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0:39

You were just saying no one has ever asked what

0:41

if. What were you about to say about

0:43

that? Well, no one has ever asked

0:47

what if there had been

0:49

no HIV epidemic, right?

0:51

No one's ever said that. Not to me

0:53

anyway. I've been around long enough. What

0:56

if I could have grown

0:58

old with my brother?

1:01

That's something that

1:03

I miss. Sometimes I'm at

1:05

home and whatever, something happens, you know,

1:07

and I want to get up and

1:10

call someone. And I realize that my

1:12

entire immediate family, almost entirely, is missing.

1:21

What if HIV had

1:24

shown up in the U.S. and

1:26

we stopped it? Could we

1:28

have stopped it? Joyce

1:33

Rivera is from the South

1:35

Bronx, which is a place where

1:37

both HIV and drug addiction

1:39

remain enormous challenges. She

1:45

is someone who has thrown her entire

1:47

life into stopping the spread of HIV,

1:50

and through her work, she has

1:52

saved thousands of lives. Unlike

1:55

in Harlem, where we were for the last

1:57

episode, where some people were very reluctant. That

2:00

to speak up, she always took

2:02

action as soon as she understood

2:04

what was going on in her

2:06

neighborhood. And the South Bronx. And

2:11

today decades later she's still runs

2:13

a syringe exchange and what she

2:15

calls a health have their They

2:17

provide all kinds of services cause

2:20

see hands corner of harm reduction.

2:25

My choice wasn't a public health leader

2:28

back when the virus first showed up

2:30

in her neighborhood and in her brother.

2:32

To me, in her office, there's an

2:34

old photograph of them together. It's

2:37

an all New York City apartment seat, a

2:39

radiator, and it's. Christmas time you can

2:41

see a Christmas tree off to

2:43

the side and crisis. In the seventies

2:45

and he has pretty long hair. He

2:50

has his arm around me and I

2:52

have my arms around his waist and

2:54

there. Was a picture. It.

2:56

As pals leave, we're pals. To

3:05

you, I assume you do know how he

3:08

got sick in the first place. Yes, He

3:10

was he was, he was

3:12

injection related, he engaged and

3:14

petty crime. the lead him

3:16

to land out at their

3:19

and a prison upstate and

3:21

dare he started to inject

3:23

and dare they were sharing

3:25

and no one. On.

3:27

One. One.

3:29

Neil among all the people and Carlos

3:31

his unit. It was

3:34

the early nineteen eighties and when cause was

3:36

released from prison truce noticed he was weak.

3:39

My. Brother as started to

3:42

develop symptoms and I've been

3:44

watching the news and I'm

3:46

matching up the symptoms with

3:49

what he's experiencing and one

3:51

nine I get up in

3:53

a metre the night and

3:56

sitting at the pot. Is.

3:58

Hits me. The like

4:00

to spend over and saw because I

4:02

knew. That. He has

4:04

it. From.

4:14

The History Channel in Dubuque, N Y C.

4:17

This is Blind Spot, The Plague in the

4:19

shadows, stories from the early days of Aids

4:21

and the people who refuse to stay out

4:23

of sight. I'm kind, right? What

4:26

could have saved Carlos and thousands of

4:28

drug users in the South Bronx alone?

4:30

So it's Rivera is going to walk

4:33

us through her decades long effort to

4:35

find an answer to that question. In

4:37

this episode, we look at the heroin

4:39

epidemic of an eighties, seventies and eighties

4:41

and how big a role it played

4:44

in the. Spread of Hiv. The

4:48

story actually begins way before hiv

4:50

had a name. We.

4:57

Know when Aids came into public consciousness

4:59

and Nineteen Eighty One it was described

5:01

as a game as disease. Or

5:04

for people who are interacting with drug

5:06

users. The sign started popping up years

5:08

earlier. In New York

5:10

there was an agency set up in

5:12

the nineteen sixties. com D S S

5:15

the Division of Substance Abuse Services for

5:17

Job was to try to study drug

5:19

use. Today's Early

5:21

was a researcher there and in

5:23

the late nineteen seventies they noticed

5:25

a huge uptick in pneumonia deaths.

5:28

And we couldn't understand what

5:30

was happening because in of

5:32

it is ammonia always say

5:34

constant threat and all the

5:37

sudden there was an explosion

5:39

of pneumonia deaths. It was

5:41

like five times the number

5:43

of deaths as the years

5:45

before He told my colleague

5:48

Lizzie Ratner desist didn't make

5:50

sense at that time. We.

