0:02

Hey,

0:05

everybody, it's Kai, back with another episode

0:07

of Blind Spot, The Plague in the

0:10

Shadows. It's a podcast

0:12

series I co-reported with my friend and

0:14

colleague Lizzie Ratner at The Nation, and

0:17

it tells stories from the early days of

0:19

HIV and AIDS in America. Today

0:21

I'd like to share the penultimate episode of

0:23

that series with you. It explains

0:26

how the war on drugs that began

0:28

in the 1970s helped spread

0:30

the virus widely among injection drug

0:33

users and those with substance use

0:35

disorder. If this reporting resonates

0:37

with you, check out the show notes for ways to

0:39

get in touch with us, because we'd love to hear

0:41

from you on this topic. Okay,

0:43

here's the episode, and I hope you enjoy it. You

0:56

were just saying no one has ever asked what if.

0:58

What were you about to say about that? Well,

1:00

no one has ever asked

1:03

what if there had been no

1:06

HIV epidemic, right?

1:08

No one's ever said that. Not to

1:10

me anyway. I've been around long enough.

1:13

What if I could have grown old with

1:15

my brother? That's

1:19

something that I miss.

1:21

Sometimes I'm in my home, and whatever,

1:23

something happens, and I

1:25

want to get up and call someone,

1:27

and I realize that my entire immediate

1:30

family almost entirely is missing. What

1:39

if HIV had shown up

1:41

in the US and we stopped

1:43

it? Could we have stopped

1:45

it? Joyce

1:49

Rivera is from the South

1:52

Bronx, which is a place

1:54

where both HIV and drug

1:56

addiction remain enormous challenges. She

2:02

is someone who has thrown her entire

2:04

life into stopping the spread of HIV,

2:07

and through her work she has

2:09

saved thousands of lives. Unlike

2:12

in Harlem, where we were for the last

2:14

episode, where some people were very reluctant to

2:16

speak up, Joyce took

2:19

action as soon as she understood what

2:21

was going on in her neighborhood in

2:23

the South Bronx. And

2:28

today, decades later, she still runs

2:30

a syringe exchange and what she

2:32

calls a health health care. They

2:35

provide all kinds of services. It's called St.

2:37

Anne's Corner of Harm Reduction. But

2:43

Joyce wasn't a public health leader back when

2:45

the virus first showed up in her neighborhood

2:47

and in her brother. In

2:50

her office, there's an old photograph of

2:52

them together. It's an old New

2:54

York City apartment. You see the radiator and... It's

2:56

Christmas time. You can see a Christmas tree off to

2:59

the side. It's in the 70s and he

3:01

has pretty long hair. He

3:06

has his arm around me and I have my

3:09

arms around his waist. And

3:12

it's a picture of pals. We were

3:14

pals. Do

3:22

you... I assume you do know how

3:24

he got sick in the first place? Yes, he was.

3:27

He was injection related. He

3:30

engaged in petty crime that led him

3:32

to land up at

3:35

a prison upstate and there

3:37

he started to inject and

3:40

there they were sharing one work.

3:46

One needle among all the people in

3:48

Carlos's unit. It was

3:50

the early 1980s and when Carlos

3:52

was released from prison, Joyce noticed he

3:54

was weak. My

3:57

brother started to develop

3:59

symptoms. And I've been

4:01

watching the news and I'm matching

4:04

up the symptoms with

4:06

what he's experiencing. And

4:10

one night I get up in the middle

4:12

of the night and sitting at the pot

4:14

it hits me. And

4:17

I just bend over and sob because I knew

4:19

that he had it. From

4:31

the History Channel and WNYC, this is

4:33

Blind Spot, the plague in the shadows.

4:36

Stories from the early days of AIDS and the

4:38

people who refused to stay out of sight. I'm

4:41

Kai Wright. What could

4:43

have saved Carlos and thousands of

4:46

drug users in the South Bronx

4:48

alone? Joyce Rivera is

4:50

going to walk us through her decades-long effort

4:52

to find an answer to that question. In

4:55

this episode, we look at the heroin epidemic

4:57

of the 1970s and 80s and

4:59

how big a role it played in the spread

5:01

of HIV. The

5:05

story actually begins way before HIV

5:07

had a name. We

5:14

know when AIDS came into public consciousness

5:16

in 1981, it was described

5:18

as a gay man's disease. But

5:20

for people who were interacting with drug

5:22

users, signs started popping up years earlier.

