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Blindspot
What If I Could Have Grown Old With My Brother?
00:39:55
How one woman refused to accept the status quo and helped save the lives of thousands of people in her neighborhood.
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- [00:10]
A
You were just saying no one has ever asked what if. What were you about to say about that?
- [00:14]
B
Well, no one has ever asked what if there had been no HIV epidemic. Right. No one's ever said that. Not to me, anyway. I've been around long enough. What if I could have grown old with my brother? Hmm. That's something that I miss sometimes. I'm at home and whatever, something happens, you know, and. And I want to get up and call someone, and I realize that my entire immediate family almost entirely is missing.
- [00:52]
A
What if HIV had shown up in the US and we stopped it? Could we have stopped it? Joyce Rivera is from the South Bronx, which is a place where both HIV and drug addiction remain enormous challenges.
- [01:12]
B
Hi, Joyce.
- [01:13]
C
Hi, baby.
- [01:14]
B
Comakta bie.
- [01:16]
A
She is someone who has thrown her entire life into stopping the spread of hiv. And through her work, she has saved thousands of lives. Unlike in Harlem, where we were for the last episode, where some people were very reluctant to speak up, Joyce took action as soon as she understood what was going on in her neighborhood in the South Bronx. And today, decades later, she still runs a syringe exchange and what she calls a health hub there. They provide all kinds of services. It's called St. Ann's Corner of Harm Reduction. But Joyce wasn't a public health leader back when the virus first showed up in her neighborhood. And in her brother in her office, there's an old photograph of them together.
- [02:07]
B
It's an old New York City apartment. You see the radiator, and it's Christmas time.
- [02:11]
A
And you can see a Christmas tree off to the side.
- [02:14]
B
Carlos. And of course, it's in the 70s, and he has pretty long hair. He has his arm around me, and I have my arms around his waist. And it's a picture of pals. We were pals.
- [02:36]
A
Do you, I assume you do know how he got sick in the first place?
- [02:40]
B
Yes, he was. He was. It was injection related. He engaged in petty crime that led him to land up at a prison upstate. And there he started to inject. And there they were sharing, you know,
- [02:57]
A
one work, one needle among all the people in Carlos's unit. It was the early 1980s, and when Carlos was released from prison, Joyce noticed he was weak.
- [03:10]
B
My brother started to develop symptoms, and I'd been watching the news, and I'm matching up the symptoms with what he's experiencing. And one night, I get up in the middle of the night, and sitting at the pot, it hits me, and I just bend over and sob because I knew that he had it.
- [03:45]
A
From the History Channel and wnyc. This is the Plague in the Shadows. Stories from the early days of AIDS and the people who refused to stay out of sight. I'm Kai Wright. What could have saved Carlos and thousands of drug users in the South Bronx alone? Joyce Rivera is going to walk us through her decades long effort to find an answer to that question. In this episode, we look at the heroin epidemic of the 1970s and 80s and how big a role it played in the spread of hiv. The story actually begins way before HIV had a name. We know when AIDS came into public consciousness in 1981, it was described as a gay man's disease. But for people who were interacting with drug users, science started popping up years earlier in New York. There was an agency set up in the 1960s called DSS, the Division of Substance Abuse Services. Their job was to try to study drug use. Don Desjarlais was a researcher there. And in the late 1970s, they noticed a huge uptick in pneumonia deaths.
- [04:59]
D
And we couldn't understand what was happening because pneumonia was a constant threat. And all of a sudden there was an explosion of pneumonia deaths.
- [05:13]
A
It was like five times the number of deaths as the years before. He told my colleague Lizzy Ratner. This just didn't make sense.
- [05:22]
D
At that time, we were monitoring death certificates among people who injected drugs.
- [05:31]
E
When you say at that time, do
- [05:32]
D
you mean in the late 70s?
- [05:34]
E
So already in the late 70s you were seeing these pneumonia deaths?
- [05:39]
D
Yes.
- [05:40]
E
Not like in the 80s, you looked back and saw the pneumonia death.
- [05:43]
D
But no, we saw them in the late 70s. They were not classified as pneumocystis pneumonia. They were just pneumonia. We didn't. Unfortunately, we didn't look carefully enough to see it was pneumocystis. But. But we saw a big increase in pneumonia deaths.
- [06:06]
A
So this organization in New York that's set up to study drug use saw something out of the ordinary. And turns out other people were seeing this same explosion of illness and death in drug users.