5:53

Were monitoring. Death.

5:55

Certificates among. People.

5:57

Who inject drugs? When.

6:00

You forget that time to. Me: A little

6:02

late seventies. Show already in the

6:04

late seventies you are seeing. These

6:07

pneumonia deaths. Guess. Not

6:09

like in the eighties you look back and saw the

6:12

pneumonia that but. He know he as we

6:14

saw them in the late seventies. They

6:16

were not. Classified.

6:18

As Pneumocystis Pneumonia, they were

6:21

just pneumonia. Or

6:23

we didn't And unfortunately, we didn't

6:25

look carefully enough to see it

6:27

was Pneumocystis. But we saw a

6:29

big increase in the Manga Deaths.

6:35

So this organization in New York

6:37

that set up to study drug

6:40

use saw something out of the

6:42

ordinary and turns out other people

6:44

were seeing the same explosion of

6:47

illness and death and drug users.

6:53

There were big red flags on Rikers

6:55

Island, your city's largest jail complex. You.

6:59

Clearly saw this will usually I'm trying

7:01

to imagine it now. walk and is.

7:03

He went to visit a nun who had

7:06

worked at Rikers Assessor I Lean Hogan. There

7:08

wasn't much communication between let.

7:10

In the late nineteen seventies history Lean

7:12

was a chaplain there. She worked at

7:15

Rikers for nine years and she was

7:17

the first female Chaplin in the permit

7:19

a question for you know I went

7:22

through another a log books in a

7:24

like what I did every day because

7:26

Israeli has these know books from her

7:29

time there and she remembers spending most

7:31

of her days in the infirmary ministering

7:33

to second mates and I was talking

7:36

about how crowded the infirmary mass. I

7:38

say is it's crowded. It's

7:41

very crowded, is crazy hair and

7:43

that was an already nineteen seventy

7:45

eight that your it's crowd and

7:47

I silence the seventy nine that

7:50

was no seventies and we didn't

7:52

even call it a disease and

7:54

of people would up they couldn't

7:56

gain weight. They were very

7:58

sin on. And usually

8:01

people came back in as they

8:03

are just on drugs. So excited

8:05

begins to sell out. Two. Or

8:07

three weeks. Of. These people that

8:09

these women weren't and we affect they

8:11

with the number. Of women up. Ups

8:14

in the infirmary because normally it

8:16

was and past normally they didn't

8:19

have to open. More rooms for

8:21

them and they had to open more rooms

8:23

they have open were rooms. Researchers

8:33

studying drug users, a nun at Rikers

8:35

Island, and then we met a doctor

8:37

who spent most of his career in

8:39

the Bronx. Or

8:44

you, Rubenstein was also saying something

8:46

new seven he'd never seen before.

8:49

Suddenly. In Nineteen Seventy Eight, Seventy

8:51

Nine Even seventy eight was Monday and of

8:53

seventy eight we so patients that be could

8:55

not see guards were dead. Are.

8:58

You is on the faculty at

9:00

Albert Einstein Medical Center and Muster

9:02

Medical Center. He's an immunologist and

9:04

back then he was spending most

9:06

of his work d dealing with

9:08

test tubes. My son a lab.

9:11

Than. That was my life they

9:13

choose I'd send some seventy

9:16

three and thin seventies eighties

9:18

Sigma Winston the there was

9:20

a and explosion of patients

9:22

was immune deficiency be didn't

9:24

understand. And then I

9:26

switched into the clinical part. In

9:29

started seeing these patients and

9:31

their immune system seemed Ottawa

9:33

was the has his said

9:35

you didn't notes. And

9:38

celebrated immunoglobulin. We

9:41

so it's it's uses a see

9:43

the immune deficiency. Most

9:45

of them were from the So swamps. And

9:48

why do you think that? The

9:53

I think this was an area

9:55

in which is drug use was.

9:58

ah There

10:01

was a lot of substance abuse

10:04

in men and also in women. So

10:07

you would assign it primarily to the drug epidemic?