5:26

In New York, there was an

5:28

agency set up in the 1960s

5:30

called DSS, the Division of

5:32

Substance Abuse Services. Their

5:34

job was to try to study drug use. Don

5:37

DeGiole was a researcher there and

5:40

in the late 1970s, they noticed

5:42

a huge uptick in pneumonia deaths.

5:45

We couldn't understand what was

5:48

happening because pneumonia

5:50

was a constant threat.

5:52

All of a sudden,

5:54

there was an

5:56

explosion of pneumonia deaths. five

6:00

times the number of deaths as the

6:02

years before. He told my

6:04

colleague Lizzie Ratner, this just didn't make sense.

6:07

At that time, we

6:09

were monitoring death

6:12

certificates among people

6:14

who injected drugs. When

6:17

you say at that time, do you mean- In the late 70s,

6:19

yeah. Already in

6:21

the late 70s, you were seeing these

6:24

pneumonia deaths? Yes. Not

6:26

like in the 80s, you looked back and saw the

6:28

pneumonia deaths, but- We saw

6:30

them in the late 70s. They

6:33

were not classified

6:35

as pneumocystis pneumonia. They were

6:37

just pneumonia. Unfortunately,

6:40

we didn't look carefully enough to

6:43

see it was pneumocystis, but

6:45

we saw a big increase in

6:47

pneumonia deaths. So

6:52

this organization in New York that set

6:54

up to study drug use saw something

6:56

out of the ordinary. And

6:59

turns out other people were

7:01

seeing this same explosion of

7:03

illness and deaths in drug

7:05

users. There

7:10

were big red flags on Rikers Island, New

7:12

York City's largest jail complex. You

7:16

clearly saw this. Well, usually I'm

7:18

trying to imagine it now. Lizzie

7:20

went to visit a nun who had

7:22

worked at Rikers, Sister Eileen Hogan. There

7:25

wasn't much communication between- In

7:27

the late 1970s, Sister Eileen was a

7:29

chaplain there. She worked at Rikers for

7:31

nine years. And she was

7:33

the first female chaplain in the Department of Corrections.

7:35

Well, you know, I went through another, a log

7:38

book, you know, like what

7:40

I did every day because- Sister Eileen

7:43

has these notebooks from her time there.

7:45

And she remembers spending most of her

7:47

days in the infirmary, ministering

7:49

to sick inmates. And then

7:51

I was talking about how crowded the

7:53

infirmary was. All I say is,

7:56

it's crowded. It's very crowded. It's

7:58

crazy here. And that was already in

8:00

1978 that it's crowded. 79,

8:03

that was in 79. We

8:09

didn't even call it a disease then. People

8:12

would, they couldn't gain weight. They

8:14

were very thin. And

8:17

usually if people came back

8:19

in and if they were just on drugs, they

8:21

would kind of begin to fill out in two

8:23

or three weeks. But these people,

8:26

these women weren't. And it

8:28

was a fact that there was a number of women

8:30

up in the infirmary.

8:33

Because normally it wasn't packed. Normally

8:35

they didn't have to open more rooms for them.

8:37

And they had to open more rooms. They

8:39

had to open more rooms. So

8:49

researchers studying drug users, a nun

8:51

at Rikers Island. And then

8:53

we met a doctor who spent most of his

8:55

career in the Bronx. So you found the house.

8:58

We found it. Hello. Dr.

9:00

Rubenstein. R.A. Rubenstein was also seeing

9:02

something new. Something he'd never

9:04

seen before. Suddenly in 1978, 79, even

9:06

78 was one the end of 78. We

9:11

saw patients that we could not figure out what they had.

9:14

R.A. is on the faculty at Albert

9:16

Einstein Medical Center and Mataphir Medical Center.

9:19

He's an immunologist. And back then, he

9:22

was spending most of his work day

9:24

dealing with test tubes, mice and a

9:26

lab. And

9:28

that was my life actually at Einstein from 73

9:31

until 78. When

9:35

suddenly there was

9:37

an explosion of patients with immune

9:39

deficiency we didn't understand. And

9:42

then I switched into the clinical part. And

9:45

he started seeing these patients and their

9:47

immune system seemed out of whack.