- [06:21]
D
Hello.
- [06:22]
B
Hi, Victor.
- [06:23]
F
Thank you.
- [06:24]
A
There were big red flags on Rikers Island, New York City's largest jail complex.
- [06:30]
E
You clearly saw this.
- [06:31]
G
Well, usually I'm trying to imagine it now.
- [06:34]
A
Lizzie went to visit a nun who had worked at Rikers, Sister Eileen Hogan.
- [06:39]
G
There wasn't much communication between.
- [06:41]
A
In the late 1970s, Sister Eileen was a chaplain there. She worked at Rikers for nine years. And she was the first female chaplain in the Department of Corrections.
- [06:50]
G
Well, you know, I went through another. A logbook, you know, like what I
- [06:54]
A
did every day because Sister Eileen has These notebooks from her time there. And she remembers spending most of her days in the infirmary ministering to sick inmates.
- [07:05]
G
And I was talking about how crowded the infirmary was. All I say is, it's crowded. It's very crowded. It's crazy here.
- [07:14]
E
And that was already in 1978, that you're. It's crowded.
- [07:18]
G
79. That was in 79. We didn't even call it a disease then. People would. They couldn't gain weight. They were very thin. And usually if people came back in and if they were just on drugs, they would kind of begin to fill out in two or three weeks. But these people, these women weren't. And it was the fact that the number of women up in the infirmary, because normally it wasn't packed. Normally they didn't have to open more rooms for them.
- [07:53]
E
And they had to open more rooms.
- [07:54]
G
They had to open more rooms.
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A
So researchers studying drug users. A nun at Rikers Island. And then we met a doctor who spent most of his career in the Bronx.
- [08:11]
H
You found the house?
- [08:12]
A
We found it. Hello, Dr. Rubenstein. Aryeh Rubenstein was also seeing something new, something he'd never seen before.
- [08:20]
H
Suddenly, in 1978 and 79, even 78, was when the end of 78, we saw patients that we could not figure out what they had.
- [08:28]
A
Aryeh is on the faculty at Albert Einstein Medical center and Montefiore Medical Center. He's an immunologist. And back then, he was spending most of his workday dealing with test tubes, mice in a lab.
- [08:42]
H
That was my life, actually. Einstein, from 73 until 78, when suddenly there was an explosion of patients with immune deficiency that we didn't understand. And then I switched into the clinical
- [08:58]
A
part, and he started seeing these patients, and their immune system seemed out of whack.
- [09:05]
H
What they had is they had huge lymph nodes, then elevated immunoglobulin. We thought that this is a severe immune deficiency. Most of them were from the South Bronx.
- [09:19]
A
And why do you think that was the case?
- [09:23]
H
Because I think this was an area in which drug use was. There was a lot of substance abuse in men and also in women.
- [09:37]
A
So you would assign it primarily to the drug epidemic.
- [09:41]
H
I think that was the initial cause of the rampant transmission.
- [09:50]
A
Aryeh was seeing all these patients, drug users and young kids with puzzling symptoms. But he was also reading the medical journals. He knew that doctors around the country were starting to see something unusual in gay men in urban centers.
- [10:05]
H
And they said, there must be some connection. And I wrote the paper. It was rejected. I mean, the people of CDC came to us and looked at our patients and did not believe that they have hiv. They said, it's possible. We're not sure. They spent. I think they spent half a day with us going over the cases. Look, we had different opinions. I was convinced about it, and they were not convinced.
- [10:45]
E
I guess one of the questions we have is, would it have made a difference if people had listened sooner?
- [10:55]
H
Well, I think concerning the epidemic, it would have made a difference because you could have prevented sexual transmission. You could have prevented transmission through drug abuse. But regarding treatment, really had no tools at that time. There were no medications. But the spreading of the disease, it may have made an impact.
- [11:20]
E
Was there a particular blind spot that the medical community you think had that prevented them from recognizing what you recognized?
- [11:30]
H
I think they were focused mainly on the gay community. They didn't look behind it and they did not look at the substance abuse community. That happened much later. Other communities were just hiding it in the substance abusing community for the South Bronx, they were getting infection, dying from infection, dying from poverty. And it did not go out to the press.
- [12:00]
B
Yep, he's right. It's exactly right. Who cares about the poor and who cared about substance use? It's nobody.
- [12:09]
A
Joyce Rivera saw it all close up.