10:10

I think that was the initial cause

10:14

of the rampant transmission. Arié

10:19

was seeing all these patients, drug

10:21

users and young kids with

10:24

puzzling symptoms, but he was also reading the

10:26

medical journals. He knew

10:28

that doctors around the country were starting

10:30

to see something unusual in gay men

10:32

in urban centers. And they

10:34

said there must be some connection. And

10:38

I wrote the paper. It was

10:40

rejected. I mean,

10:42

the people of CDC came to us and

10:47

looked at our patients and did not believe

10:49

that they have HIV. They

10:55

said it's possible. I mean,

10:57

not sure. They spent, I

10:59

think they spent half a day with us going over the

11:01

cases. Look,

11:03

we had different opinions. I

11:06

was convinced about it. And they were not

11:08

convinced. I

11:14

guess one of the questions we have is

11:18

would it have made a difference if

11:21

people had listened sooner? Well,

11:24

I think concerning the epidemic, it

11:28

would have made a difference because you

11:30

could have prevented sexual transmission.

11:32

You could have prevented transmission from

11:34

drug abuse. But

11:37

regarding treatment, really had no tools

11:39

at that time. There

11:41

were no medications. But the spreading

11:43

of the disease, it may

11:46

have made an impact. Was

11:49

there a particular blind spot that the

11:51

medical community you think had that prevented

11:54

them from recognizing what

11:56

you recognized? focused

12:00

mainly on the gay community. They

12:03

didn't look behind it and they

12:05

did not look at the substance abuse

12:07

community. That

12:09

happened much later. Other communities

12:12

were just hiding it. In

12:15

the substance abuse

12:17

community for instance, they

12:20

were getting infection, dying from infection, dying

12:22

from poverty and it

12:25

did not go out of the press. Yep,

12:29

he's right. He's exactly

12:32

right. Who cares about the poor

12:34

and who cared about substance abuse?

12:37

It's nobody. Joyce Rivera saw

12:39

it all close up. It's very sad.

12:41

You know, it's very sad.

12:43

How do you allow this

12:45

infection to just be in the lifeblood

12:47

of a community and basically

12:50

like, let people

12:52

die, let people infect each other. To

13:00

really understand what happened, why and

13:02

how the virus was able to

13:04

flourish among drug users, it's

13:07

worth taking a walk with Joyce through the

13:09

South Bronx, but she grew up.

13:12

Hi, how are you? Thank you so

13:14

much. Thank you so much. For sure.

13:17

On a rainy day, Joyce bounds out

13:19

of an Uber and calls out

13:21

as she opens up an umbrella

13:24

to protect her head of silver

13:26

and pink hair. I love the pink in your

13:29

hair. Is it new? Is it always new? Joyce

13:31

meets our producer, Ana Gonzalez. You know, I used

13:34

to have it all over her. And then I only

13:36

had one. She tours us around her neighborhood. I really

13:38

am a city kid. I learned how

13:40

to swim there. All

13:43

the kids would come and we

13:46

would go swimming. I was

13:48

like 10 or 11. Make

13:50

sure it had 25 cents at 30. I

13:52

mean, it really dates you but you could

13:55

get two little hamburger pads or pizza, which

13:57

was for us like we would never ever mean I come

13:59

from a traditional. We never ate out.

14:01

Her parents had come from

14:03

Puerto Rico when they were young. Growing

14:06

up, Joyce and her brother lived in the

14:08

same apartment building as her grandparents. We

14:11

had apartment 4, apartment 16, apartment 17. A

14:14

whole family right there. Her

14:17

parents were on the fifth floor, the grandparents on

14:19

the second. Joyce's

14:21

family got even bigger with two younger

14:23

sisters. Joyce and her brother,

14:25

they would go stay downstairs with the grandparents.

14:28

The two of us were like two little puppies for the

14:30

old people. And

14:32

we were like two shits who was running around

14:35

the house, very indulged by these old ladies. There

14:37

were four kids, but Joyce and

14:39

Carlos, or Carlito as they called

14:42

them, they were especially tight. They

14:44

were a year and ten months apart. Always

14:47

together. We played under the bed.

14:49

We had fun. Her

14:56

mom's apartment was on the top floor of

14:58

the building, right by the staircase that went

15:00

out onto the roof. Both

15:02

of which were big hangouts for people

15:04

getting high. Drug users

15:06

were part of the life in the neighborhood. They

15:09

all knew Joyce, and they all knew

15:11

her mom, Nellie, and they trusted each other.