9:51

What they had is the eugene of

9:53

notes and elevated

9:55

immunoglobulin. We

9:57

thought that this is a... Severe

10:00

immune deficiency. Most

10:02

of them were from the South Bronx. And

10:05

why do you think that was the case? Because

10:09

I think this was an area in

10:12

which drug use was... There

10:17

was a lot of substance abuse

10:21

in men and also in women. So

10:24

you would assign it primarily to the drug epidemic?

10:27

I think that was the initial cause

10:31

of the rampant transmission. Arié

10:36

was seeing all these patients, drug

10:38

users and young kids with

10:40

puzzling symptoms. But he was also reading

10:42

the medical journals. He knew

10:45

that doctors around the country were starting

10:47

to see something unusual in gay men

10:49

in urban centers. And they

10:51

said there must be some connection. And

10:54

I wrote the paper it

10:57

was rejected. I mean,

10:59

the people of CDC came to us and

11:03

looked at our patients and did not believe

11:06

that they have HIV. They

11:11

said it's possible. I'm not sure.

11:14

I think they spent half a

11:16

day with us going over the

11:18

cases. Look,

11:20

we had different opinions. I

11:22

was convinced about it. And they were not

11:25

convinced. I

11:30

guess one of the questions we have is,

11:35

would it have made a difference if

11:37

people had listened sooner? Well,

11:41

I think concerning the epidemic, it

11:44

would have made a difference because you

11:47

could have prevented sexual transmission.

11:49

You could have prevented transmission through

11:51

drug abuse. But

11:53

regarding treatment, really had no tools

11:55

at that time. There

11:58

were no medications. Spending

12:00

or the disease. It

12:03

may have had made an impact. With.

12:06

Their particular blind spot that the

12:08

medical community you think had that

12:10

prevented. Them from recognizing

12:12

what you recognized. I

12:16

six your focus mainly on the gay community.

12:19

To. Didn't look me land it and

12:21

they did not look at these substance

12:24

abuse communities. That

12:26

have been much later. Other

12:28

communities were just hiding it

12:30

a in this sub snowy

12:32

i'm abusing communities for themselves

12:34

books as they were getting

12:36

say sunday for mean section

12:38

saying from poverty and I'm

12:40

it not go out to

12:42

the press. Yep,

12:46

he's right. Is

12:48

exactly right, cares about the

12:51

poor and Will cared about

12:53

substances. Is Betty so it's Rivera.

12:55

Saw it all close up. A

12:57

very sad. And I

12:59

sorry sad, how do you

13:01

allow disinfection to just be

13:04

in the lifeblood of a

13:06

community and and is basically

13:08

like slip people die, let

13:10

people infected similar. To

13:17

really understand what happened, why and

13:19

how the virus was able to

13:21

flourish among drug users. It's

13:23

worth taking a walk with choice through the South

13:26

Bronx. But she grew up and. Thank

13:31

so you so much. on

13:34

a rainy day to balance out

13:36

of a super and called out

13:38

as see opens up an umbrella

13:40

for protect her head of silver

13:42

and pink hair out of the thinking

13:44

ahead as a new that only

13:46

three sweets or producer on our

13:48

gonzalez. Or

13:52

all and and towards us around her

13:54

neighborhood I. Really am a city

13:56

says Alan had a son less.

14:00

All the kids would come and

14:02

we would go swimming. I

14:04

was like 10 or 11. We'd

14:06

make sure it had 25 cents at 30. I'm

14:09

going to make it really tasty. But you could

14:11

get two little hamburger pads or pizza, which was

14:13

for us like we would never have it. And

14:15

I come from a traditional home. We never ate

14:18

out. Her parents had come from

14:20

Puerto Rico when they were young. Growing

14:22

up, Joyce and her brother lived in

14:25

the same apartment building as her grandparents.

14:27

We had apartment four, apartment 16,

14:30

apartment 17. And we had a whole

14:32

family right there. Her parents were

14:34

on the fifth floor, grandparents on

14:36

the second. And Joyce's family got even

14:39

bigger with two younger sisters. Joyce and

14:41

her brother, they would go stay downstairs

14:43

with the grandparents. The two of

14:45

us were like two little puppies for the old people. And

14:49

we were like two shits who was running

14:51

around the house, very indulged by these old

14:53

ladies. There were four kids,

14:55

but Joyce and Carlos or

14:58

Carlito, as they called them, they were especially

15:00

tight. A year and 10 months

15:02

apart. Always together. We

15:04

played under the bed. We had fun. Her

15:12

mom's apartment was on the top floor of

15:15

the building, right by the staircase that went

15:17

out onto the roof. Both

15:19

of which were big hangouts for people

15:21

getting high. Drug users were

15:23

part of the life in the neighborhood. They

15:26

all knew Joyce and they all knew

15:28

her mom, Nellie, and they trusted each other.