- [12:11]
B
It's very sad. You know, it's very sad how do you allow this infection to just be in the lifeblood of a community and basically, like, just let people die, let people infect each other.
- [12:30]
A
To really understand what happened, why and how the virus was able to flourish among drug users, it's worth taking a walk with Joyce through the South Bronx that she grew up in.
- [12:42]
B
Hi, how are you?
- [12:44]
I
Good.
- [12:44]
B
How are you? Thank you so much. Thank you so much.
- [12:47]
J
Oh, sure.
- [12:48]
A
On a rainy day, Joyce bounds out of an Uber and calls out as she opens up an umbrella to protect her head of silver and pink hair.
- [12:58]
B
I love the pink in your hair.
- [13:00]
I
Is it new?
- [13:00]
B
Is it always new?
- [13:01]
A
Joyce meets our producer, Ana Gonzalez.
- [13:03]
B
You know, I used to have it all peripheral.
- [13:06]
I
Oh.
- [13:06]
B
And then I only had she tours
- [13:08]
A
us around her neighborhood.
- [13:09]
B
I really am a city kid. I learned how to swim there, swim in the pool. All the kids would come and we would go swimming. It was like 10 or 11 and make sure it had 25 cents at 30. I'm gonna make really dates you. But you could get two little hamburger pads or pizza, which was for us, like. Like we would never have. You know, I come from a traditional home. We never ate out.
- [13:33]
A
Her parents had come from Puerto Rico when they were young. Growing up, Joyce and her brother lived in the same apartment building as her grandparents.
- [13:41]
B
We had apartment 4, apartment 16, apartment
- [13:45]
A
17, a whole family right there. Her parents were on the fifth floor, the grandparents on the second. When Joyce's family got even bigger with two younger sisters, Joyce and her brother, they would go see, stay downstairs with the grandparents.
- [13:59]
B
The two of us were like two little puppies for the old people. And we were like two Shih Tzus running around the house, very indulged by these old ladies.
- [14:08]
A
There were four kids, but Joyce and Carlos, or Carlito as they called him, they were especially tight.
- [14:15]
B
You're a year and 10 months apart, always together. We played under the bed. We had fun.
- [14:27]
A
Her mom's apartment was on the top floor of the building, right by the staircase that went out onto the roof. Both of which were big hangouts for people getting high. Drug users were part of the life in the neighborhood. They all knew Joyce and they all knew her mom, Nellie, and they trusted each other.
- [14:46]
B
And they would knock on the door and ask Susan, Nellie, you know, Nelly, can we have some water? And Nelly would give them water, and then they would either leave or something bad happened. They would say, nelly, call the cops. And I would call.
- [15:02]
A
But by the 70s, as Joyce finished college and started working, things had gotten a lot worse. Some streets in her neighborhood just had become completely complete. Open air drug markets.
- [15:17]
B
Brook Avenue was like a bazaar. So, I mean, every, every car length, there would be a different dealer selling a different brand. You know, when you walk, you would hear everyone hawking their brand. You know, Gucci dead on arrival, Michael Jackson, you know, whatever. They had different names, different brands. So I had heroin or heroin.
- [15:45]
A
The Bronx became a central place for the distribution of heroin throughout New York City. And a center for drug addiction too.
- [15:53]
B
Those are terrible years, just terrible years. And the Bronx looked like no man's land.
- [15:59]
A
People argue about which things were caused, which things were effect. But here are some realities about the late 60s and early 70s that led to this moment in the Bronx. Economic collapse. Across the city, but particularly in poorer neighborhoods, like much of the Bronx, the
- [16:19]
B
fiscal crisis reduces the services, social services, healthcare services by over 40%.
- [16:25]
A
Jobs disappeared.
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B
And then we have a homeless crisis.
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A
Landlords burning buildings for insurance money.
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B
The housing stock in the Bronx is burning for somebody else's profit.
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A
And then an influx of drugs.
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B
So we ignored that. We sort of decide, okay, the Bronx can die on the vine.
- [16:50]
A
In that moment, many responses were possible. More addiction treatment centers to help drug users, economic development to create new jobs, a robust social service network. To provide support for families that were struggling. But that is not where this country was politically.
- [17:11]
D
America's public enemy number one in the
- [17:14]
A
United States is drug abuse. This was from a speech President Nixon gave in 1971, and it kicked off what became the war on drugs. Nixon set up the Drug enforcement administration, the DEA, in 1973.
