Speaker 1:	Thank you for being here today, good afternoon. My name is Milton Malchuka Galbas, I am the Latin American latino studies coordinator and visiting professor. On behalf of the black cultural center, the black studies program, the Vince office, the history department, the intercultural center, and the latino studies program, I want to welcome you today to the long awaited 2016 2016 Jerry Wood Memorial Lecture, titled, Caribbean Complexities, Migration, Tourism, Drugs and AIDs in the Dominican Republic, by professor Mark Padilla.
	Before I go ahead and introduce professor Padilla, I want to thank to the many people in bold in putting together this event. First, for the time, effort, and energy invested in this event I thank the lecture steering committees, my colleague and friend Liz Brown, dean of students, Tim Burke, professor of history, Sid Carpenter, black studies program coordinator, and professor of studio art. Diane Lewis, dean of junior class, director of the black cultural center and interim director of the intercultural center, [inaudible 00:01:11] assistant director of the intercultural center.
	Phil Stern, from communications, from the beautifully designed poster. Dominican photographer Tamara Valdez San Pedro for graciously providing the main photo for the post. Jeremy Polk from ITS, and professor [inaudible 00:01:34] Greyhack from [inaudible 00:01:36] studies for lending their time and skills. Jay Moore, Susan Lewis and Anna Avericks for them helping coordinated all of the little details to put together at the lecture. The media services department, and the office of communications for their technical support. Stephanie Wong for her detective like skills in finding archival material, and the sophomore libraries for providing it. I hope I am not forgetting anyone, and if I have, my sincere apologies. This afternoon also I had a pleasant surprise, Mr. Benjamin Williams, professor whose lifetime partner is here accompanying us, and we welcome him. 
	Above all, this lecture honors the life, career, and legacy of Swarthmore professors Jerry Wood. But who was professor Wood? Younger generations might not know him, who he was. With the help of Jeremy Polk and Bov Greyhack, here is more information about professor wood. 
Speaker 2:	The Jerome H. Wood lecture series in Afro Latin american history and culture was established in 1997 in honor of former history professor Jerome Jerry H. Wood. The first such series to honor an African American professor at Swarthmore College. Professor Jerry Wood was born in 1941 and grew up in Washington D.C. In 1962 he received his BA in history suma cum laude from Howard University. In 1969 he received his PhD in American Civilization from Brown University. In 1970, after teaching at Temple University and Haverford College, he joined the Swarthmore faculty. 
	Originally trained as a historian of Colonial America, Professor Wood later developed a deep interest in the black experience in Latin America. He organized the first African Diaspora music symposium at Swarthmore in the 1970's. Proficient in both Spanish and Portuguese, Professor Wood was a prolific scholar who traveled extensively throughout the Latin American region. In 1977 he was invited to present his research at the first congress on black culture in the Americas in Cali, Columbia. In 1980, he traveled to Uruguay, Brazil, and Venezuela as a Fulbright Hayes Fellow. In 1983, '84, Professor Wood was a Fulbright lecturer in US History at Nankai University in the People's Republic of China.
	During his time at Swarthmore, Professor Wood attainted the status as full professor, served as Associate Provost from 1986 to 1989, was twice chair of the black studies program, and served on several committees, including the sager black and minority concerns, and the CPC task force on cultural diversity. As a scholar and teacher, he made lasting contributions in the areas of Colonial history, Latin American studies, and black studies. Equally important, Professor Wood made a difference in the lives of students and colleagues throughout his 27 years at Swarthmore. In the spring of 1996, Professor Wood retired because of vision problems and his worsening health. Professor Jerome H. Wood Jr., professor emeritus of history, died September 15, 1996. Mentor, educator, advocate, and imaginative storyteller, Professor Wood is remembered as much for his kindness and sense of humor as for his scholarship, teaching and activism. 
Speaker 1:	So this is the man we honor today. Before our former program starts, some housekeeping details. If you have a cell phone, please take this opportunity to turn it off. We are recording the lecture, and it will be available soon on Swarthmore website. At the end of the lecture, Professor Padilla will hold a Q&A session, so please hold your questions until then. Now, it is my great pleasure to introduce our speaker. Mark Padilla, associate professor of anthropology at Florida International University is an American Anthropologist with research and teaching interest in issues of gender, sexuality, race, migration, political economy, commercial and transactional sex, theories of tourism and critical HIV, AIDs, and drugs research. His applied research has been conducted primarily in the Hispanic Caribbean, particularly in the Dominican Republic in Puerto Rico. 
