MIAMI — Earlier this month 51 Haitian refugees, most of them with full-blown AIDS, were flown quietly to the United States and paroled to relatives in Miami, New York and Boston after they became so sick they no longer could be treated at a dusty, barbed wire-enclosed camp at Guantanamo, Cuba, where they have been held for more than a year.
Still remaining at the makeshift tent city at the U.S. Naval Base at Guantanamo, however, are 191 other Haitians, including 161 who have tested positive for the AIDS virus. They are waiting, in the words of one refugee advocate, "to become sick enough to be brought to America."
Adds Michael Ratner, a lawyer with the Center for Constitutional Rights in New York: "It's shocking. This is an absurd situation where people want to creep up on death rather than get healthy so they can get treatment. This is the Byzantine result of running a camp like this."
What to do with the last of about 40,000 Haitian refugees interdicted at sea by the U.S. Coast Guard since the September, 1991, coup that ousted Jean-Bertrand Aristide remains a vexing problem for the Clinton Administration. All of the refugees have been found to have plausible claims to political asylum and thus cannot be returned to Haiti. But neither, under current U.S. law, can people who test positive for HIV, the virus that causes AIDS, be admitted to the United States.
Although President Clinton has said that immigrants should not be turned away simply because they are HIV-infected, he has not addressed the plight of the Guantanamo Haitians.
The legal logjam was broken for the sickest of the refugees March 26 by a federal judge in New York who ordered the government to either provide the Haitians with adequate medical care on Guantanamo, or bring them to the United States. The order by U.S. District Judge Sterling Johnson Jr. pertained to those people with CD-4 cell counts of 200 or lower. CD-4 cells, also known as T4 Helper cells, are critical immune system cells that are targeted by the AIDS virus. The normal range is 800 to 1,200 cells per cubic milliliter of blood.
In response to Johnson's order, the Justice Department conceded that adequate medical treatment was unavailable for the sickest Guantanamo refugees and agreed to bring them to the United States.
But the Clinton Administration has not articulated a policy on how the remainder of the refugees at Guantanamo will be treated. The de facto policy, however, seems clear to refugee advocates and resettlement officials.
"My understanding is that when they meet the criteria of the judge's order (and have CD-4 counts of 200 or less), then they will be brought," says Roseann Micallef, director of the Church World Service refugee program in Miami, which is resettling the Haitians.
"It's appalling that people would not be allowed to join relatives here. Conditions at Guantanamo warrant clearing out the camp regardless of what (CD-4) count they have.
"Resettlement here has to be infinitely cheaper than keeping Guantanamo open and functioning. To me it's inhumane continuing to keep them in camp. I don't know what would motivate someone to continue that policy."
Indeed, the costs are high, both in money and public image. Those who have visited the refugee camp on Cuba's eastern tip, including teams of physicians, the Rev. Jesse Jackson and others, have deplored the conditions.
On the March 29 Oscar awards telecast, actors Tim Robbins and Susan Sarandon chastised the Clinton Administration for its policy on Haitian refugees before a worldwide audience of an estimated 1 billion viewers.
According to figures supplied by the AIDS Action Council in Washington, the cost of treating an AIDS patient from the time of HIV diagnosis to death averages $102,000. Ratner says that estimates of keeping the refugees at Guantanamo, where they are guarded by a military detachment of about 350, runs about $1 million a month.
A spokesman for the U.S. Justice Department said this week that the policy on interdiction and the ban on admitting HIV-infected immigrants except on an emergency basis remains unchanged.
Of the 51 Haitians brought to the United States in two groups earlier this month, 39 were HIV positive and had CD-4 cell counts below 200. The others in the groups were dependents.
Over the last few months, even before Judge Johnson's order, some 28 other Guantanamo Haitians also have been granted "humanitarian parole" status and were admitted to the United States for medical treatment.
Meanwhile, both the government and attorneys for the refugees await a further ruling from Johnson on a lawsuit filed by Guantanamo Haitians seeking access to attorneys and an end to detention at the camp. The judge could rule next week.