- [17:31]
C
And it becomes clear that part of what we're going to do to bring the problem of drugs down is think about not the public health issues of high rates of addiction and use.
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A
Robert Fullalove teaches at Columbia University School of Public Health.
- [17:46]
C
Now, let's think about how much drugs are leading to crime and make it a criminal justice issue. We don't deal with issues of addiction. There's a medical problem that can be managed if there are appropriate resources. No, we declare this a criminal justice issue. Let me scare you away from drug use by threatening you with many, many, many years of incarceration.
- [18:08]
A
Eventually, states like New York passed laws making it illegal not only to sell, but to use any drug equipment like needles and syringes. And what that meant in practice is that you could get arrested simply for carrying around a needle. So just as a new virus lands in our cities, one that spreads through bodily fluids, you have a drug policy that ends up concentrating IV drug users in tight spaces with little access to clean needles. One was in prisons and jails. Remember how crowded the infirmary was at Rikers? And another was on the outside in places like the South Bronx. Drug users began to change where they would gather to get high. Addicts aren't stupid, and dealers aren't stupid either. All those empty, often burned out buildings in the Bronx, they could be put to another use. Shooting galleries started appearing, abandoned buildings where drug users could rent or borrow needles and then inject heroin right there, away from the eyes of police.
- [19:16]
C
How about we take over whole buildings where it might be possible for you to come and buy product as well as as your tools, injection equipment, so
- [19:26]
A
that the law leads people to create shooting galleries, which is an irony, right? Like, people didn't used to shoot up that way.
- [19:35]
C
They did not. They did not.
- [19:37]
A
And shooting galleries brought together a group of people where needle sharing was common,
- [19:42]
C
suddenly makes it possible for HIV to have a hugely efficient route through which it can infect other people.
- [19:53]
A
By the end of the 1980s, the highest concentration of HIV infection in the entire country was in the South Bronx. Dr. Kathy Anastos was a primary care doctor there at Matafir Medical Center.
- [20:06]
J
I don't think anyone saw that. It would devastate whole communities. It would devastate the gay men's community, and it really did devastate the South Bronx.
- [20:19]
A
She treated heart disease, diabetes, asthma, regular stuff. But a full half of her time was spent treating patients with HIV and AIDS.
- [20:28]
J
Well, how much patient care did I do? Six sessions, probably. Actually, probably 40 to 50 people in a week was the leading cause of Death for people 15 to 49, 15 to 45. For a decade at least, injection drug
- [20:49]
A
use had surpassed all other risk factors as a cause of new cases of AIDS in New York State. And the thing was, there was a way to change this, to slow the rate of transmission, and it wasn't even that complicated. Remember the drug researcher, Don Djerlay, the guy who saw all those pneumonia deaths in the 1970s? He said he knew a doctor at the time who offered up clean needles in his waiting room. He didn't give us the guy's name. It was definitely illegal back then.
- [21:20]
D
There was a long time between knowledge that the virus was being transmitted through sharing syringes, which was developed in the mid-80s till New York City got syringe exchange programs in 92.
- [21:39]
E
What do you think the consequence of that delay was?
- [21:45]
D
Tens to maybe hundreds of thousands of unnecessary deaths.
- [21:53]
A
That's a worldwide figure, not just New York City. But it might have included Joyce Rivera's brother, Carlos Rivera.
- [22:02]
B
Yeah, it was terrible. He died at New York Hospital. My brother was just 31 years old. What's that song? You Ain't Heavy, you're My Sister? Something like that. He would sing that, you know. That's a beautiful song. I guess what I want to say is, is for anyone that I love, I'm always gonna stand up, you know, always, you know, like be their best advocate. I didn't want my brother Carlos to just be one more on a heap of a pile of people. And I also didn't want the community to just be unremembered.
- [23:10]
A
After all, it wasn't just Carlos. She loses friends, a cousin, another cousin, many neighbors. So Joyce Rivera charts a new life plan. When we come back,
- [23:32]
K
Are you hungry for some great investigative journalism? That sounds like music. Then Radiolab might be the show for you. Radiolab began over 20 years ago as an exploration of science, philosophy and ethics. The show has since expanded to become a platform for some of the best long form journalism and storytelling you'll hear today. Join Jad, Lulu Miller and myself, Latif Nasser, as we investigate stories that provoke delight and ask you to completely change the way you view the world. You can find Radiolab wherever you get Podcasts.