	His books include Caribbean Pleasure Industry, Tourism, Sexuality and AIDs in the Dominican Republic, University of Chicago Press 2007, which analyzes the life of young men in the Dominican Republic who engaged in sexual exchanges with foreign men and women. In Love and Globalization, Transformations of Intimacy in the Contemporary World, Vanderbilt University Press 2007, which examines issues of gender and intimacy across the globe. More recently, he has been working with transgender women, documenting their experiences and stories, and their challenging engagements with healthcare. His work seeks to shift research, dialogue and policy by amplifying their voice and experiences in the communities he studies to raise awareness of social inequalities and provide directions for policy change, community engagement and social transformation. His lecture today is based on his current research in the Dominican Republic. Please help me to welcome professor Mark Padilla. 
Mark Padilla:	Good afternoon. 
Audience:	Good afternoon.
Mark Padilla:	It's such an honor and such a pleasure to be here, and I want to take some credit for the amazing weather that I think I brought up from Miami, but it's just been absolutely incredible to get to know many of you today and to walk around campus, it's the first time I've had the pleasure of being here, and I'm so impressed. It really is an honor, and particularly an honor to be here for the Jerry Wood memorial lecture. 
	I'm going to talk as the introduction indicated, on my research in the Dominican Republic where I've been working for more than 20 years at this point. I'm going to combine a little bit, the introduction said that I was going to talk more about my present research, I'm going to talk a little bit about the research I did previously as context. So the book, Caribbean Pleasure Industry, I'll be reviewing some of those points there a little bit, and then I'll move onto the more contemporary research that I'm doing right now.
	I have quite a bit to show, and I'm going to try to get through it in the most efficient way possible. My goals for the talk today are essentially to introduce a little bit of the syndemics project, so the more recent research I'm doing in the Dominican Republic, and what that involves in particular, and how it attempts to move a little bit beyond traditional approaches to health issues in the Caribbean in particular. 
	I want to summarize some of the patterns in HIV and drug addiction epidemics in the Caribbean for those of you who might not know or be very familiar with some of those important issues in the region. Then I would like to consider how two key structural factors, in particular the sale of sex and drugs in tourism areas, and racialized deportation policies that convert illegals into criminals affect the HIV and drug epidemics in the Dominican Republic. That's kind of a complicated set of issues there, and hence the title, Caribbean Complexities, I think is actually very appropriate. There is a lot that I'm trying to fit into this one discussion.
	Then at the end I'd like to briefly address some issues of policy and social transformation as a consequence of these patterns that I'm going to be identifying. The project that I'm currently leading, and it's a large team between Florida International University, the University of Puerto Rico, and the University of California in San Francisco, we have investigators in all those different places. We are subcontracted to a Dominican university there to do this big project that is basically trying to understand the intersection of migration, tourism, and the HIV, drug syndemic. I'm going to talk a little bit about what the syndemic means, what that terminology means. 
	We briefly refer to this project as the syndemics project, or in Spanish, we often talk about it as bregeto syndemias. In Santo Domingo, that's how they are familiar with that. It's a mixed method anthropological study. What that means for those who might not be anthropologist is that we do participant observation and ethnography in tourism areas in particular which is our focus in Santo Domingo and Boca Chica. We are working specifically with male tourism employees. We are trying to understand how these dynamics of tourism, migration and HIV and drugs intersect on men who are employed in this industry in particular. We are focusing on men also who have a migratory history. That can be migratory history either internally within the Dominican Republic, which is a rather large country, so people move between their home communities or rural areas and tourism areas quite commonly in the Dominican Republic. 
	We are focusing in particular on these two areas, two cities. Santo Domingo, which is the capital of the Dominican Republic, and has about a population of around 3 million people, and Boca Chica, which is a small tourism town about 30 kilometers to the east of Santo Domingo. We use this idea of syndemic theory to theorize the social and structural inequalities that contribute to the HIV and drug use syndemic in the Caribbean region. Let me explain a little bit about what a syndemic is. 
	Often times when we talk about epidemics in public health or in medical anthropology, we tend to isolate one epidemic, or one disease process from another. We tend to talk about the HIV epidemic, we tend to talk about the drug epidemic, TB, or whatever the outcome may be. But what medical anthropologists had tended to argue in recent years is that that is a little wrong headed, because what really often happens and particularly in marginalized disenfranchised communities that may be disenfranchised in various ways, they tend to suffer from multiple epidemics or a cluster of epidemics. 
	What is really driving that is different expressions of social inequality that they experience. You can't necessarily separate these processes from one another, such as HIV and the drug epidemics in the Caribbean. One example of that dynamic has been argued quite a bit, has been discussed quite a bit by the anthropologist Merrill Singer. If any of you are particularly interested in this approach to syndemic theory, the anthropologist Merrill Singer has written quite a bit on syndemic theory, and has essentially founded this notion of syndemic theory. Merrill Singer wrote about one very common, he argues, syndemic in African American communities in the urban United States, which he labeled the SAVA syndemic, which is substance abuse, violence, and AIDs, how those all tend to cluster together among disenfranchised urban African American populations in the United States is what he is looking at. He is not that far away, he is at UCONN, Hartford Connecticut. 