15:15

And they would knock on the door and ask, you

15:17

know, say Nellie, you know, Nellie,

15:19

can we have some water? And then we would

15:22

give them water, and then they would either leave

15:24

or something bad happened. They would say,

15:26

Nellie, call the cops. And I would

15:28

call. But

15:32

by the 70s, as Joyce finished

15:34

college and started working, things

15:37

had gotten a lot worse. Some

15:41

streets in her neighborhood just had

15:44

become complete open-air drug markets. Brook

15:47

Avenue was like a

15:49

bazaar. So, I mean,

15:51

every car length there would be

15:54

a different deal of selling a

15:56

different brand. You

15:58

Know, when you walk, you would hear everyone. Walking

16:00

their brand their know who's

16:02

she's dead on arrival. Michael

16:05

Jackson? you know? whatever. They

16:07

had different names, different brands.

16:10

all heroin or heroin. The.

16:14

Bronx became a central place for

16:16

the distribution of heroin throughout New

16:18

York City and the center for

16:21

drug addiction to. Does a

16:23

terrible years. This is terrible years

16:25

and am depressed of like no

16:27

man's land. People argue about

16:29

which things were cause which things were

16:32

of fact. But here's some realities about

16:34

the late sixties and early seventies that

16:36

led to this moment in the Bronx.

16:41

Economic collapse or crossed city,

16:43

but particularly in poor neighborhoods.

16:45

Like much of the Bronx,

16:48

the fiscal crisis reduces the

16:50

and services social services healthcare

16:52

services by over forty percent.

16:54

Jobs disappeared. And then we have a

16:57

homeless crisis. Landlords burning buildings

16:59

for insurance may. That

17:01

housing stock and a bus is.

17:03

Burning for. Somebody else is processed.

17:06

And then an influx of

17:08

drugs. So we

17:10

we ignored that we so of

17:12

decide what get a bronze can

17:15

die and a bind. In

17:19

that moment, Many. Responses

17:21

were possible: more addiction

17:23

treatment centers to help

17:25

drug users, economic development

17:27

to create new jobs,

17:30

Have robust social service network to

17:32

provide support for families that were

17:34

struggling. But. That.

17:36

Is Not where this country

17:39

was politically America's public enemy.

17:41

Number one in the United

17:43

States is drug abuse. This

17:47

was from the speeds President Nixon

17:49

gave Nineteen Seventy One and it

17:51

kicked off what became the War

17:54

On Drugs. Nixon set up the

17:56

Drug Enforcement Administration Dea A in

17:58

Nineteen Seventy Three. And

18:01

it becomes clear that part of what we're

18:03

going to do to bring the problem of

18:05

drugs down is think about not the

18:08

public health issues of high rates of

18:10

addiction and reuse. Robert Fullilove teaches at

18:13

Columbia University School of Public Health. Now,

18:15

let's think about how much drugs are leading to

18:17

crime and make it a criminal justice

18:19

issue. We don't deal with

18:21

issues of addiction. It's a medical problem

18:24

that can be managed if there are

18:26

appropriate resources. So, we declare this a

18:28

criminal justice issue. Let me

18:30

scare you away from drug use by

18:32

threatening you with many, many, many years

18:34

of incarceration. Eventually,

18:38

states like New York passed laws

18:40

making it illegal not only to

18:42

sell, but to use any drug

18:44

equipment like needles and

18:47

syringes. And what that meant

18:49

in practice is that you could get arrested

18:51

simply for carrying around a needle. So,

18:54

just as a new virus lands

18:56

in our cities, one that spreads

18:59

through bodily fluids, you

19:01

have a drug policy that ends

19:03

up concentrating IV drug users in

19:05

tight spaces with little access to

19:08

clean needles. One

19:10

was in prisons and jails. Remember

19:12

how crowded the infirmary was at Rikers?

19:16

And another was on the outside. In

19:18

places like the South Bronx, drug

19:21

users began to change where they would gather

19:23

to get high. Addicts aren't

19:25

stupid. And dealers aren't stupid

19:27

either. All those empty, often

19:30

burned out buildings in the Bronx,

19:32

they could be put to another use. Shooting

19:35

galleries started appearing. Abandoned

19:38

buildings where drug users could rent

19:40

or borrow needles and then inject

19:42

heroin, right there, away from the

19:44

eyes of police. How about we

19:46

take over whole buildings where

19:48

it might be possible for you to

19:51

come and buy product as well as

19:53

your tools, injection equipment so

19:55

that the law leads

19:58

people to create

20:00

shooting galleries, which isn't already right. Like people didn't

20:02

use to shoot up that way. They did not.