- [24:08]
A
You're listening to the Plague in the Shadows. Joyce Rivera didn't see anybody coming around doing anything to stop the mounting death toll in her neighborhood. It's the late 1980s. HIV and AIDS are a leading cause of death in the Bronx. At this time, in Harlem, a neighborhood with more political clout, needle exchange was a no go. That's the story we told you in the last episode. But there was nothing getting in Joyce's way. She was studying political science in graduate school. She quit. And after her brother's death, she looked around and decided she needed to deal with problems closer to home.
- [24:49]
B
So when I look at people who decided to do their own thing, I like those people.
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A
Because you're getting out of the straightjacket?
- [24:56]
B
Yeah, because they. Their resilience comes from the power that they just say no.
- [25:03]
A
She got a job with the National Drug Research Institute. She was a researcher, an ethnographer on one of the first studies of drug use in the United States. And she ended up meeting a drug dealer, a guy who went by the name Cousin. He worked with his cousin, and between the two of them, they were bringing in about $3.6 million a year from their drug trade.
- [25:27]
B
The first time I met this man, I met him behind the barrel of a gun. All right, to go down to meet this guy. One of his security guards had a gun. And I said to myself, whoa, what did you get yourself into now?
- [25:43]
J
You know?
- [25:44]
B
But it turned out all right.
- [25:52]
A
We found Cousin at a prison in Pennsylvania. He is now serving life on 13 counts, plus 185 years on a slew of charges that would make Tony Soprano blush. Murder, kidnapping, distributing heroin. You get the idea. We wanted to hear his side of the story, though. What did he see in Joyce?
- [26:14]
B
This call is from a federal prison. You will not be charged for this call.
- [26:19]
A
Couscon has a case that's still pending, so he wasn't willing to talk on the record, but he told us he remembers Joyce, and she remembers him.
- [26:27]
B
He looked like a Latino man, my complexion, slender, someone who is burning a lot of calories.
- [26:38]
A
And he looked like a guy with power. The power to make stuff happen in a place that had been abandoned by the people who were officially in charge.
- [26:48]
B
I made an appointment, put him in my calendar. You know, how about next Tuesday? Can we meet? Oh, yeah, I'll be here. Okay, great. And then I come, and I'd have my car, and I'd say, we'll get in, we'll drive around, we'll talk.
- [27:02]
A
Now, Joyce knew what she was Dealing with.
- [27:04]
B
I don't want to tell you that I in any way romanticized. This was a man who solved disagreements with violence.
- [27:14]
A
But she realized he could help her and they might help the community combat HIV and aids.
- [27:20]
B
I mean, obviously I hated drug dealers because my brother had just died of HIV aids, you know, through drugs. And I was furious around all of that. But I'm teaching him about HIV AIDS and he wants to know, well, what can I do about it? And of course, I have a ready answer.
- [27:37]
A
She says, give out free clean syringes with each heroin sale. No way. He says he does not want to get that involved, but he has another
- [27:47]
B
idea, that I should do it in his spot.
- [27:50]
A
Casson wouldn't hand out the needles himself, but he'd make a space for Joyce to do it.
- [27:55]
B
And he says, no, we'll close out for you. And he did.
- [27:59]
A
For a couple hours every week, the drug trade stopped and that same location became what you might call a pop up DIY public health site.
- [28:11]
B
And then he said, you have any business cards?
- [28:14]
D
No.
- [28:14]
B
He says, make some. We'll give it out with every sale. That's what we did. It said, stay healthy, you know, and did it in Spanish.
- [28:24]
A
Stay healthy, cousin. And his team would take Joyce's business cards and pass them out during drug deals.
- [28:31]
B
And they came.
- [28:38]
A
That first Saturday in spring of 1990. Joyce drove her hatchback down to the park and unloaded boxes of literature about HIV transmission and boxes and boxes of clean syringes.
- [28:51]
B
Hold on. This tree was here. This was a big drug dealing spot.
- [28:56]
A
This was like she placed them on three tables and held them down with rocks and bricks from the park. And true to his word, Couscon was not there, but his men were.
- [29:05]
B
They unpacked my car and. And they stood sort of like, you know, sentinels. And it occurred to me that people had to learn to exchange syringes because this had never happened before, because this had never. In a way, their sentinels allowed me to create a line that somewhat mimicked the lines that they had for the drug dealing.