	Here we are using that very approach of the syndemic theory to look at HIV and drug addiction among migrant tourism workers in the Dominican Republic specifically. I wanted to give you a little bit of an overview, as I said, of the epidemiology. For those of you who might not work in public health, the epidemiology is essentially the notion of how do disease processes get patterned, and how do they move within populations. 
	In the Caribbean, talking about HIV in particular, a lot of you may not be aware that it's the highest HIV prevalence rate in the Caribbean outside of sub Saharan Africa. We have over 1% adult HIV prevalence in the region. There is approximately 11,000 deaths due to HIV infection per year in the Dominican Republic, and around 250,000 people who are estimated to be HIV positive currently. Another fact that people don't know is that the vast majority of those infections are in one island, the island of Hispaniola, where the Dominican Republic and Haiti are both located. 73% of HIV positive persons are on that one island. 
	Now one of the things that is important to point out and it connects to some of the things that I'll talk about shortly is that the highest prevalence rates are among MSM, and this is a label from public health that is often used in epidemiology to track HIV rates, and that refers to men that have sex with men. The reason that they use that terminology is that they are not focusing necessarily on identities so they are not looking at gay identified individuals, but they are looking at the suite of men who have sex with me, the whole range of men who have sex with men, which may include different identities. It's focusing on their behaviors. 
	Sex workers in the Caribbean have the highest rates of HIV. These are just a couple of quick graphs to illustrate that, and these are from the UN AIDs, the United Nations AIDs division. Here you can see in kind of a pie chart format that Haiti composes 55% of those who currently live with HIV in the Caribbean, and the Dominican Republic has 18%. Then the rest of the countries you can see distributed there, Jamaica follows, and then Cuba interesting is the next one. As things are changing in Cuba, recently what we will see unfortunately is probably the same pattern that we've seen throughout the Caribbean which is increasing HIV rates with the exposure to tourism, which I'm going to talk about now shortly. 
	Here is a couple other statistics for you that I think are pretty dramatic. When you look at MSM, so men who have sex with men in the Caribbean, look at the high rates. We talked about the general epidemic being just above 1% of the Caribbean in the larger population, but among men who have sex with men these rates are much, much higher. In particular, if you look at Jamaica, one out of three men who have sex with men are HIV positive. That's really dramatically incredible, right? We need to do a lot more research in Jamaica to understand what that means. 
	In the Dominican Republic we also have an elevated rate of HIV at 7%. In sex workers we see similar kinds of patterns. In the Dominican Republic it's around 5% HIV prevalence among sex workers in that country, and higher in Haiti and Jamaica is about the same as the Dominican Republic. This is just for you to get an impression of what the epidemic is doing here. An important point is that sex work is very closely connected to the tourism areas. It tends to cluster. Sex work and sex workers and sights or venues where sex work happens tend to cluster around tourism areas, which is a point that has often not been articulated very directly. It's part of the problem I think conceptually in understanding the HIV epidemic in this region. 
	There has also been very extensive anthropological research in the Caribbean on issues of sex work. For those of you who may be interested in the topic, there is quite a few ethnographies. In the Dominican Republic alone there is a number of them, four or five of them that have done research on this topic. There is four and a half million tourist arrivals in the Dominican Republic alone. I think that's a little outdated, I think it's getting closer to five million, or even approaching six million now. 
	One anthropologist who has done work on sex work in the Caribbean, Denise Brennan, has talked about this idea of sexscapes. Sexscapes are this notion, she is actually using a theorist named Arjun Apoteri, who is an anthropologist who has talked about globalization quite a bit. Apoteri uses this notion of escapes to say that there is particular techno scapes, or media scapes, various kinds of scapes that he is describing at a global level that link one another together. That link people together, and bring together a globalized kind of sense of human behavior and society. 
	Sexscapes are the notion that people within tourism areas are actually linked to the global through these negotiations of touristic relationships and sex work with tourists who come. We'll talk about that extensively, lots of sex tourism in these areas. There is also lots of stereotypes of black or Latin sexuality that circulate within the tourism economy, that drive the economy, that make it marketable, that make the market function in the tourism industry. Camalak Hempadu is someone who some of you may be aware of who has done a lot of work in the Caribbean on these issues, and has talked about the issue of the racialization of the tourism market that drives the market, that people are seeking particular representations of sexuality in the market, and that's how the market functions. 