20:04

They did not. And

20:06

shooting galleries brought together a group of

20:09

people where Neil's sharing was common. Suddenly

20:12

makes it possible for HIV to have a

20:14

hugely efficient route through which it

20:17

can infect other people. By

20:22

the end of the 1980s, the highest concentration of

20:25

HIV infection in the entire

20:27

country was in the South Bronx.

20:30

Dr. Kathy Anastas was a primary

20:32

care doctor there at Matzohir Medical

20:35

Center. I don't think anyone

20:37

saw that it would devastate

20:39

whole communities. It would devastate

20:42

the gay men's community. And it

20:45

really did devastate the South Bronx. She

20:48

treated heart disease, diabetes, asthma, regular

20:50

stuff. But a full half of

20:53

her time was spent treating patients

20:55

with HIV and AIDS. Well,

20:58

how much patient care did I

21:00

do? Six sessions, probably, actually

21:04

probably 40 to 50 people in a

21:06

week. It was the leading cause of

21:08

death for people 15 to 49,

21:13

15 to 45 for a decade

21:15

at least. Injection

21:17

drug use had surpassed all other risk

21:20

factors as a cause of new cases

21:22

of AIDS in New York State. And

21:25

the thing was, there was a way

21:27

to change this, to slow the rate

21:29

of transmission. And it wasn't even

21:31

that complicated. Remember the drug

21:34

researcher Don DeGirlay, the guy who

21:36

saw all those pneumonia deaths in

21:38

the 1970s? He said he

21:40

knew a doctor at the time who offered

21:42

up clean needles in his waiting room. He

21:45

didn't give us the guy's name. It was

21:47

definitely illegal back then. There

21:49

was a long

21:51

time between knowledge that

21:56

the virus was being transmitted through

21:58

sharing syringes. which was developed

22:00

in the mid 80s till New

22:03

York City got syringe

22:05

exchange programs in What

22:08

do you think the consequence of that delay was?

22:14

Tens to maybe hundreds of

22:17

thousands of unnecessary

22:19

deaths. That's

22:22

a worldwide figure, not just New York

22:24

City, but it might have

22:26

included Joyce Rivera's brother, Carlos Rivera.

22:31

Yeah, I was terrible. He

22:33

died at New York Hospital. My

22:36

brother was just 31 years old. What's

22:46

that song? You ain't heavy. You're my sister,

22:48

something like that. He would sing that, you

22:50

know. That's

23:07

a beautiful song. I

23:11

guess what I want to say is, is

23:13

for anyone that I love, I'm always going

23:15

to stand up, you

23:17

know, always, you

23:20

know, be their best advocate. I

23:26

didn't want my brother, Carlos, to

23:29

just be one more on the heap

23:32

of a pile of people. And I also didn't

23:34

want the community to just be unremembered. After

23:39

all, it wasn't just Carlos. She

23:42

loses friends, a cousin, another

23:44

cousin, many neighbors. So

23:47

Joyce Rivera charts a new life plan

23:50

when we come back. Blindspot

24:02

is supported by Housing Works. Housing

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24:06

group of AIDS activists in 1990

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and today is one of the

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largest community-based organizations in the country

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serving tens of thousands of New

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Yorkers annually through community-based health care,

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harm reduction services, supportive housing,

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job training, advocacy, and more.

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25:07

If you're listening to Blindspot, the plague in the

25:10

shadows. Joyce

25:12

Rivera didn't see anybody coming

25:14

around doing anything to stop

25:16

the mounting death toll in

25:19

her neighborhood. It's

25:22

the late 1980s. HIV and AIDS

25:24

are a leading cause of death in the Bronx at

25:26

this time. In Harlem, a

25:28

neighborhood with more political clout, needle exchange was

25:30

a no-go. That's the story we told you

25:32

in the last episode. But

25:35

there was nothing getting in Joyce's

25:37

way. She was studying

25:39

political science in graduate school. She quit.

25:42

And after her brother's death, she looked

25:44

around and decided she needed to deal

25:46

with problems closer to home. When

25:48

I look at people who've decided to do

25:50

their own thing, I like those

25:53

people. Because you're getting out of

25:55

the straight jacket. Yeah, because Their

25:58

resilience comes from the power of. That

26:00

they just say no. To

26:02

get a job with the National Drug

26:04

Research Institute. She's a researcher and ethnographer

26:06

on one of the first studies of

26:08

drug use in the United States and

26:11

seen it up meeting a drug dealer.

