Profile of the Month
David H.A. John, MD, DABFM
HHC Morrisania Diagnostic & Treatment Center
Dr. John with some of his patients
From Trinidad to New York and Back
I came to New York from Trinidad in 1980 and went to York College and Cornell Medical College. I did my Internal Medicine Internship in Long Island and a Family Medicine Residency in Brooklyn. I worked here a few years and in 1994, I decided to return to Trinidad to make a contribution to my homeland.
Comforting AIDS Babies
In Trinidad I began working at the Cyril Ross Nursery, a home and treatment center
established to care for HIV-infected babies who were neglected and abandoned by their drug-addicted or incarcerated parents. The Nursery at that time had two babies and my main intervention was pain control and other comfort care. I worked together with the Ms.
Universe of 1998, Wendy Fitzwilliam, to bring antiretroviral treatment to the children.
Every 6-8 Weeks
By 2000 I returned to the U.S. But my heart was heavy. Who would take care of the children of
Trinidad? The Hibiscus Foundation offered to pay my airfare to go back and run the medical clinic as a volunteer. So every 6 to 8 weeks, I go to JFK Airport on a Friday and hop a plane to Trinidad. I work at the clinic Saturday and Sunday and see about 30 patients, who are 5 to 16 years old. Sunday night, I head back home to Brooklyn. And on Monday, I’m back at work in the Bronx. I’ve been making these trips for 14 years. And this year marks the 20th anniversary of my work with the Cyril Ross Nursery.
Fighting the Stigma
I remember when babies were dying one or two a week. In those days, there were not
many antiretroviral drugs approved by the Trinidadian government. And there was
a lot of stigma. Some medical offices would get rid of the waiting-room chairs
used by AIDS patients. Some people felt mosquitos contributed to the spread. This ignorance targeted the population as a whole including the medical community. Some doctors
would not aggressively treat those who were very ill. This was a period full of
ignorance and lacking in compassion.
A Turning Point
In 1998, Miss Universe Wendy Fitzwilliam began to champion the cause of HIV and AIDS-infected children to the UN and other international relief groups. She and others
founded the Hibiscus Foundation in Trinidad to procure life-saving medicine
from abroad. At the Cyril Ross Nursery, we were able to get 95% of patients to
an undetectable viral load. By 2000, deaths had dropped dramatically. I probably
pronounced three deaths over the last four year period. We began to
accept more children, 38 at the peak. Today the clinic houses 35 children and
treats about 30 more as outpatients.
A Success Story
A young man in his mid-20’s was the first patient treated at the clinic to have an
undetectable viral load as a result of drug therapy. Today, his HIV is
fully controlled and he now advocates against the stigma of living with HIV
throughout the Caribbean. He is truly a role model to others who are young and
reminds us that living with HIV is not a death sentence.
A Troubling Trend
Total infections are decreasing, but we are seeing a similar pattern of an increase in HIV
infections in the 15-24 age group in both countries. It’s a troubling trend. One of the
challenges is that because we are so good at treatment, there is complacency,
particularly among the younger population. We have to keep talking about safe
sex practices to kids here at every opportunity particularly our teenagers.
Trinidad & The Bronx
I’ve been medical director at Morrisania since 2011. A lot of our clients are from the
Dominican Republic and West Africa. Both are immigrant communities with similar
issues, including stigma against people living with HIV and AIDS and a general lack of
education about HIV as a disease. I take pride in helping to close those healthcare disparities. But, it’s a big challenge to change the thinking about what healthcare should be for them. We want to support wellness, not just care of folks when they are sick.