HIV/AIDS patients at the San José Hospice, San Pedro Sula, Honduras. Jan/Feb 1993

Introduction

This project originated from a trip I made to visit my sister, a doctor working with Jospice International, a Liverpool based Catholic charity based in San Pedro Sula, Honduras, during January/February 1992. I intended to produce stock photography images illustrating general health-care activities she was involved with such as child inoculation programmes, midwifery and health clinics. A couple of days before my departure a woman and her child arrived at the clinic saying that her husband had just died from an HIV/ AIDS related illness and the local undertaker was demanding extra money to bury him, money she did not have and could we help her. She said that such was the stigma of HIV/AIDS that undertakers were reluctant to bury people who had died from the disease and would only consider burials by paying a premium.

I made further inquiries with local health workers who predicted that Honduras and in particular San Pedro Sula (SPS) was in the early stages of a potentially devastating HIV/AIDS epidemic. It was at this point I decided to return the following year to document what I found.

It is generally accepted that the HIV virus originated from North America, partly from the influx of US military personal during the early 1980’s, but principally from transient migrant workers being infected by homosexual transmission in San Francisco, US. The first recorded case of HIV/AIDS in Honduras was in 1985.

HIV is a virus that attacks the bodies immune system. If untreated, the person’s immune system will eventually be completely destroyed, making it impossible to fight infections and diseases. AIDS refer to a set of symptoms and illnesses that occur at the very final stage of HIV infection.

In 1992, 2019 people had been diagnosed with HIV/AIDS in Honduras, with numbers predicting to double each year, 41% of those were from SPS. Clearly an epidemic was unfolding and gaining strength. The Ministry of Health in Honduras estimated the number of people infected by the HIV virus was between 50-100,000, all of whom would develop AIDS within 5-10 years. The ratio of men to women infected in 1992 was 2:1.

The resulting photographs from this and associated projects have been widely used to illustrate published articles on HIV/AIDS in Honduras. A complete exhibition was purchased by the United Nation Population Fund in 1994 and exhibited at the International Conference on Population and Development in Cairo. A selection of these photographs were also used in the 1994 C4 documentary ‘the Bar Girl, the Catholic, the Pimp and the Priest ‘, which documented the ‘debt’ system that enslaves girls into prostitution.

In 2007 these photographs were used exclusively by amfAR, The American Foundation for Aids Research, in New York, to help fund and promote their work. The resulting DVD presentation was narrated by the late Elizabeth Taylor and Edward Kennedy.

The San José Hospice

I returned to Honduras in January 1993 and based myself at the San José Hospice, San Pedro Sula. The hospice opened in 1991 and was specifically devoted to the care of HIV/AIDS patents.

Before the hospice opened many sufferers had been abandoned by the health authorities, their families and left to fend for themselves on the city streets. Often described as the ‘living dead’, these people had already suffered exclusion, lack of understanding, ignorance and fear from their fellow citizens. Many were never visited by family or friends at the hospice and were buried in unmarked graves.

Contracting the HIV virus in 1993, meant a swift and certain death, no antiretroviral drugs or therapies were available at this time. As the general health of these patients in Honduras was low, many died quickly from opportunistic infections such as tuberculosis (TB) and pneumonia caused by the breakdown of their bodies immune system. The hospice at this time could only provide basic medication, care and spiritual support for the patients.

Every patient gave permission to be photographed in the hope their images would put a ‘human face’ to the HIV/AIDS epidemic and they would not be forgotten.

The tragic reality of being infected with the HIV/AIDS virus in 1993 meant that when I returned to visit the hospice a year later in January 1994 every single patient at the hospice I had photographed and befriended had died.

Web pages that relate to this project:

This work was supported by Panos Pictures, World Health Organisation and UNFPA.