	That has created certain kinds of identities that are being performed on the market by locals who are attempting to sell themselves to tourists in the context of sex tourism. In my context in the Dominican Republic one of those identities is referred to as the sanki panki. The sanki panki is a term that comes from English, it's basically a dominicanization of the English term hanky panky, and it refers to a black identified individual who performs a particular role, usually on the beach, to try to sell himself. This is a man who tries to sell himself to tourists using a very racialized representation of self to do that. 
	I wanted to just point out that there is a number of different media representations of these issues throughout the Caribbean. Some of you may be aware of some of these. These are highly problematic in many ways, but there is a lot of representations of this phenomena. You can see here, some of you may have seen How Stella Got Her Groove Back, which is one of the most popular media representations of this kind of dynamic, of male racialized performance within tourism contexts. There is also a local movie within the Dominican Republic which is a comedy that actually kind of tries to joke about this issue in humorous tones. It's called Sanki Panki, and now there is a Sanki Panki number two in the Dominican Republic. 
	The two in the middle are actually more serious representations, even though I think they also have some problematic dimensions to them, but Heading South is a movie that talks about European women that go to Haiti in the 1970's to make these connections with black men and to explore their own sexuality. Then there is a documentary that's called Rent-a-Rasta, which is an actually term that's used in Jamaica. It expresses obviously the racialized nature of this. People are performing a Rasta identity for the market in the case of the Rent-a-Rasta. Sometimes they call them Rent-a-Dreds.
	All of this is part of a connection between tourism, the sale of and marketing of sexuality in tourism areas, and what I wanted to do is to take it in a slightly different direction and to talk about how in the region, patterns of HIV infection are actually highly connected to the tourism economy. If you look at the highest rates of HIV infection in the region, these are the countries with the highest rates of HIV infection in the Caribbean, and then a few years back the Caribbean epidemiological center in Trinidad and Tobago pointed out that if you look at the highest tourism dependent countries in the region, you see these countries here. Then you look at HIV prevalence right here, which is the red, you see a strong association. 
	The countries that have the highest tourism dependence also have very high rates of HIV. But this has not actually been very successfully explored in the literature, this connection between tourism, HIV. We really don't have interpretations of a mechanism, we don't have explanations of a mechanism for why this is the case. 
	A few words about substance use and tourism. Some research suggest that there are associations between tourism and drug addiction in the region, but this is highly understudies in the Caribbean. We need a lot more research on the association between tourism and drug addiction in the region. Our current region suggests that high prevalence rates of drug use in tourism areas are due to tourism demand and the culture of escapism. When I'm referring to that, what I mean is that there is a highly escapist dimension to these tourism areas in the sense that people kind of move away from what their normal routines are. They do something different, this is the kind of what happens in Las Vegas stays in Las Vegas dimension, right? This is doing something different than what you would normally do. 
	Drugs are a part of that. Drugs and sex are a part of that. The primary drugs in tourism areas are cocaine, marijuana, and party drugs of various kinds with smaller but growing amounts of heroin and crack use in the region. Like sex, drugs are also part of the economy of pleasure, and abandonment that is sold to tourists. 
	Okay, so the syndemics project has examined how migration and the social context of tourism areas are what we are referring to as tourism ecologies shaped the syndemic of HIV and drugs in the Caribbean. Essentially what we are trying to understand is what is it about these ecological, social ecological dimensions of tourism areas that contribute to this syndemic of HIV and drugs in the Caribbean. 
	I don't want to spend too much time on this because this is actually kind of a complicated conceptual diagram, but this is the conceptual framework that we are using for the larger project in the Dominican Republic. In particular I just wanted to point out that we are studying five factors that we believe compose these tourism ecologies, that contribute to HIV and drugs in the region. Those are social inequality and stigma, social isolation, this is in the tourism ecologies box there, availability and demand for drugs, alcohol, and sex. Business norms and practices, and touristic escapism, this notion that people are doing something different, performing different kinds of experiences when they are on vacation. 
	As a little bit of foreshadowing of what my primary arguments are before I actually get into some of the ethnographic data, these are the two main points that I wanted to make today. The growth of tourism in the Dominican Republic is generating internal migration to tourism zones where large numbers of poor or underemployed Dominicans work informally, selling sex and or drugs to tourists. These are people that are moving within the country to tourism areas searching for work and that often are involved in selling sex or drugs. This is contributing to the syndemic conditions for HIV infection and drug addiction in these areas specifically. 
	The second point is that global deportation policies and the US criminal injustice system provide a constant supply of exploited workers, mostly black and brown men, who have an essential role as informal salesman in the global industries of sex and drugs. This dramatically affects their health. There is an important point here is that there is a need to have these informal salesman of both sex and drugs in order for the whole tourism economy to function. It's the only way that it can actually function. 