26:13

A guy who went by the name cause. He

26:16

work with his cousin and between

26:19

the two of them they were

26:21

bringing in about three point six

26:23

million dollars a year from their

26:25

drug trade. The. First time

26:27

I met this man, I met him. Behind

26:29

the barrel of a gun. Or

26:33

I asked go down to meet this guy.

26:35

Won the his security guys had a gun.

26:38

And. I said to myself. Oh

26:40

where did you get yourself into now? Sweaty

26:43

turn out alright. As.

26:51

We. Found his own at a

26:53

prison in Pennsylvania. He is

26:55

now serving life on thirteen

26:57

counts plus one hundred and

26:59

eighty five years on a

27:01

slew of charges pet would

27:03

make Tony Soprano plus murder,

27:05

kidnapping, distributing heroin to get

27:08

the idea. What is this

27:10

story? See

27:12

enjoys college federal prison. He

27:14

will not charged. That is.

27:18

Chris. Own have a case that still pending

27:20

so he wasn't willing to talk on the

27:22

record, but he told us he remembers Joyce

27:25

and she remembers him. Know

27:27

slicer. Let's you know

27:29

man, my com site

27:31

says send their someone

27:33

whole defending a lot

27:35

of calories. And

27:38

he looked like a guy with power.

27:40

The power to make stuff happened in

27:42

a place to had been abandoned by

27:45

the people who were officially in charge.

27:47

Aminu Boy men. But I'm in my family.

27:50

you know I have my next Tuesday. Can.

27:52

we meet oh yeah other yeah okay great

27:54

and then accounts and i have my car

27:57

and i trouble getting you acquire them i

27:59

will talk Now, Joyce

28:01

knew what she was dealing with. I don't

28:03

want to tell you that I, in

28:05

any way, romanticized this is

28:07

a man who solved

28:10

disagreements with violence. But

28:13

she realized he could help her, and

28:15

they might help the community combat HIV

28:18

and AIDS. I mean, obviously,

28:20

I hated drug dealers because my brother

28:22

had just died of HIV-AIDS, you know,

28:24

through drugs. And I was furious

28:26

around all of that. But I'm

28:28

teaching him about HIV-AIDS, and he wants

28:30

to know, well, what can I do

28:32

about it? And of course, I have

28:34

a ready answer. She

28:37

says, give out free, clean syringes

28:39

with each heroin sale. No

28:42

way, he says he does not want to

28:44

get that involved. But he has

28:46

another idea. That I should do it in

28:48

his spot. Cason wouldn't hand out

28:50

the needles himself, but he'd make a space for

28:53

Joyce to do it. And he says, no, we'll

28:55

close off for you. And

28:57

he did. For a couple hours

28:59

every week, the drug trade stopped.

29:03

And that same location became what

29:05

you might call a pop-up

29:07

DIY public health site. And

29:10

then he said, you have any business cards? He

29:12

said, no, he just makes them. We'll

29:15

give it out with every sale. That's

29:17

what we did. It said, stay

29:19

healthy, you know, and entered in Spanish,

29:22

en oquil es eso salud. Stay

29:24

healthy. And his

29:26

team would take Joyce's business cards and pass them

29:28

out during drug deals. And they

29:30

came. That

29:37

first Saturday in spring of 1990, Joyce

29:40

drove her hatchback down to the

29:43

park and unloaded boxes of literature

29:45

about HIV transmission and boxes

29:48

and boxes of clean syringes. Oh,

29:52

this tree was here. This

29:54

was a big drug dealing spot. She

29:56

placed them on three tables and held them down with rocks

29:59

and bricks from the park. the park and

30:01

true to his word, Koussoune was not there, but

30:03

his men were. They unpacked

30:05

my car and they

30:08

stood sort of like, you

30:10

know, sentinels. And it occurred

30:12

to me that people had to learn

30:15

to exchange syringes. Because

30:19

this had never happened before. Because they said not.

30:21

In a way, their sentinels allowed

30:24

me to create a line

30:26

that somewhat mimicked the lines that

30:28

they had for the drug

30:30

dealing. Joyce's

30:33

DIY needle exchange in partnership

30:36

with a drug kingpin was

30:38

a success. In fact,

30:40

it was so successful, Joyce ran out of

30:42

those little red sharps containers that you put

30:45

used needles in. So she

30:47

put out the word, she needed help and

30:49

help came. Then the grandmas came

30:51

with their bottles of

30:53

detergent. Just store the used needles.