15:31

And they would knock on the door and ask you

15:34

to say, Nellie, you know, Nellie,

15:36

can we have some water? And Nellie would

15:38

give them water. And then they would either

15:40

leave or something bad happened. They would say,

15:42

Nellie, call the cops. And I

15:45

would call. But

15:49

by the 70s, as Joyce finished

15:51

college and started working, things

15:54

had gotten a lot worse. Some

15:58

streets in her neighborhood. has to

16:00

become complete open air drug market? Brooke

16:03

Avenue was like

16:06

a bazaar. So I

16:08

mean every car length there would

16:10

be a different dealer selling

16:12

a different brand. You

16:15

know, when you walk, you would

16:17

hear everyone walking their brand, you

16:19

know, Gucci, Dead on Arrival, Michael

16:22

Jackson, you know, whatever, they had different

16:24

names, different brands. All heroin?

16:27

All heroin. The

16:31

Bronx became a central place for

16:33

the distribution of heroin throughout New

16:35

York City and a center for

16:37

drug addiction too. Those are terrible

16:40

years. This is terrible years and

16:43

the Bronx look like no man's land. People

16:45

argue about which things were caused,

16:48

which things were effect, but here

16:50

are some realities about the late

16:52

60s and early 70s that led

16:54

to this moment in the Bronx. Economic

16:58

collapse across the city, but particularly

17:00

in poorer neighborhoods, like much of

17:03

the Bronx. The fiscal

17:05

crisis reduces the services,

17:07

social services, healthcare services by over

17:09

40%. Jobs

17:11

disappeared. And then we have a homeless

17:13

crisis. Landlords burning buildings for

17:16

insurance money. The housing stock in

17:18

the Bronx is burning

17:20

for somebody else's profit. And

17:23

then an influx of drugs. So

17:27

we ignored that. We sort of

17:29

decide, look at the Bronx, can

17:31

die on the vine. In

17:36

that moment, many responses

17:38

were possible. More

17:40

addiction treatment centers to help

17:42

drug users, economic development to

17:44

create new jobs, robust

17:47

social service network to provide support

17:50

for families that were struggling. But

17:53

that is not where this country

17:55

was politically. America's public

17:57

enemy number one in the

17:59

United States. United States is drug

18:01

abuse. This was

18:04

from a speech President Nixon gave in 1971, and

18:08

it kicked off what became the war

18:10

on drugs. Nixon set

18:12

up the Drug Enforcement Administration, the DEA, in

18:14

1973. And

18:18

it becomes clear that part of what we're

18:20

going to do to bring the problem of

18:22

drugs down is think about not the

18:25

public health issues of high rates of

18:27

addiction and reuse. Robert Fullilove teaches at

18:29

Columbia University School of Public Health. Now,

18:32

let's think about how much drugs are leading to

18:34

crime and make it a

18:36

criminal justice issue. We don't deal with

18:38

issues of addiction. There's a medical problem

18:41

that can be managed if there are

18:43

appropriate resources. No, we declare this a

18:45

criminal justice issue. Let me scare you

18:47

away from drug use by threatening you

18:50

with many, many, many years of incarceration.

18:54

Eventually, states like New York passed laws making

18:56

it illegal not only to sell, but to

18:58

use any drug equipment like needles and syringes.

19:02

And what that meant in practice is that you

19:04

could get arrested simply for carrying around a needle.

19:08

So just as a new virus lands in

19:11

our cities, one that spreads through bodily fluids,

19:13

you have a drug policy that ends up

19:15

concentrating IV drug users on the

19:19

site with little access to clean needles.

19:22

One was in prisons and jails. Remember

19:25

how crowded the infirmary was

19:27

at Rikers? And another

19:29

was on the outside in places like the South Bronx.

19:33

Drug users began to change where they

19:35

would gather to get high. Addicts

19:37

aren't stupid. And dealers

19:39

aren't stupid either. All

19:41

those empty, often burned out buildings in the

19:43

Bronx. They could be put to another

19:45

use. Shooting galleries started

19:47

appearing abandoned buildings where drug users could

19:52

Rent or borrow needles and then inject heroin right

19:54

after the drug use. They're

20:00

away from the eyes of police. About

20:02

we take over whole building where

20:05

it might be possible for you

20:07

to com and byproduct as well

20:09

as your thoughts injection of with.