	I'm going to now show you a couple of pieces of ethnographic evidence to kind of contribute to both of these points. I'm going to start off now talking about the original study from 1999 to 2002. The book came from this set of research phases between 1999 and 2002. These are the two research sites, Santo Domingo, and Boca Chica. The participants in that study, the people that I studied in that first study where young men who exchanged sex for money with male and female tourists and importantly, they did all kinds of other types of tourism work. They weren't just doing sex work. They were also engaging in other kinds of tourism work of all kinds, and in a little bit I'll show you some of the types of the work that they were involved with. 
	They were identified as a priority population, informative research that we conducted, and then we got the funding to do a larger study with them. In contrast to female sex workers, male sex workers in the region are very understudies. We knew very little about male sex workers prior to this project. They often do not self identify as gay or homosexual, and that's an important point to make. You can see in this graph down here, this is based on a survey with 200 male sex workers, that only 3% of them self identified as homosexual or gay in the survey. Most of these are heterosexually identified men, despite the fact that their behavior is bisexual. On the tourism market, they are behaving bisexually. They are often married or intimately involved with women. 
	This is the book that we just discussed briefly at the beginning of the talk. It presents the survey and ethnographic findings from the research among several hundred men who were involved in this industry. It involved three years of multi sited ethnographic fieldwork in Santo Domingo and Boca Chica. I want to recognize the collaboration with the local NGA named Amigo Siempre Amigos that helped conduct the research, and to access the population.
	A little bit of historical or political economic context here. We don't have a whole lot of time for that, but I want to make sure that there is some kind of context for what we are talking about here, these kind of phenomena. Since the 1970's there has been a rapid shift in the Dominican development approach from one that was a more traditional approach, in particular sugar production was huge in the economy of the Dominican Republic, to one that now emphasizes more tourism focus. This was a shift, this was a set of decisions that was made starting primarily in the 1970's, and former President Balaguer was a big part of that transition. He was someone that was essentially a puppet in many ways of the United States, and he decreed various things in the Dominican Republic, including passing a law allowing us to appropriate, allowing the country to appropriate coastal land for tourism development, and give tax breaks to tourism investors at that time in the 1970's. 
	The country promoted like all over the Caribbean this notion of a smokeless industry of tourism as a benefit to the economy and the GDP of the Dominican Republic and throughout the Caribbean because it had no negative outputs. It had supposedly nothing negative, this was something that was going to be entirely positive for the economy and for development. Since that time you see the top graph actually shows the increase in tourism arrivals in the Dominican Republic from I think it's ... I'm not sure how far back that goes, but before 2000. Those are all years before 2000, and down here it continues and you can see it is approaching six million at this point in the Dominican Republic. 
	That's in a country that has 10 million people, it receives six million tourists per year. Dramatic change, and it also shows and indicates how important tourism is in the daily lives of Dominicans. You can see in the internal migratory changes that have been provoked by this transition in the economy when you look at the patterns of migration among our survey sample among male sex workers. Here you can see the migratory pathways of those who immigrated to Santo Domingo in the sample. Overall, 75% of our participants of 200 sex workers migrated from other areas of the country. Here is the Boca Chica migratory pathways, and there they are together. You can see that there is a dramatic internal migratory pathway into tourism areas. 
	In the in depth interviews, so we conducted a lot of in depth interviews with these guys, and they talked about what their motives were for migrating. Probably not surprisingly, these were all migratory pathways that had to do with transitions in work for men. Men who were unemployed in their home communities, or had no access to work, and that saw their only option for advancement to be working in these tourism zones. Here is a few examples of things that they said. 
	"I came to find a way to make a living." Buscarme la vida is the way that they say that in the Dominican Republic. Me la gusco, me gusco la vida. But buscarme la vida was the most common response to why they were going to tourism areas to make a living. "There is nothing for me there in my home community or pueblo. What can I do? I have to take care of my family. At least here I have things to do to make money. Tourists have too much money to spend." That was a common thing, tourists have more money, I have no money, so this is a perfect combination for us to find some productive work. 
	This slide shows some of the results from the survey also of those who had engaged in other kinds of informal sector activities aside from sex work. This is just to show you that these guys are not really only engaging in sex work. They are engaging in a whole range of other kinds of informal sector employment from informal sales, to working in bars and restaurants and hotels. That mechanic and electrician is a very Dominican thing. There is often lay mechanics and electricians who work in these communities and they are not really formally trained as tradesman, but they work in that for a living. 
	Beach rentals, various other things that you can see. 8% of them were actually studying at the university and paying for their studies through this. So informal sex work is absolutely essential to the structure of tourism areas. Men provide services directly, or they work as intermediaries to negotiate between clients and sex workers. They may not provide, sometimes they provide these services directly, and sometimes they mediate between others, clients and tourists. 