30:56

And then in those lines that they brought me

30:58

those bottles, they talked about their despair about having

31:00

a daughter that was in jail. Needle

31:04

exchange was still illegal in New

31:06

York City. And at this point,

31:08

Joyce was totally improvising. She

31:10

cashed out a retirement fund to keep the work

31:12

afloat. Wasn't a lot of money, but

31:15

you know, it was like,

31:17

you know, 15K. Soon

31:20

it wasn't just the grandmothers in line. People

31:23

came with, you know, evident

31:26

HIV, right, and

31:28

sickness. This time

31:31

she found a physician's assistant from Beth

31:33

Israel to help people get tested for

31:35

HIV, which wasn't so easy back

31:37

then. When Joyce says she

31:39

runs a health hub now where you can get lunch as

31:41

well as a flu shot, this is

31:43

where it started. Of

31:48

course, drug dealers are not the

31:50

most reliable people on earth. Koussoune

31:53

and his cousin were fighting, and

31:55

eventually Koussoune was charged with hiring

31:57

someone to murder his cousin. the

32:00

local police who had basically been turning

32:02

a blind eye to this free syringe

32:05

exchange operation, they told Joyce

32:07

she had to cut it out. She couldn't keep operating

32:09

here. So

32:11

now Joyce had a mini outdoor

32:13

public health one-stop shop for drug

32:16

users with nowhere to put it.

32:19

She had to find someone to help and someone

32:21

told her to turn to, of all

32:23

things, a local church, a guy

32:26

named Luis. Oh

32:29

there you are, right here.

32:31

I'm Father Luis

32:33

Barrio. Even though she never made

32:36

her first communion and rarely went to church,

32:38

Joyce Rivera is strategic. She was

32:40

not afraid to use the church.

32:44

Father Luis Barrios was the priest of

32:46

the Episcopal Church a few blocks up

32:48

the street. He was already making

32:50

a name for himself as a bit of a radical. What

32:53

I bring to the pulpit is activism.

32:56

You don't get the community

32:58

inside the church. You get the church inside

33:00

the community. Father

33:03

Barrios had seen Joyce at her pop-up

33:05

meal exchange and he could tell she

33:07

was a powerful person. I

33:09

knew all the drug users in the community

33:12

but I never saw them in the line. I'm

33:14

so organized so she's giving our

33:16

nighters and condoms and I say oh

33:18

this is very interesting and

33:21

then later we talk. And he said listen this

33:23

is what we're going to do and he used a

33:25

word in Spanish, truca. Let's

33:30

trick them. Let's just move this operation

33:33

up the block to outside of St.

33:35

Ed's because the police they're not going

33:37

to cross on the church grounds. You'll

33:39

be safe in here. Father

33:44

Barrios isn't just a priest. He

33:47

teaches psychology and Latin American studies

33:49

at CUNY and he

33:51

was drawn to Joyce in part because

33:53

his story was a lot like hers.

33:56

With George, she lost her brother. With

33:59

me, I love her. those three brothers, HIV-AIDS,

34:03

they were infected in New

34:05

York City, in the South Brown. Do

34:07

you know how they contracted it? Dirty

34:09

needles. That was

34:11

it. We only had

34:13

the hypothesis, well, it can be, sex

34:16

can be, but no, they

34:18

were sharing needles, dirty needles. And

34:21

then the other three died of overdose. Father

34:27

Barrios gave Joyce an office inside the

34:29

church building. This is where the office

34:31

used to be. Well, I

34:33

was too fast in here. It was a

34:35

tiny room across from the priest's office. This

34:38

was the party where we kept the syringes.

34:41

Joyce was one of a bunch of activists and

34:43

community groups. Theater, you know, off-off, off-Broadway

34:45

theater. The Rainbow Office,

34:47

the LGBTQ that we created. The

34:49

Rainbow Office, in the midst

34:51

of all the sorrow and struggle,

34:54

this place radiated all this life.

