Justice Must Sustain Compassion for Those With HIV

Courtland Milloy's comment [Metro, March 18] on the rate of AIDS infection in the District, " . . . be afraid, D.C. Be very afraid," was a reasonable first response. But compassion and a sense of justice can motivate us to do more.

There is the parable of the small community by a river. One day, a woman notices a baby floating in the wildly churning river. Without a thought for her own safety, she jumps in and rescues the baby. The next day, another baby comes floating down the river and someone else notices; an equally courageous and committed person jumps in to save the baby. This goes on day after day until sometimes four or five babies come down in a day. In its concern and compassion, the community sets up an elaborate system for rescuing the babies, devotes its own resources to the task and manages to save most of them, although some slip through to their deaths. Yet this elaborate system of compassion raises questions: Why hasn't anyone gone upstream to see who is throwing the babies into the water and do something about that? Compassion isn't enough without justice.

For 19 years, we at Joseph's House have continuously cared for those who, without us, would die in the streets or in the hospital. At the end-stage of HIV disease, these men and women are dying not only from the disease itself but also because the rest of us lack the will to combat poverty and the conditions that come with it, including AIDS, homelessness and substance abuse. You can't manage your HIV disease if you are also homeless and suffering from mental illness or substance abuse.

"We tend to think of AIDS as a disease that people bring on themselves, and in one sense it is, much like lung cancer, heart disease, diabetes and a whole host of 'lifestyle' diseases," says David Hilfiker, founder of Joseph's House. "But African American men are nine times more likely to contract AIDS than white men, and African American women are 18 times more likely to get the disease than white women." In part, the discrepancy lies in the extreme injustice that created the inner-city ghetto. "The bottom line is that the same society that benefits middle- and upper-middle-class people . . . builds structures that consign millions to poverty. The problems that come out of that ghetto are as much the responsibility of the rest of us as they are of the black community," Hilfiker says.

At Joseph's House, we sometimes ask ourselves: How much are we like that community by the river, reaching out to pull black men and women from the river of AIDS and isolation while ignoring the issues upstream? To what degree does our work at Joseph's House lessen the pressure on the wider society to confront the problem?

I don't know. But I know what I see.

The homeless and poor in Washington are largely non-Caucasian. They are so marginalized that Main Street Washington almost never really sees these people. At Joseph's House, we do see them. They are suffering. Here, as they die, each person is cared for with compassion and respect. They needed to receive it sooner.

The writer is executive director of Joseph's House.