All images are Strictly Copyright © Bill Stephenson All Rights Reserved

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 01] Father Jim Barnett performs the ‘last rights’ for a dying patient. Father Jim is an American Dominican Friar that regularly visited the hospice providing spiritual support for the patients and staff. He is an exceptional person who has devoted his life to the needs of the poor and sick. He had recently been forced to leave El Salvador after death threats were made against him whilst campaigning for civil rights and trade union reform. He is now semi-retired and resides at Purdue University, Indiana, USA.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 02] Father Jim visits patients in the men’s ward.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 03] José Maria in the hospice canteen. José is in denial of his HIV status believing he has been miss diagnosed and will be able to return home soon. He died 2 months later in March 1993.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 04] José listening to a Michael Jackson tape.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 05] José Maria and José Angel Estrada keep warm up on a rare cool day.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 06] Yenny, a Honduran carer with HIV+ child and teenager with learning difficulties.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 07] Honduran nurses in the hospice dispensary.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 08] Honduran nurse helps a patient drink water.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 09] Patient uses a damp towel to help him keep cool.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 10] Hospice patient.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 11] Hospice patient and Carlos Bautisba holding a relative’s child.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 12] Suyapa Rivera Y Familia, age 21, is visited by her sister and niece. Suyapa contacted HIV from her husband who has since died from AIDS. She draws great strength from bible readings and bears no grudge against her husband. She said, ‘my life will finish before it has started’.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 13] Carlos Baubista and friend.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 14] Dario reveals the devastating effect of AIDS has had on his body. Dario died seven days after this photograph was taken.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 15] Dario.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 16] Júlio César was a merchant seaman who worked on banana boats from the coastal port of La Ceiba, frequently visiting Liverpool and US ports. He died in February 1993.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 17] The hands of Júlio César. His white finger nails are indicative of a failing immune system.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 18] Young man under the sheets.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 19] Newly arrived patient in the TB isolation room.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 20] Gracie is a housewife and mother with her friend, a former sex worker in the women’s ward.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 21] Gracie struggles with sickness. She died in March 1993.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 22] Olga Mejia Escobar is a 33 year old former sex worker. She had been abandoned at a local hospital and brought to the hospice. She had no family and was never visited by anyone.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 23] Olga and Gracie in the women’s ward. Olga died several days later on the 8th February 1993.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 24] Digging Olga’s grave at a cemetery on the outskirts of San Pedro Sula. This work was carried out by a grave digger employed by the hospice, Carlos Baubista and myself.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 25] Carlos Baubista and grave digger. Carlos was one of the strongest patients from the hospice and helped with much of the grave digging. Such was the effort needed to dig the grave through hard, dry earth, a guard was placed overnight to stop the grave being stolen and used for another deceased person. Olga was buried the following day.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 26] After the burial, Carlos Baubista places the only grave marker on Olga’s grave.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 47] Myself and a patient at the San José Hospice, February 1993.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 01] Father Jim Barnett performs the ‘last rights’ for a dying patient. Father Jim is an American Dominican Friar that regularly visited the hospice providing spiritual support for the patients and staff. He is an exceptional person who has devoted his life to the needs of the poor and sick. He had recently been forced to leave El Salvador after death threats were made against him whilst campaigning for civil rights and trade union reform. He is now semi-retired and resides at Purdue University, Indiana, USA.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 02] Father Jim visits patients in the men’s ward.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 03] José Maria in the hospice canteen. José is in denial of his HIV status believing he has been miss diagnosed and will be able to return home soon. He died 2 months later in March 1993.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 04] José listening to a Michael Jackson tape.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 05] José Maria and José Angel Estrada keep warm up on a rare cool day.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 06] Yenny, a Honduran carer with HIV+ child and teenager with learning difficulties.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 07] Honduran nurses in the hospice dispensary.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 08] Honduran nurse helps a patient drink water.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 09] Patient uses a damp towel to help him keep cool.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 10] Hospice patient.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 11] Hospice patient and Carlos Bautisba holding a relative’s child.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 12] Suyapa Rivera Y Familia, age 21, is visited by her sister and niece. Suyapa contacted HIV from her husband who has since died from AIDS. She draws great strength from bible readings and bears no grudge against her husband. She said, ‘my life will finish before it has started’.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 13] Carlos Baubista and friend.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 14] Dario reveals the devastating effect of AIDS has had on his body. Dario died seven days after this photograph was taken.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 15] Dario.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 16] Júlio César was a merchant seaman who worked on banana boats from the coastal port of La Ceiba, frequently visiting Liverpool and US ports. He died in February 1993.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 17] The hands of Júlio César. His white finger nails are indicative of a failing immune system.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 18] Young man under the sheets.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 19] Newly arrived patient in the TB isolation room.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 20] Gracie is a housewife and mother with her friend, a former sex worker in the women’s ward.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 21] Gracie struggles with sickness. She died in March 1993.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 22] Olga Mejia Escobar is a 33 year old former sex worker. She had been abandoned at a local hospital and brought to the hospice. She had no family and was never visited by anyone.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 23] Olga and Gracie in the women’s ward. Olga died several days later on the 8th February 1993.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 24] Digging Olga’s grave at a cemetery on the outskirts of San Pedro Sula. This work was carried out by a grave digger employed by the hospice, Carlos Baubista and myself.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 25] Carlos Baubista and grave digger. Carlos was one of the strongest patients from the hospice and helped with much of the grave digging. Such was the effort needed to dig the grave through hard, dry earth, a guard was placed overnight to stop the grave being stolen and used for another deceased person. Olga was buried the following day.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 26] After the burial, Carlos Baubista places the only grave marker on Olga’s grave.

HIV/AIDS Honduras Project Jan/Feb 1993

[HON 47] Myself and a patient at the San José Hospice, February 1993.

All images are Strictly Copyright © Bill Stephenson. All Rights Reserved.