Sun, sea, sand, hospitable people, a tourist's paradise...That's only part of the story. The other part is of a region uncomfortable with open discussion on sexuality. This has made grasping HIV by the throat, rather difficult. A highly conservative region with a proliferation of religions, this Region bears the excesses permissible at Carnival time but is uncomfortable with discussion on the right to quality health care of its soi-disant hidden populations - sex workers, men who have sex with men, intravenous drug users and persons living with the virus.

Our politicians say all the right things but lack emphatic action. No news there to anyone but unlike most regions, the Caribbean has no shortage of capacity nor donor funding nor commitment to policy change. We have it all except the will to act with a sense of urgency. As a region second to sub-Saharan Africa in HIV incidence, we are plagued by the old shibboleths - stratification along class and colour lines; disapproval of difference; disregard of other ways of being that a 'good society' would not approve of; rampant stigma and discrimination; conversations that are not rights-based but tied to 'who knows you and who you know'.

Change though is coming. Burying our heads in the sand is proving more and more difficult as more activists up their commitment to be heard. People are being forced to acknowledge those issues which they could once have ignored. I have hope. I love my region with all its complexity. No tiny island is a mirror image of the other. Each must be carefully understood so the right approach applies. Most people coming in to the Caribbean see us as one happy melting pot of 5M people. This is simply not so.

We are a highly literate region but not peas in a pod. Some speak English, others Spanish, Creole, Patois, French, Mandarin and German. Finding a rallying point for such variety has always been a challenge. We had invested our pride heavily in our West Indies(a.k.a Caribbean) Cricket Team but poor succession planning meant that when the stars of the Team dimmed, there were few competent enough to take up the mantle. We're getting there once again but the Region shares the pain of no longer trouncing England easily, or Australia or India. Into this add a virus which is rooted in one's sexuality and one understands why the Caribbean shies away from further emotional pain.

Part of the answer lies in helping the Region to understand and accept its own vulnerability. Another part lies in helping people upend the legacy of seeing each other as lacking in some way - not bright enough, pretty enough, fair enough, rich enough...When these points are made with empathy and humour, people own them and in so doing, often commit to doing things differently. I really feel that we can benefit from the SALT approach, creating managers of our own competence. I am delighted to be part of the process of deeper engagement of Caribbean peoples everywhere.

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Comment by Ian Campbell on March 2, 2009 at 4:53pm
Hello Bernice

It is good to meet you again

Having travelled and worked with HIV in the Caribbean, in several of the countries, I can agree that there is no region that is more complex and resistant to a 'one size fits all' approach. You are right -the SALT approach is built upon local response which is based on human strengths for response -capacity to care, to find community, to determine mutually helpful change , to transfer optimism and ways of working,and to feel and find hope .

Respectful of culture and community specificity, the local response is the key.Support organisations are supposed to respond to the potential and actuality of the local response -but they usually do not because there is no time, money, nor intentional commitment to SALT and other approaches that bring out Human Capacity for Response

Underneath the reality that local response is possible is that transfer, ie the root of going to scale, is mediated through invitation to a setting to intentionally share and learn in the host setting

So health and life competence is nurtured from the inside out-anywhere , not just in the Caribbean.But because what you say is true, I cannot help but realise that there is no other way, long term for your region.

Thanks for your stirring note

Ian Campbell

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