- [29:34]
A
Joyce's DIY needle exchange in partnership with a drug kingpin was a success. In fact, it was so successful, Joyce ran out of those little red Sharps containers that you put used needles in. So she put out the word she needed help, and help came.
- [29:51]
B
Then the grandmas came with their bottles
- [29:54]
A
of detergent to store the used needles.
- [29:57]
B
And then in those lines that they brought me those bottles, they talked about their despair about having a dog daughter that was in jail.
- [30:04]
A
Needle exchange was still Illegal in New York City. And at this point, Joyce was totally improvising. She cashed out her retirement fund to keep the work afloat.
- [30:14]
B
Wasn't a lot of money, but, you know, it was like, you know, 15K.
- [30:20]
A
Soon it wasn't just the grandmothers in line.
- [30:23]
B
People came with, you know, evident hiv, right, and sickness.
- [30:31]
A
This time she found a physician's assistant from Beth Israel to help people get tested for hiv, which wasn't so easy back then. When Joyce says she runs a health hub now where you can get lunch as well as a flu shot, this is where it started. But of course, drug dealers are not the most reliable people on earth. Cousin and his cousin were fighting, and eventually cousin was charged with hiring someone to murder his cousin. The local police, who had basically been turning a blind eye to this free syringe exchange operation, they told Joyce she had to cut it out. She couldn't keep operating here. So now Joyce had a mini outdoor public health one stop shop for drug users with nowhere to put it. She had to find someone to help. And someone told her to turn to, of all things, a local church, a guy named Luis.
- [31:30]
B
Oh, there he is.
- [31:32]
F
Mi amor, I'm Father Luis Barrio.
- [31:35]
A
Even though she never made her first communion and rarely went to church, Joyce Rivera is strategic. She was not afraid to use the church. Father Luis Barrios was the priest of the Episcopal church a few blocks up the street. He was already making a name for himself as a bit of a radical.
- [31:54]
F
What I bring to the pulpit is activism. You don't get the community inside the church. You get the church inside the community.
- [32:03]
A
Father Barrios had seen Joyce at her pop up meal exchange, and he could tell she was a powerful person.
- [32:10]
F
I knew all the drug uses in the community, but I never saw any in the line. I'm so organized. So she's giving out knitters and condoms, and I say, oh, this is very interesting. And then later we talk, and he
- [32:23]
B
said, listen, this is what we're gonna do. And he used a word in Spanish. Truco. Mamoja te truco.
- [32:31]
A
Let's trick him. Let's just move this operation up the block to outside of St. Anne's because the police, they're not gonna cross onto church grounds.
- [32:40]
B
You'll be safe in here.
- [32:45]
A
Father Barrios isn't just a priest. He teaches psychology and Latin American studies at cuny. And he was drawn to Joyce in part because his story was a lot like hers.
- [32:57]
F
With Joyce, she lost her brother. With me, I lost three brothers. Hiv, aids. They were infected in New York City in the South Broom.
- [33:08]
B
Do you know how they contracted it?
- [33:10]
F
Dirty needles. That was it. We always had the hypothesis, well, it can be sex can be. But no. They were sharing needles, dirty needles. And then the other three die of overdose.
- [33:27]
A
Father Barrios gave Joyce an office inside the church building.
- [33:31]
F
This is where your office used to be?
- [33:33]
B
Well, there were two desks in here.
- [33:35]
A
Yes, it was a tiny room across from the priest's office.
- [33:38]
B
Luis. This was the closet where we kept the syringes.
- [33:42]
A
Joyce was one of a bunch of activists and community groups.
- [33:45]
B
Theater. You know, off off of Broadway theater.
- [33:47]
F
The Rainbow Office. Lgbtq.
- [33:50]
B
LGBTQ office. In the midst of all of the sorrow and struggle this place radiated, all this life.
- [33:57]
A
I mean, Comiteno, Father Barrios encouraged a certain ecclesiastical creativity. One time, he told her to store the used needles in the crypt below the church.
- [34:07]
B
You would bury them? No, we didn't bury them. We just kept them there until we could find a place to discard them.
- [34:14]
A
Another time, he got involved. He knew that if people felt like the needles and condoms were blessed, they would be more likely to use them.
- [34:22]
F
I still think that we are the only one who blessed the needles and the condom.
- [34:27]
A
Some people came back asking.
