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(continued) This is why Dr. Martin accepted an offer during a recent conference on Border Health to visit the HIV Counseling Services program in Eagle Pass, Texas. The flight from D.C. landed in Austin at about 5 pm, we rented a car and headed into the setting sun for the Texas border with Mexico. Three hours later, after some heavy traffic in the loop around San Antonio, we found ourselves traveling down a simple two-lane highway. Gradually the terrain began to change, the sky darkened, and the street lights appeared further apart. There was only smattering of houses and convenience stores. It was mostly open road, a steady stream of trucks, cactus, sage brush, flat land, and big sky. We were traveling from urban into rural, westbound on highway 57. We soon came upon a mileage sign that read “Eagle Pass Texas 42 – Piedras Negras, Mexico 43,” a sign I found humorous in it’s “now you see it, now you don’t” characterization. It was as if it said: “Ok, everybody clear on that? The United States stops here. Mexico starts there. Any questions?” What I didn’t see in that unique mile marker, as it disappeared into the darkness behind the car, was how it foreshadowed the equally unique circumstances of a people that live right on top of the line drawn between two countries. 42 miles later we entered the city limits of Eagle Pass, the sky was black and the stars infinite. We couldn’t see much of our surroundings, just the brightly lit signs of American franchises scattered about the landscape. We found the only open restaurant, dined, chose a hotel, and ended our day’s journey to prepare for the early morning meeting at the lone HIV services organization this side of San Antonio. The morning is gray as we enter the comfortable offices of the HIV Counseling Services program directly affiliated with the United Medical Center, a community health center situated a few miles away. One of the first things I focus on is a piece of white paper with big print tacked to a bulletin board that states in one sentence the mission of both the medical center and the program: “to improve the quality of life through the provision of comprehensive health care services.” This is a sentence and sentiment that we are all very familiar with, all of the professionals and volunteers that work in HIV or health. “Improving the quality of life” is the timeless goal of people who work in all levels of HIV, from federal policy makers to volunteers who stand on selected street corners late at night talking to folks about being safe. “Quality of life” is a common term that can be eloquently spoken on Capitol Hill, stated as an objective in a grant proposal, or surfaces in the reams of paperwork produced by the CDC, the NIH, HRSA, and SAMSHA. It’s just recently had a very new use, strategically placed in a compelling public discourse on global and domestic HIV uttered by the president of the United States. A man who, I should note, shares some common characteristics with the author of this text. We are both from Texas, we both work in Washington DC, we both speak with a slight twang, we both hold executive offices – his being the president of the United States, and mine being the associate executive director of AIDS Action – and we have both lived for many years about a four hour drive from where I am right now, Eagle Pass -- the Texas town that borders it’s sister city, Piedras Negras, Mexico. As I read these words tacked to the bulletin board nailed to a light wood panel wall, I nod to myself and smugly think I understand what they mean, I’m an HIV professional, been in the field for darn near 15 years. I give myself a secret pat on my extended belly of wisdom and settle into a chair that sits in front of the large desk of Gustavo de la Cerda, the clinical case manager of the HIV Counseling Services program. His desk is framed by simulated wood paneling giving the office the illusion of intimacy, though several times in the course of our conversation Gustavo picks up the phone to summon one of his colleagues, and after several futile rings, ends up calling them to the office by slightly raising his voice enough to penetrate the lean walls, the phone receiver cradled in his hand, momentarily forgotten. Washington had gone to Texas, invited to talk to the people working in HIV, invited to take a look and see what life was like in that part of the nation. Neither Dr. Martin nor I knew exactly what we would see and hear. Two weeks later, as I write these words, I can say that thanks to Gustavo and Jose Luis, the social services and data manager, my understanding of America and of HIV in America is much deeper. These
two members of a staff of four people plus a mini van have been
waiting for us to brave the snow storm of the northeast and come
to the open skies of the Texas flat lands, eager I presume, to
be visited by a national AIDS advocacy organization based in Washington
D.C. So here we sit, an African-American woman with long dread
locks and an anglo American woman with short blondish hair, both
dressed in rigorous Washington black, pads and pens out, eye glasses
in place, waiting to hear the HIV stats on Eagle Pass. And waiting,
of course, to see how these men have “improved the quality of
life” of the people living in this Texas border town, so that
we can then rush back to Washington, back to our policy shop. |