Profile of the Month

David H.A. John, MD, DABFM
Medical Director
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.