20:12

says. It's the law

20:14

leads people. To.

20:16

Create shooting galleries which isn't already right my people

20:18

it used to shoot up that way they did

20:21

that they the net. And

20:23

shooting galleries brought together a group

20:25

of people were neil searing was

20:27

common. Suddenly. Makes it possible

20:29

for Hiv to have a hugely

20:31

efficient route through which they can

20:33

infect other people. By

20:38

the end of the Nineteen eighties,

20:41

the highest concentration of Hiv infection

20:43

can the entire country was in

20:45

the South Park's. Doctor.

20:47

Kathy and Nesters was a primary care

20:49

doctor there at much of your medical

20:51

center. I. Don't think anyone saw

20:54

said it would. Devastate.

20:56

Whole communities it would devastate

20:59

than the gay men's community.

21:01

And it really did devastate the South Bronx.

21:04

She. Treated heart disease, diabetes, asthma,

21:07

regular stuff, but before half

21:09

of her time was spent

21:11

treating patients with Hiv. And

21:13

it's. Ah, it's pacing

21:15

care and and I do

21:17

six sessions flee I'm. Actually

21:21

probably forty to fifty people in a

21:23

week as the leading cause of death

21:25

for. People's. Fifteen

21:28

To Forty Nine. Fifteen To

21:30

forty size. for a decade,

21:32

at least. Injection

21:34

drug use had surpassed all other risk

21:36

factors as a cause of new cases

21:38

of Aids in New York State, And

21:42

the thing was, there was a way

21:44

to change this to slow the rate

21:46

of transmission and wasn't even that complicated.

21:49

remember the drug research or done these

21:51

are lay the guys who saw all

21:53

those pneumonia deaths in the nineteen seventies

21:55

he said he knew a doctor at

21:57

the time who offered up clean needle

21:59

in his waiting room. He

22:01

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

22:04

definitely illegal back then. There

22:06

was a long

22:08

time between knowledge

22:12

that the virus was being

22:14

transmitted through sharing syringes, which

22:16

was developed in the mid-80s till

22:19

New York City got syringe

22:22

exchange programs in 1992.

22:25

What do you think the consequence of that delay was?

22:27

Um, tens

22:31

to maybe hundreds of thousands

22:34

of unnecessary

22:36

deaths. That's

22:39

a worldwide figure, not just New York

22:41

City, but it might have

22:43

included Joyce Rivera's brother, Carlos Rivera.

22:48

Yeah, it was terrible. He

22:50

died at New York Hospital. My

22:52

brother was just 31 years old. What's

23:02

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

23:05

sister, something like that. He would sing

23:07

that, you know. That's

23:24

a beautiful song. I

23:27

guess what I want to say is, is

23:29

for anyone that I love, I'm always going

23:31

to stand up, you

23:34

know, always, you

23:36

know, like, be their best advocate. I

23:43

didn't want my brother Carlos to

23:46

just be one more on the heap

23:48

of a pile of people, and I also didn't

23:50

want the community to just be remembered. After

23:56

all, it wasn't just Carlos. She

23:58

loses friends. a cousin,

24:01

another cousin, many neighbors. So

24:04

Joyce Rivera charts a new life plan

24:07

when we come back. You're

24:25

listening to Blind Spot, The Plague in the Shadows.

24:29

Joyce Rivera didn't see anybody

24:31

coming around doing anything to

24:33

stop the mounting death toll

24:35

in her neighborhood. It's

24:38

the late 1980s. HIV and

24:40

AIDS are a leading cause of death in the Bronx

24:43

at this time. In Harlem,

24:45

a neighborhood with more political clout, needle exchange

24:47

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

24:49

you in the last episode. But

24:52

there was nothing getting in Joyce's way.