	Here is an example, just a little piece from one participant. Of course these are all pseudonyms, but just explaining his philosophy or his rationale for why he was engaging in this kind of exchange. He says, "I've gone for about 10 or 12 years without work, so here in the Dominican Republic, things are really hard. Since there is some opportunities with tourists who come from abroad and they offer you money or something to be with them, you grab it, you understand? It's the easiest way to make money, that's what's going on." 
	I wanted to give you that impression from the first study of what's happening in terms of the sex work and the informal tourism economy, and then now what I would like to do is to move to a different dimension, which is about international migration policies and deportation, and how that fits into this picture. In phase one of our current study, we have interviewed 36 men twice. We had two interview sessions with each of them to talk a little bit about their background in migration and their current employment as well as their risks for HIV and drugs. They were each interviewed twice, not by design. 23 of 24 international migrants were deportees. 
	In other words, we weren't looking for deportees, it just happens to be that if you have a history of international migration in the Dominican Republic and you are working in tourism, you are very, very likely to be a deportee. That may not be surprising, but it actually was a little bit of a surprise to use the degree to which that was the case. A key point is that the international deportation policies contribute to health related vulnerabilities of men who work in tourism areas. That's part of the argument that I would like to make. Why is that the case that deportation policies contribute to health related vulnerabilities. 
	A little bit of a backstory is that there is a huge increase in deportation, some of you may be aware of this. But a huge increase in deportation all over the Caribbean, and in the Dominican Republic in particular there is a large increase historically in deportation. One of the policy issues or laws that has permitted that to be the case is the passing of IIRAIRA. It's called the illegal Immigration Reform and Immigrant Responsibility Act of 1996. A sociologist, criminologist that has done work on Dominican deportees, his name is David Brotherton, and his coauthor Barios. They say, and I totally agree with this analysis, that following the enactment of IIRAIRA in 1996, the number of Dominicans deported for non criminal offenses increased exponentially. You see a massive increase in deportation of Dominicans at that point. That is part of what is happening in this context of having so many deportees in tourism areas. 
	IIRAIRA makes it easier to profile, arrest, and deport people of color for minor offenses. One of the main things that happened is that there were new legal mechanisms that would allow people to very easily deport Dominicans as of 1996. A very large proportion of those deportations are related to drug crimes, at least officially related to drug crimes. What we found in our interviews is often times men told stories about how they had absolutely nothing to do with drug sales or crimes, but those were trumped up, invented charges to justify their deportation. 
	Dominicans are among the most deported in the Caribbean. There is between 30,000 and 50,000 deported Dominicans in the DR. Most of those are males. We did actually ethnographically witness a deportation event essentially, what happens is when men arrive in the Dominican Republic is there is a government unit that receives them all literally off the plane. We collaborated with that unit of the government to actually witness the process of reinsertion and registry, which I'll talk about shortly. Because part of the problem is that they are re-registered and remade into criminals when they arrive into the Dominican Republic. They are made into criminals in the US to justify their deportation, and then they are reconstructed as criminals once they arrive there. 
	We had this sample that I mentioned of 23 male deportees that we interviewed in depth, mostly were adults, migrants, and a minority were child migrants. When they originally migrated to the United States, they were mostly adults. 16 had been deported from mainland United States, and 7 from Puerto Rico. We have those two sites and slightly different stories. There was a concentration of them not surprising being deported from New York, where there is the highest population of Dominicans in the US. Most men said they migrated to the US in search of employment. 
	In the in depth interviews we also had them draw maps of their migratory pathways. They had actual maps that they could use markers and draw. Later on what we are doing now is to digitize those migratory pathways and to associate them with their narratives, we are looking both at their narratives of migration and deportation. We have all these maps along with stories of their deportation. They are very complicated migratory maps, because often times people, we thought what would happen is that people are being deported once, but it's not actually the case. People come, they often try to return again. They may try to go through Puerto Rico, they may try to go other ways, but there is multiple deportations that are occurring in most cases. 
	Their employment, I'm going to take you a little bit through their trajectory of what happens in the United States and their stories of essentially discrimination in the United States, and exploitation in the United States, and then take them down to the DR, and talk about the conditions that they currently face in the Dominican Republic. A number of them described barriers to formal work. This is common both in the United States, and in the Dominican Republic. Not perhaps terribly surprising, but documentation status, language instability, housing instability, exploitative employer practices, limited social connections, and generally low education level and lack of support. All of those things were issues or barriers to their formal employment in the United States. 
