haiti's. The rate is greater than some African countries, including Nigeria, Congo and Cote d'Ivoire. While factors fueling the problem include widespread poverty and a tendency for men to migrate to areas rife with the virus, some of the main culprits are social stigma, discrimination and a lack of HIV education.

Enter the arts. Colorful community theatre, dance and music groups in many Garifuna towns are giving performances that offer messages about HIV prevention in a bid to educate the population. From local social workers to health ministry and NGO officials, those who know the Garifuna epidemic best say this cultural approach can be more effective than traditional forms of education such as handing out pamphlets. That's because music, dance and storytelling are such vital components of Garifuna culture that they engage people and help them reverse bad habits such as unprotected sex. The Garifuna's cultural traditions are indeed assets: UNESCO proclaimed their music and dance a "masterpiece of the oral and intangible heritage of humanity." The genre holds the late Belizean Garifuna musician Andy Palacio as one of its stars.

"The plays are more effective because they attract attention, they're entertaining, people have fun," says Garcia, the actor from the Corozal theater troupe, which has 30 members. "Here in the community, we have many companions who have become involved with us because the plays have helped them change the way they live their lives. Before they lived crazy lives, and now they take more precautions."

On a different afternoon in the nearby village of Tornabé, the sound of drums began attracting people again, this time despite a thickening drizzle. Under a palm-thatched patio on the beach, five women in red and green flowered dresses danced in unison to the pounding rhythm, stomping their feet on the floor before twisting around in circles. Over the beat, they sang a song in the Garifuna language that warned about the dangers of HIV and called for the end of prostitution to help put an end to the virus. "I will die from this world and no more sex workers will there be," they sang. Digna Lambert, a vocalist in the group who has lost family members to the virus, spoke after the show. "There are people who don't have mothers and fathers because of HIV," she said. "We have to learn how to take care of ourselves."

Just before the song, 20-year-old Sarahi Flores demonstrated to the crowd the proper use of a condom. Teenagers giggled nervously, and the presenters even cracked smiles, but they succeeded in bringing a largely taboo subject into the light. Afterwards, Flores said her work combined with the performances had inspired people she knew to start practicing safe sex. Flores, who has seen loved ones die from HIV as well, said the shows have also helped people who are already HIV positive shed their fear of stigma. "People say they don't have to pay attention to discrimination anymore," she says. "Now they can keep their heads up."

That's hard-fought progress here. In recent years, new state-funded clinics have begun offering more access to doctors and antiretroviral medicine at almost no cost. That's keeping people healthy, a major change from a decade ago when many Garifuna were dying of AIDS. But even with that opportunity, the stigma is so strong that many HIV positive people don't seek treatment at all. And many who do are already in advanced stages of AIDS. Some people even continue to have unprotected sex without telling their partners, further spreading the virus.

Indeed, going public about one's diagnosis is an act of bravery that many Garifuna shy away from. Numerous people refused to be interviewed for this article or would only speak anonymously. Men were especially reticent: only five of the 19 people interviewed in-depth were male. Magno Julian Garcia, a 41-year-old percussion player in the village of Sambo Creek, was an exception. He says his ex-wife slept with another man who had HIV, and she then gave him the virus. It took him eight years to seek help after he was first diagnosed, and he says many others do the same. "It was hard for me to go look for treatment," says Garcia, a father of five children. "I felt afraid. I was ashamed."

Across town sat Lesbia Martinez, who tried to hang herself after being diagnosed with HIV. Better to end her life, she thought, not knowing treatment existed that could save her from death from AIDS. Her loved ones made it worse: far from supporting her, they called her names and avoided her for fear of contracting the virus. "I couldn't take that much humiliation from my family," says Martinez, 33. "I was desperate. I felt alone. I wanted to die." Luckily, the noose Martinez had prepared failed, she found HIV treatment, and eight years later she leads a healthy life with two daughters. But the circumstances surrounding her attempted suicide are common here.

In the villages, there is much anecdotal evidence that theater and music programs are helping lessen fear like Martinez's. Hundreds of miles away in the capital of Tegucigalpa, officials are eager for scientific data that can show just how effective such approaches are. The health ministry and the CDC are completing a study that will provide new data on the HIV prevalence among the Garifuna. If the rate falls from 4.5%,that could mean not only that the government's clinics are effective, but that the cultural programs are working too.

In an interview, health ministry officials said they were optimistic, even though they couldn't reveal official data until the study is released later this year. "I think the prevalence is improving," says Jorge Fernandez, who is head of the national medicine commission. "If that's not true, we'll have to grab ourselves by the hair and figure out what we're going to do because we've invested so much to not only stabilize but to lessen the epidemic," said Health Minister Roxana Araujo.

USAID, a U.S. government agency that funds theater programs with HIV messages, has also seen an improvement. "Although the Ministry of Health is completing a study that will provide updated HIV prevalence rates, we have observed a substantial decline in the number of positive HIV tests among beneficiaries of USAID's program in the Garifuna community, especially among women," said Kellie Stewart, director of USAID's Honduras health office. CDC officials declined to comment on the outcome of the study.

Back in Corozal, the theatre troupe was finishing its play. The prosecutor and defense attorney had given their arguments in the court case against HIV. But narrator Yilian David said that despite the horrors of HIV, the court decided there was no outcome yet. "Since the case is ongoing, there's no verdict," she said. The reason? HIV is still a major problem, she said. The Garifuna can't declare victory yet.



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