24:55

She was studying political science in graduate

24:57

school. She quit. And after

24:59

her brother's death, she looked around and

25:01

decided she needed to deal with problems

25:03

closer to home. She

25:19

got a job with the National Drug

25:21

Research Institute. She was a researcher, an

25:23

ethnographer, on one of the first studies

25:25

of drug use in the United States. And

25:28

she ended up meeting a drug dealer, a

25:30

guy who went by the name Kuzun. He

25:33

worked with his cousin. And between

25:35

the two of them, they were bringing in

25:37

about $3.6 million a year from

25:42

their drug trade. But

26:00

it turned out alright. We

26:08

found Kucin at a prison in

26:10

Pennsylvania. He is now serving life

26:12

on 13 counts plus

26:14

185 years on a

26:17

slew of charges that would make

26:19

Tony Soprano blush. Murder,

26:21

kidnapping, distributing heroin, you get

26:24

the idea. We wanted

26:26

to hear his side of the story though. Why did

26:28

he see in Joyce? This call

26:30

is from a federal prison. He will

26:32

not be charged for this call. Kucin

26:35

has a case that's still pending so he wasn't willing

26:37

to talk on the record. But he

26:39

told us he remembers Joyce and

26:41

she remembers him. He looked

26:44

like a Latino

26:46

man, my complexion, slander.

26:50

Someone who is burning a lot of

26:53

calories. And

26:55

he looked like a guy with power. The

26:57

power to make stuff happen in a

27:00

place that had been abandoned by the

27:02

people who were officially in charge. I

27:04

made an appointment. Put him in my calendar, you know.

27:07

How about next Tuesday? Can

27:09

we meet? Oh yeah, I'll be here. Okay,

27:11

great. And then I come and I have my

27:13

car and I come and get in. We'll grab

27:15

a round. We'll talk. Now,

27:18

Joyce knew what she was dealing with. I don't

27:20

want to tell you that I

27:22

in any way romanticized this

27:24

is a man who solved

27:27

disagreements with violence. But

27:30

she realized he could help her and

27:32

they might help the community combat HIV

27:34

and AIDS. I mean, obviously

27:37

I hated drug dealers because my brother

27:39

had just died of HIV-AIDS, you know,

27:41

through drugs. And I was

27:43

furious around all of that. But I'm teaching

27:45

him about HIV-AIDS and he wants to know,

27:48

well, what can I do about it? And

27:50

of course I have a ready answer.

27:53

She says, give out free clean

27:55

syringes with each heroin sale. No

27:58

way. does not want to

28:01

get that involved. But he has

28:03

another idea. That I should do it in

28:05

his spot. Cason wouldn't hand out

28:07

the needles himself, but he'd make a space

28:09

for Joyce to do it. And he says, no,

28:11

we'll close off for you. And

28:14

he did. For a couple of hours

28:16

every week, the drug trade stopped.

28:19

And that same location became what

28:21

you might call a pop-up

28:24

DIY public health site. And

28:27

then he said, you have any business cards? No,

28:30

he just makes them. We'll

28:32

give it out with every sale. That's

28:34

what we did. It said, stay healthy, you

28:37

know, and entered in Spanish. En oquías

28:39

de salud. Stay healthy.

28:42

Cason and his team would take Joyce's business cards

28:44

and pass them out during drug deals. And

28:47

they came. That

28:54

first Saturday in spring of 1990, Joyce

28:57

drove her hatchback down to the

29:00

park and unloaded boxes of literature

29:02

about HIV transmission and boxes

29:05

and boxes of clean syringes. This

29:09

tree was here. This was

29:11

a big drug dealing spot. She

29:13

placed them on three tables and held them down

29:15

with rocks and bricks from the park. And

29:18

true to his word, Cason was not there, but

29:20

his men were. They unpacked

29:22

my car, and they

29:25

stood sort of like, you

29:27

know, sentinels. And it occurred

29:29

to me that people had to learn

29:32

to exchange syringes. Because

29:36

this had never happened before. Because they said, no.

29:38

In a way, their sentinels allowed

29:41

me to create a line

29:43

that somewhat mimicked the lines that

29:45

they had for the drug dealing.

29:50

Joyce's DIY needle exchange in

29:52

partnership with a drug kingpin

29:55

was a success. In

29:57

Fact, it was so successful, Joyce ran out of

29:59

those little lines. Read Sharp's containers that

30:01

you put used needles and so you

30:03

put out the word she needs help

30:06

and help Came in the grandma's. Came

30:08

with their. Photos of

30:10

detergent to store the used needles.

30:13

And then in those lines that they brought me

30:15

those bottles they talked about the despair about having

30:17

a daughter that was in. Jail. Needle

30:21

Exchange was still illegal in New

30:23

York City and at this point

30:25

so was totally improvising sketched out

30:27

of retirement funds to keep the

30:29

work afloat. Within a lot

30:31

of money, but kinda. Like

30:34

you know, fifteen kang since. Soon,

30:37

it wasn't just the grandmother's align.