- [34:32]
F
So he said, okay, put your hands. Put your hands.
- [34:34]
A
Father Barrios extends his hands as he remembers the prayer.
- [34:37]
F
We're gonna bless these needles and these condoms and just say, God, the preservation of life. This is what we're gonna do. Bless us. And some people really believe it.
- [34:49]
B
That's his ministry. He reminds everyone that they have God inside them.
- [35:00]
A
So here are two people who, in the absence of any coherent or effective public health policy, took it upon themselves to fight the virus in their community. Needle exchange finally became legal in New York City in 1992. Joyce was ready to stop improvising. She wrote her first grant, and in 1993, she got it. $70,000. St. Ann's Corner of Harm Reduction was born.
- [35:28]
B
I was doing harm reduction where? At the corner of St. Anne's and so it became St. Anne's corner of harm Reduction.
- [35:38]
A
Joyce's work has had real impact. Syringe exchange combined with the onset of effective treatment for HIV infection, which came in 1996, they dramatically slowed the spread of the virus in the South Bronx. St. Anne still has a van that parks on corners offering up free needles.
- [35:58]
B
And this is our syringe exchange right now. It's outside of the park.
- [36:04]
A
In the early days, the numbers were bad. Well, more than half of the people they tested had HIV.
- [36:10]
B
We had 65% plus of our 250 drug users were HIV positive.
- [36:16]
A
So it went from 65 to 5.
- [36:18]
B
Less than 5, it's about 3.
- [36:21]
A
In 2022, in New York City, 1% of new HIV infections were through injection drug use. How singular would you say? Like access to clean needles?
- [36:33]
B
Absolutely. Essential.
- [36:35]
A
Change.
- [36:36]
B
Pivotal. Pivotal. So we taught people, in effect, a new way of viewing syringes that you didn't have to pay for them. A new. It was much more profound than we thought going in. We transformed the commodity into a public health intervention. The syringe lost its dollar value and it became a human endeavor. It had a humanistic value like that, and we didn't know that until we started doing it. The work has made me touch my own humanity in so many ways that it has transformed. It's made me a better human being. I mean, and yes, I've had loss, but it's never shaken my faith in humanity.
- [37:44]
A
Today, Joyce Rivera is turning her focus toward another danger for drug users. The South Bronx is now ground zero in New York City for overdoses. Joyce is trying to open a safe injection site. And look, she knows that for thousands of people in the South Bronx, her efforts aren't going to be enough. Most households around where St. Ann's is based have an income of $20,000 or less. And Joyce knows that the problems of poverty can easily lead to addiction. But Joyce also remembers the lessons she learned with Father Barrios and that drug kingpin. When systems and institutions fail, individuals can still save lives. So now, if she can keep drug users safe until they can get into recovery, at least she knows she is honoring her brother and making a difference. Next time on Blindspot. Living with HIV today. I knew that I was HIV positive
- [38:55]
I
since I was very, very young. And even though I didn't really know what it meant, I knew that I had it.
- [39:11]
A
The Plague in the Shadows is a co production of the History Channel and WNYC Studios in collaboration with the Nation magazine. Our team includes Emily Bottin, Karen Franklin, Ana Gonzalez, Sophie Hurwitz, Lizzy Ratner, Christian Reedy and myself, Kai Wright. Our advisors are Amanda Aronczyk, Howard Gertler, Ginny Lawton, Marianne McCune, Daruba Richen and Linda Villarosa. Music and sound design by Jared Paul. Additional music by Isaac Jones and additional engineering by Mike Kutchman. Our executive producers at the History Channel are Jesse Katz, Eli Lehrer and Mike Diller. Thanks to Miriam Barnard, Lauren Cooperman, Andy Lancet and Kenya Young. I'm Kai Wright. You can also find me hosting Notes from America live on public radio stations each Sunday or check us out wherever you get your podcasts. Thanks for listening.
- [40:26]
L
Expedia hey you. What you doing scrolling doom scrolling looking at other people's vacations. Miami, San Diego, Cancun. Okay, what about you? What places will you go? Expedia is the one place you go to go places. Your trip can earn rewards which you can use towards your next eligible stay. Soon people will be doomscrolling you. You'll be that friend's friend, but with rewards. What are you waiting for? Expedia, the one place you go to go places. Terms apply.
- [40:56]
A
So good.
- [40:57]
G
So good. So good.
- [40:59]
I
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