	Some of them managed to find some very low income positions in the US labor market, but most of them, over half of them, made money by selling or distributing drugs such as marijuana, crack, and cocaine in either the US or Puerto Rico. These were described by them as strategies for survival due to these employment barriers. I want to show you a few of those samples from their narratives of when they are describing that connection. Often they talked about in Spanish [Spanish 00:43:29] is basically I'm going to hit the streets in order to try to find a way to survive in this difficult situation. 
	Here is a few of those quotes. "I couldn't work because I didn't know anyone. I came alone so I took to the streets again. I found a friend that lived there." "You're working?" "No, I'll go buy drugs." "And he brought me to the drug work." "My experience in New York was that I had to work and that I had to be out on the street early selling drugs. It started to take me away from my friends, and that's how I started. Always looking for money, I had to work a lot." 
	Essentially I don't want to read all of these for you, but these are all of them talked a lot about their feeling of desperation and their need to engage in small scale drug sales as a coping mechanism. Post deportation, I'm skipping over a whole series of discussions of their time in jail, because there was a lot of discussion of their time in Jail. In IIRAIRA, one of the things that happens with IIRAIRA is that people spend extended periods of time in deportation proceedings. They might be incarcerated for a long period of time, but for the sake of time, I'm not going to include that here. 
	Post deportation, many deportees are absorbed into the informal tourism economy. The question is why does that happen? What is, it's kind of a strange bedfellow to talk about. Deportation history and informal tourism employment, that's not something that we often talk about together. Why is that the case? They have a command of English, which is the lingua franca of tourism work. Being able to connect with tourists in English is absolutely critical. They have some cultural knowledge and capital that actually helps them to do that as well. These are skilled negotiators in the local tourism economy. 
	Many of them, again, repeating the same patterns, were functionally barred from formal work in the Dominican Republic. Why is that the case? Because as I mentioned earlier, the Dominican state actually remakes them into criminals when they arrive. It's not as if they come and have a blank slate. They are remade into criminals in the Dominican system of registry where they establish what's called a Ficha, which is a registry where they are actually prevented from gaining formal employment or wage labor because they actually exist in the system. Despite the fact that they committed no crimes in the Dominican Republic, they are remade into criminals through creating the Ficha. 
	Part of that is related to a very intense stigmatization they face in the Dominican Republic for being a deportal. There is a lot of history about the deportal, the deported person in the DR, and a number of people that have written about the deportal, the stigma of being a deportal. It's partly related to assumptions about what Dominican Yorks bring to the Dominican Republic and some of you if you are familiar with the Dominican Republic you might know a little bit about this phenomenon of the Dominican York. This someone who was raised in New York who is of Dominican dissent, and is thought to be the cause of a lot of crime and chaos and problems back in the Dominican Republic. That stigma contributes to labor issues and all sorts of social problems they face when they are back home after being deported. 
	Deportal, when you talk to just many common Dominicans on the street in Santo Domingo, they will often talk about it as being almost synonymous with being a drug addict or being even a narco trafficante, a narco trafficker, right? There is these very intense associations of criminality with being a deportee. Then they are also tracked through the Ficha. This is a picture here when we were actually allowed to be in the registry process after people had arrived, I think there were 104 of them that had arrived in one shipment. There is usually 100 of them that arrive every two weeks. We were in there, this is a picture of someone getting registered and them taking mug shots. 
	The action of taking a mug shot of course is something you do with a criminal. This is the process of them, again, remaking them into criminals in the course of registering them. The deportees that we spoke with there talked a lot about the ficha and the problems with the ficha and being able to survive in the local market. Here is someone that said, "Yes, the ficha affected me, I've gone to companies here where I've wanted to work, they were going to give me a cook job, but I couldn't because the deportation came up, the ficha came up, you understand? It's affected me." 
	Lots of narratives like this about the ficha. It was the most common barrier that was described to employment among our sample. Nearly half of our participants reported working in the drug trade in the DR. Drug sales were combined with other forms of informal work such as sex work, informal sales of other kinds, and tour guiding. Many of them conducted informal tour guiding. In the context of that they sold sex and drugs. 
	Now, I've said a lot of things about different phenomena, and I wanted to read one case on an article that I'm writing right now on all of these connections that I think brings them all together. This is the case of Fernando. Fernando is a 40 year old man who was deported to the DR eight years prior to our interview in Santo Domingo in September 2014. He illustrates how deportation, tourism, HIV and drugs all intersect in a person's life. Fernando was arrested in New York for small scale drug sales, spent six years in different US prisons, and was forcibly returned to the DR in 1994. Since that time, he has supported himself primarily through informal tourism labor, working as a tour guide in the Colonial zone of Santo Domingo to connect international tourists to sex and drugs, a market that he describes as ubiquitous within the tourism areas of Santo Domingo, and one of the few ways that he can make a living as a deportal. 