30:39

People came less yeah

30:41

no. As a dancer

30:43

hiv I tend their

30:46

success. To sign, she

30:48

found a physician's assistant from Beth Israel

30:50

to help people get tested for Hiv,

30:52

which wasn't so easy back then. When.

30:55

Joy says he runs a health hub now

30:57

range of months as well as a flu

30:59

shot. This is where it started. But.

31:05

Of course, drug dealers are not the

31:07

most reliable people on earth. Could.

31:10

Phone and his cousin were fighting

31:12

and eventually concern was charged with

31:14

hiring someone to murder his cousin.

31:17

The local police who had basically been

31:19

turning a blind eye to this free

31:21

syringe exchange operation the Dodgers see had

31:23

to cut it out. Can keep operating

31:26

here. So.

31:28

Now Tories had a many outdoor

31:30

public health than stop shop for

31:32

drug users with know where to

31:34

put it said to find someone

31:36

to help and someone told her

31:38

to turn to of all things.

31:41

A. Local church. A guy

31:43

named Luis. De.

31:48

Mars. or fatherly

31:50

value even though she never made

31:52

her first communion and rarely went

31:54

to church joyce rivera is to

31:56

digit she was not afraid to

31:58

use the church Father

32:01

Luis Barrios was the priest of the

32:03

Episcopal Church a few blocks up the

32:05

street. He was already making a name

32:07

for himself as a bit of a radical. What

32:10

I bring to the portrait is activism.

32:13

You don't get the community

32:15

inside the church. You get the church inside

32:17

the community. Father

32:20

Barrios had seen Joyce at her pop-up

32:22

needle exchange, and he could tell she

32:24

was a powerful person. I

32:26

knew all the drug users in the community,

32:29

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

32:31

so organized. So she's giving

32:33

our leaders some condoms, and I say,

32:35

oh, this is very interesting. And

32:38

then later we talk. And he said, listen, this is

32:40

what we're going to do. And he used a word

32:42

in Spanish, truca. Let's

32:44

trick them. Let's

32:49

just move this operation up the block

32:51

to outside of St. Ed's because the

32:53

police, they're not going to cross on

32:55

the church grounds. You'll be safe in here.

33:01

Father Barrios isn't just a priest. He

33:04

teaches psychology and Latin American studies

33:06

at CUNY. And he

33:08

was drawn to Joyce in part because

33:10

his story was a lot like hers.

33:13

With Joyce, she lost her brother. With

33:16

me, I lost three brothers, HIV-AIDS.

33:20

They were infected in New York

33:22

City, in the South Brom. Do you know

33:24

how they contracted it? Dirty leaders.

33:28

That was it. We always

33:30

had the hypothesis, well, it can be

33:32

sex, it can be, but

33:34

no, they were sharing needles. Dirty

33:36

leaders. And then

33:38

the other three died of overdose. Father

33:44

Barrios gave Joyce an office inside the

33:46

church building. This is where your office

33:48

used to be. It

33:52

was a tiny room across from the priest's

33:54

office. Joyce

33:58

was one of a bunch of activists. and community

34:00

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

34:02

theater. The Rainbow Office, the LGBTQ

34:05

that we created. We had an LGBTQ

34:07

office. In the midst of all

34:09

the sorrow and struggle, this place radiated

34:11

all this life. I mean, for me,

34:13

then, everything. Father Barrios encouraged

34:16

a certain ecclesiastical creativity.

34:19

One time he told her to store the used

34:21

needles in the crypt below the church. You

34:23

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

34:26

kept them there until we could find a place to

34:28

discard them. Another

34:30

time he got involved. He knew that

34:32

if people felt like the needles and

34:34

condoms were blessed, they would

34:37

be more likely to use them. I still think that

34:39

we are the only ones who bless the needles and

34:42

the condoms. Some people came back asking,

34:44

you know. I need to bless them.

34:48

So he said, okay, put your hands, put

34:50

your hands. Father Barrios extends his hands as

34:52

he remembers the prayer. We're going to bless

34:54

these needles and these condoms. And

34:57

just say, God, the preservation

34:59

of life. This is what we're going to do. Bless

35:01

us. And

35:04

some people really believe. That's his ministry.