34:57

Father Barrios encouraged a

34:59

certain ecclesiastical creativity. One

35:02

time he told her to store the used

35:04

needles in the crypt below the church. You

35:07

would bury them? No, we didn't bury them. We just

35:09

kept them there until we could find a place to

35:11

discard them. Another

35:13

time he got involved. He knew that

35:15

if people felt like the needles and

35:18

condoms were blessed, they would

35:20

be more likely to use them. I still think that

35:22

we are the only ones who bless the needles and

35:25

the condoms. Some people came back asking,

35:27

you see. So

35:31

he said, okay, put your hands, put your

35:33

hands. Father Barrios extends his hands as he

35:36

remembers the prayer. We're going to bless these

35:38

needles and these condoms and just

35:41

say, God, the preservation of life. This

35:43

is what we're going to do. Bless us. And

35:47

some people really believe. That's his ministry. He

35:50

reminds everyone that they have God inside

35:53

them. people

36:00

who, in the absence of any

36:02

coherent or effective public health policy,

36:05

took it upon themselves to fight the virus in

36:07

their community. Legal

36:10

Exchange finally became legal in New York

36:12

City in 1992. Joyce was ready to

36:14

stop improvising.

36:17

She wrote her first grant, and in 1993, she got it. $70,000. St.

36:24

Anne's Corner of Harm Reduction was

36:26

born. I was

36:28

doing harm reduction where? At the corner

36:30

of St. Anne's, and so it became St.

36:33

Anne's Corner Harm Reduction. Joyce's

36:38

work has had real impact. Syringe

36:41

Exchange, combined with the onset of

36:43

effective treatment for HIV infection, which

36:45

came in 1996, they dramatically

36:48

slowed the spread of the virus in

36:50

the South Bronx. St.

36:53

Anne's still has a van that parks

36:55

on corners, offering up free needles. This

36:57

is our syringe exchange right now. In

37:03

the early days, the numbers were bad.

37:05

Well more than half of the people

37:07

they tested had HIV. We had 65% plus

37:11

of our 250 drug users were

37:13

HIV positive. So it went from 65 to 5. Less

37:17

than 5. It's not 3. In

37:21

2022, in New York City, 1% of

37:24

new HIV infections were through injection drug

37:26

use. How

37:28

singular would you say like access

37:31

to clean needles? Absolutely

37:34

essential. Pivotal. Pivotal.

37:38

So we taught people, in effect,

37:41

a new way of

37:43

viewing syringes. If you didn't have

37:45

to pay for them, a new, it

37:47

was much more profound than

37:49

we thought going in. We

37:52

transformed the commodity into

37:55

a public

37:57

health intervention.

38:00

the syringe lost its dollar

38:02

value and it became

38:04

a human endeavor. It

38:06

had a humanistic value like that.

38:10

And we didn't know that until

38:13

we started doing it. The

38:19

work has made me touch

38:21

my own humanity in so many

38:24

ways that it has transformed, it's

38:27

mainly a better human being. And

38:29

yes, I've had loss, but

38:32

it's never shaken my

38:34

faith in humanity. Today,

38:43

Joyce Rivera is turning her focus

38:45

toward another danger for drug users.

38:48

The South Bronx is now ground zero in

38:50

New York City for overdoses. Joyce

38:53

is trying to open a safe injection

38:55

site. And look, she

38:57

knows that for thousands of people in the

38:59

South Bronx, her efforts aren't going to be

39:01

enough. Most households around where

39:03

St. Ann's is based have an income of

39:05

$20,000 or less. And

39:09

Joyce knows that the problems of

39:11

poverty can easily lead to addiction.

39:15

But Joyce also remembers the lessons

39:17

she learned with Hader Barrios and

39:19

that drug Kingpin. When

39:22

systems and institutions fail, individuals

39:24

can still save lives.

39:29

So now, if she can keep drug users

39:31

safe until they can get into recovery, at

39:34

least she knows she is honoring her brother and

39:36

making a difference. Next

39:49

time on Blind Spot, living with

39:51

HIV today. I knew that

39:53

I was HIV positive since I was very,

39:55

very young. And

39:57

even though I didn't really know what it meant, I

40:00

knew that I had it. I'm

40:30

Ky Wright. You can also find me hosting Notes

40:32

from America, live on public radio stations each Sunday,

40:35

or check us out wherever you can find us. Thank

41:01

you very much. I'm

41:30

Ky Wright. You can also find me hosting Notes

41:32

from America, live on public radio stations each

41:34

Sunday, or check out my other videos. I'm

41:37

Ky Wright. You can also find me hosting Notes from America,

41:39

live on public radio stations each Sunday, or check out

41:41

my other videos. Thank

41:44

you very much.