HIV/AIDS Honduras Project Jan/Feb 1993
This project originated from a trip I made to visit my sister, a doctor working with Liverpool based charity Jospice International, in San Pedro Sula, Honduras, Central America, during 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 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 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 was in the early stages of a potentially devastating AIDS epidemic. It was at this point I decided to return the following year to document what I found.
HIV is a virus that attacks the immune system. If untreated, the person’s immune system will eventually be completely destroyed. AIDS refers 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 AIDS in Honduras, with numbers predicting to double each year, 41% of those were from San Pedro Sula. 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 project have been widely used to illustrate published articles on HIV/AIDS in Honduras. A complete exhibition of this work was purchased by the United Nation Population Fund in 1994 and exhibited at the International Conference on Population and Development in Cairo. A wide selection of these photographs were 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.
This project is divided into three sections:
The first section are portraits of the AIDS patients at the San José Hospice, the second records the sex workers at the Hotel Fanny and the third section documents the final days, death and funeral of José Martínez.
The tragic reality of being infected with the HIV 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.
All images are Strictly Copyright © 1993 Bill Stephenson All Rights Reserved.
I returned to Honduras in January 1993 and based myself at the San José Hospice, San Pedro Sula, run by Jospice International a Liverpool based Catholic charity. The hospice opened in 1991 and was specifically devoted to the care of 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 anti-viral drugs or therapy’s 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 the ‘human face’ to the AIDS epidemic and they would not be forgotten.
[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.
[HON 02] Father Jim visits patients in the men’s ward.
[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.
[HON 04] José listening to a Michael Jackson tape.
[HON 05] José Maria and José Angel Estrada keep warm up on a rare cool day.
[HON 06] Yenny, a Honduran carer with HIV+ child and teenager with learning difficulties.
[HON 07] Honduran nurses in the hospice dispensary.
[HON 08] Honduran nurse helps a patient drink water.
[HON 09] Patient uses a damp towel to help him keep cool.
[HON 10] Hospice patient.
[HON 11] Hospice patient and Carlos Bautisba holding a relative’s child.
[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’.
[HON 13] Carlos Baubista and friend.
[HON 14] Dario reveals the devastating effect of AIDS has had on his body. Dario died seven days after this photograph was taken.
[HON 15] Dario.
[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.
[HON 17] The hands of Júlio César. His white finger nails are indicative of a failing immune system.
[HON 18] Young man under the sheets.
[HON 19] Newly arrived patient in the TB isolation room.
[HON 20] Gracie is a housewife and mother with her friend, a former sex worker in the women’s ward.
[HON 21] Gracie struggles with sickness. She died in March 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.
[HON 23] Olga and Gracie in the women’s ward. Olga died several days later on the 8th February 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.
[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.
[HON 26] After the burial, Carlos Baubista places the only grave marker on Olga’s grave.
Community health workers had informed me that the principle route of the HIV virus transmission in San Pedro Sula was heterosexual. The accepted culture of men and boys using the services of sex workers was commonplace, also in a country with high levels of poverty, unemployment and poor education, women not in monogamous relationships often supplemented their income as part time sex workers. The virus was therefore transmitted into the general population from sex worker to male client, onto wife or partner and pregnant mother-to-child. It is generally accepted that the HIV virus originated from North America, the first recorded case of AIDS in Honduras was in 1985.
This section of the project involved photography of the most vulnerable group likely to carry the HIV virus, that is the sex workers at a bordello or brothel. Health workers had suggested the Hotel Fanny in the barrio (district of) Cabanas, a marginal community on the outskirts of San Pedro Sula could be approached. The women working here had not been tested for HIV, however it was most likely they all were carrying the virus. Their future was bleak as they would continue working at the bordello until they were too sick to work and will most likely be admitted to the San José Hospice, possibly together with their clients.
Accessibility and cooperation to photograph in the bordello was gained after I contacted the Bishop of San Pedro Sula. After explaining my purpose, which he fully supported, provided me with a letter of introduction that requested the reader assist me with my project. This letter enabled me to make several visits to photograph at the Hotel Fanny and helped me contact Renée, a transgender street sex worker.