35:06

He reminds everyone that

35:08

they have God inside them. So

35:16

here are two people who, in the

35:18

absence of any coherent or effective public

35:21

health policy, took it upon themselves

35:23

to fight the virus in their community. Needle

35:27

Exchange finally became legal in New York City

35:29

in 1992. Jerry's

35:32

was ready to stop improvising. She

35:34

wrote her first grant and in 1993, she got it. St.

35:41

Anne's Corner of Harm Reduction was

35:43

born. I was

35:45

doing harm reduction where? Like

35:47

the corner of St. Anne's and so it

35:49

became St. Anne's Corner Harm Reduction. Joyce's

35:55

work has had real impact. Syringe

35:58

Exchange combined with the onset. of

36:00

effective treatment for HIV infection, which

36:02

came in 1996, they dramatically

36:05

slowed the spread of the virus in

36:07

the South Bronx. St.

36:10

Anne still has a van that parks

36:12

on corners, offering up free needles. This

36:14

is our syringe exchange right now. In

36:20

the early days, the numbers were bad. Well

36:22

more than half of the people they tested

36:25

had HIV. We had 65% plus

36:28

of our 250 drug users were

36:30

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

36:34

than 5. It's not 3. In 2022, in New York City, 1%

36:41

of new HIV infections were through injection drug

36:43

use. How

36:45

singular would you say like access

36:48

to clean needles? Absolutely

36:50

essential. Pivotal.

36:53

Pivotal. So we taught people,

36:56

in effect, a

36:58

new way of viewing

37:00

syringes. That you didn't have to

37:02

pay for them. It

37:04

was much more profound than

37:06

we thought going in. We

37:09

transformed the commodity into

37:13

a public health intervention.

37:17

The syringe lost its dollar

37:19

value. And it

37:21

became a human endeavor.

37:23

It had a humanistic value like

37:25

that. And we didn't

37:28

know that until we started

37:31

doing it. The

37:36

work has made me touch

37:38

my own humanity in so many

37:41

ways that it has transformed, it's

37:44

mainly a better human being. And

37:46

yes, I've had loss, but

37:48

it's never shaken my

37:51

faith in humanity. Today.

38:00

Today, Joyce Rivera is turning her focus

38:02

toward another danger for drug users. The

38:05

South Bronx is now ground zero in

38:07

New York City for overdoses. Joyce

38:09

is trying to open a safe injection

38:12

site. And look,

38:14

she knows that for thousands of people

38:16

in the South Bronx, her efforts

38:18

aren't going to be enough. Most households

38:20

around where St. Ann's is based have an income

38:22

of $20,000 or less. And

38:26

Joyce knows that the problems of

38:28

poverty can easily lead to addiction.

38:32

But Joyce also remembers the lessons

38:34

she learned with Father Barrios and

38:37

that drug kingpin. When

38:39

systems and institutions fail, individuals

38:41

can still save lives.

38:45

So now, if she can keep drug users

38:48

safe until they can get into recovery, at

38:50

least she knows she is honoring her brother and

38:53

making a difference. Next

39:05

time on Blind Smart, living with

39:08

HIV today. I knew that

39:10

I was HIV positive since I was very,

39:12

very young. And

39:14

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

39:17

that I had it. Blind

39:27

Spot, The Plague in the Shadows is

39:29

a co-production of the History Channel and

39:31

WNYC Studios in collaboration with

39:33

The Nation magazine. Our

39:35

team includes Emily Votin, Karen

39:37

Froman, Ana Gonzalez, Sophie Hurwitz,

39:39

Lizzie Ratner, Christian Reedy, and

39:41

myself, Kai Wright. Our

39:44

advisors are Amanda Aroncik, Howard

39:46

Gertler, Jenny Lawton, Mary Ann

39:48

McCune, Yoruba Ritten, and Linda

39:50

Villarosa. Music and sound designed

39:52

by Jared Paul. Additional music by

39:54

Isaac Jones. Additional engineering by

39:57

Mike Kuchman. Our executive producers

39:59

at History Channel. are Jesse Katz,

40:01

Eli Lehrer, and Mike Stiller. Thanks

40:04

to Miriam Barnard, Lauren Cooperman, Andy

40:06

Lanson, and Kenya Young. I'm

40:08

Kai Wright. You can also find

40:10

me hosting Notes from America, live

40:12

on public radio stations each Sunday,

40:15

or check us out wherever you get your podcasts. Thanks

40:18

for the listen.