CAHE profs work with grad students
to help Honduran AIDS crisis

by Mark McGowan

Jim Sells took his family to Honduras two years ago for a sabbatical to research indigent counseling methods.

Their journey provided Sells an unexpected new passion: helping to combat the rapid spread of HIV and AIDS in the Central American country.

Sells, an associate professor in the NIU College of Education’s Department of Counseling, Adult and Higher Education, rented a home from Enoch Padilla, a physician who with his wife, Fatima, operates the only clinic in Tegucigalpa solely dedicated to HIV intervention and prevention.

Now Sells, CAHE colleague Fran Giordano and some graduate students are writing a grant proposal that could – at long last – begin long-term and stable funding for the Padillas and their work.

They also are developing a vision for a hospice and orphanage, rallying AIDS activists, starting work on an HIV prevention program for high schools and courting a Colorado-based international development relief foundation that at the least has committed to serve as a not-for-profit bank to channel dollars to the Padillas.

“HIV and AIDS pose an emerging crisis among the most serious of the Western countries. The poorest countries are the hardest-hit: Haiti, Honduras, Brazil. They’re losing control of their HIV management,” said Sells, who with Giordano and the students returned to Honduras in November.

“We need to assist this physician in developing more effective interventions. He does not have the resources, both in medicine and research, to effectively address the need in Tegucigalpa,” Sells added. “It’s possible to get medicine through USAID (the United States Agency for International Development) and Doctors Without Borders, but it’s difficult to establish a regular fundraising base. That’s our goal.”

Sells said Honduras, which accounts for 17 percent of the population of Central America, has about 60 percent of the AIDS cases.

According to the U.S. Government Fact Book, an estimated 63,000 people are living with HIV/AIDS in a country slightly larger than the state of Tennessee. The estimated prevalence rate is 1.8 percent – and, Sells said, history has shown that when a prevalence rate reaches 2 percent, it begins to climb at a quicker pace.

In Africa, he said, the disease will orphan nearly 40 million children in the next 10 to 15 years. Their rearing without parents is “a crisis for the country, the continent and the globe,” he said. “The potential is very high for Honduras to have a serious disaster in 10 years.”

Honduran leaders compound the problem, he said.

The government is “not interested in having its HIV status publicized,” Sells said, creating a “tendency of suppression.” Catholics, members of the country’s prominent denomination, are reluctant to distribute resources. Representatives of the Ministry of Health, meanwhile, claim that the resources are reaching the people.

The unemployment rate in Honduras is a staggering 27.5 percent, and 53 percent of the people live below the poverty line.

Hondurans living with HIV are “seriously disenfranchised,” Sells said, and are prone to several mental health issues including depression. “They have minimal economic resources, and what little options they have are usually taken away from them.”

Ostracism and its resulting unemployment make matters worse, and because HIV and AIDS are viewed as a “family disease,” the exclusion can extend to relatives not infected with the disease.

Yet they all have friends in the Padillas, who have staffed their clinic alone for eight years.

“This is about a personal commitment for them,” Giordano said.

“We want to encourage them around their very difficult job, and join them in their vision of bringing care to people who aren’t particularly cared for,” Sells said. “We are building a long-term strategy to make it work. We’re formulating a vision for 20 years. We’re educating them on long-term funding. Our objective is slow and steady and to hit a home run versus just going out there and swinging at everything we can find.”

Meanwhile, the NIU professors and their graduate students are bringing their knowledge of counseling to the country – and gaining a global perspective of the field.

“Counseling as a multicultural enterprise is of prominent value in the profession to allow other ways of doing things to inform how we act and think,” Sells said. “They’re not influenced by North American academia. The folks doing counseling are not thinking of the models we use here.”

The notion of offices with stuffed couches and insurance reimbursements does not exist, he said. In Honduras and other developing countries, he said, “the process of counseling is severely influenced by the cultural values … (in this case) a direct result of poverty.”

“It’s familial, it’s informal, it’s relational. Clients will not go for counseling with someone they haven’t had over to their house for dinner,” he said. “It might be an educated neighbor, a father figure or a member of the community who understands the family.”

The HIV prevention program for high schools in Tegucigalpa is being developed with the hopes of reaching Honduran youth before they become sexually active. Patients of the Padillas would serve as the HIV educators.

“HIV-positive patients are able to articulate the experience of the disease in a unique way others cannot,” Sells said. “It also offers a form of employment for people in Dr. Padilla’s care, and it’s indigenously appropriate interaction.”

For the professors, the work in Honduras offers life-changing reflection.

“I am very committed to grassroots, community-based counseling. I do a lot of work with poor people in the United States. If you would’ve asked me two years ago if I knew real poverty, I would have said yes,” Giordano said. “When I went to Honduras for the first time, I saw real poverty for the first time.”

“It’s made me think of how I can be effective with my time in doing things that are important and matter,” Sells said. “In some ways, I’ve grown less patient in the use of my time around things that are trivial. I focus on things that have substance and merit. It’s something I can emulate as a professor, share with my students and teach my children.”

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