I returned the following year and found that the Hotel Fanny had been burnt to the ground by a rival bordello owner.
[HON 27] A sex worker outside her room at the rear of Hotel Fanny.
[HON 28] The interior of her room where she brings her clients. She sleeps and lives in this small room which contains all her possessions.
[HON 29] Three sex workers in the largest room at Hotel Fanny.
[HON 30] The women have fun pretending to present themselves to clients.
[HON 31] This woman is known at Hotel Fanny as ‘the crazy one’.
[HON 32] The women prepare to meet the evening’s clients.
[HON 33] It’s 10am and some of the women have just returned from working all night at a cattle ranch on the outskirts of San Pedro Sula. They wash their clothes, themselves, and then sleep until the evening and start work again. One has a cigar given to her by a client.
[HON 34] Renée is a transgender sex worker. He was born male but identifies himself as female. His partner had recently died from an AIDS related illness. Renée is justifiably concerned about his own health and has not been tested for HIV. Renée’s clients are gay men.
[HON 35] The room where Renée lives and brings his clients.
The Last Days, Death and Funeral of José Martínez
The third part of this project records the death of José Alberto Martínez, age 29, a married painter and decorator. José was dying from AIDS related tuberculosis (TB). He had contracted the HIV virus from a sex worker and his wife Rosa was now HIV+. I suggested to them that documenting the reality of contracting the HIV virus would raise public awareness, influence, educate and even stimulate the research for new drugs. It was also possible people would alter their sexual behaviour by seeing the cruel reality of dying from an AIDS related illness. José, Rosa and his mother all agreed to this with the hope that at least something positive may come from his death.
José’s family wanted to show that he was a much loved family member who had not been rejected or abandoned by them. I promised them that would make every effort to publish these photographs as widely as possible to inform others and make this project a lasting memorial to him and all the other patients at the hospice.
[HON 36] Rosa caring for José.
[HON 37] José keeps his legs cool.
[HON 38] The last photograph of José, he died shortly after this photograph was taken.
[HON 39] His body is washed then dressed in the football team kit of San Pedro Sula, his final wish.
[HON 40] José is placed in an open coffin in the hospice Chapel of Rest. José Maria comes to pay his respects to his friend.
[HON 41] Rosa with José’s coffin en route to his mother’s house, the following day.
[HON 42] José’s mother and brother holding a photo of José. José Maria is in the background.
[HON 43] José’s mother, brother and sister grieve on the roadside.
[HON 44] Jose’s coffin is removed to his mother’s house for a night vigil to be attended by family and friends.
[HON 45] José’s mother, Rosa and other relatives try to open the coffin whilst in a state of hysteria, they hope he can be brought back to life. José’s mother is overcome by grief, collapses and hits her head on the floor, causing her temporary unconsciousness.
[HON 46] Rosa holding the photograph of José.
I returned to Honduras four more times, working with a Channel 4 documentary on the debt system which enslaves sex workers in the cities bordello’s into inescapable servitude. In association with Arie Hoekman representative of the United Nations Population Fund (UNFPA), based in San Pedro Sula, I produced images to support reports and presentations on the conditions at the city prison, the extensive ‘maquilas’ or clothing factories on the edge of the city, the suppression of trade unions and human rights abuses.
My final visit to San Pedro Sula was in 1997. It was becoming clear that law and order was completely breaking down in the city as gangs fought to dominate the drugs trade. It was possible to murder with impunity in San Pedro Sula, the police at this time being ineffective and mostly corrupt.
A turning point occurred when I witnessed the murder of a man gunned down on a busy street in the barrio Cabanas. Perhaps the most shocking part was that after the murderer fired six bullets into the man from a revolver, he drove deliberately slowly though the crowded street proudly boasting to all onlookers that he was the murderer and was untouchable. He stopped and looked at me, reloaded his gun then thankfully drove on. It was clearly not safe for me to continue to work in the city any further, regretfully I left and have never returned.
In 2013 San Pedro Sula had been confirmed as the city with the highest murder rate in the world.
[HON 47] Myself and a patient at the San José Hospice, February 1993.