	Manejo lillioma, "I speak the language," he says, referring to English, the lingua franca of tourism work and a skill that greatly improves ones employment possibilities in the informal tourism market. His experience with conversational casual English allows Fernando to make small commissions or tips when he connects tourists to drug dealers or sex work establishments. Fernando relies on his daily income on commissions of 800 pesos, which is approximately $20 that he regularly receives from a local brothel when he brings them clients who stay overnight. 
	In the past, he also provided sexual services to male tourists to make ends meet. An activity that he was quick to clarify was, "Due to the need to make money, and thank god I took another path." He is frustrated and ashamed by this type of work however, which he regards as morally and physically dangerous. In his interview he discussed his dreams of going back to school and getting a job as a legal assistant, a remote possibility given the labor discrimination he faces as a deportal. "Society hasn't let me advance," he explained. "They believe that a deportee is a leper, and has no right to live again." 
	He lamented that his work with tourists regularly threatens to tempt him back into the drug addiction that he has battled for most of his adult life. He has gone through the dos de pasos, the 12 steps in narcotics anonymous in Santo Domingo, and struggles on a daily basis to avoid relapsing while negotiating constant requests by tourists for cocaine, marijuana, crack, or other party drugs. When asked how he envisioned his tourism work evolving in the future, he explained that, "Tourism is rotten in the Dominican Republic," and that he is determined to abandon the illicit activities that characterize the tourism economy. 
	Fernando expressed repeatedly his desire to avoid the sale of sex and drugs, despite the near impossibility of putting this into practice given the configuration of demand and his role of the labor hierarchy. Indeed, he was still delivering tourists to a local brothel in my last interview with him despite his expressed desire to advance beyond this role, which he considered shameful. 
	Importantly, the illicit work that men like Fernando engage in exposes them to the double stigma that is so often confronted by deportees. Due to their deportee status, they are presumed to be drug dealers or even drug traffickers, converting the deportee into an almost inhuman creature, whose pathological criminality is presumed by society, including the employers who might otherwise hire him. This logic is evident from the exclusion from formal work. I think that's a nice representation of how all of these things come together, and it's important to emphasize in Fernando's case, in a lot of their cases, they had suffered from previous issues of drug addiction and had tried to go through drug rehab, but were unable to do that because the context of their labor and the context of the tourism area doesn't allow them to do that essentially, doesn't allow them to escape that. 
	There is a few factors that promote drug addiction among tourism employees. Prior struggles with drug addiction while abroad. I just want to kind of go through some of these quickly. I know we are getting closer to the end here, but a lot of them talked about prior struggles with drug addiction while living abroad. Many of them expressed issues with mental health, not surprisingly trauma, PTSD, and depression. There is also a lack of access to effective rehab progams in the Dominican Republic. There is very few of them available. It's one of the things that we are talking about possibly helping to intervene in. 
	There are very strong zero tolerance approaches that criminalize drug use and limit options for clinical treatment. When I talk about clinical treatment, there is certain addictions like heroin that you can only really get off of effectively if you have clinical treatments for opiate replacement therapy for example. But that's criminalized in the Dominican Republic by law, there is no way that you can have access to those legally, those treatments because it's criminalized as much as an illegal, or an illicit substance would be. 
	The pleasure market, which we've also already mentioned in tourism areas, which forces men, especially deportees to return to selling drugs and sex to survive. Doping policies that exist in tourism businesses. A lot of hotels and restaurants will actually conduct these, what they call doping, as they use that word in the Dominican Republic. They conduct tests of one's presence of drugs in one's system, and they expel them if they show any signs of having used drugs. 
	All of those factors together contribute to a problem of drug addiction within this context of tourism areas among men. Just kind of moving this a little bit further along, rethinking the war on drugs, and the global neo liberal economy, most Dominicans were barred from formal labor, both in the US and in the Dominican Republic due to their migratory status. I think it's an important point that's often forgotten, because when we talk about deportation, most of the research that's been done on deportation is pre deportation experience, not post deportation experience. 
	What we see in post deportation experience in this example is another case of exclusion through this deportal stigma. That it really functions to keep people from formal employment. Global systems of labor use migratory status as a means to exploit black and brown bodies for global pleasure markets for drugs and sex, and this generates a permanent global underclass. Not just in the United States, where this has been discussed quite a bit, but also in a receiving country like the Dominican Republic, they continue to exist as an underclass to provide these services, these pleasure services to tourists. 
	The system replicates the structural and symbolic violence on both sides of the global deportation regime. I'm using the term deportation regime, which is something that is a concept that's emerged in deportation studies which I really like. It's a new political regime that is globalized now, that is contributing to all of these factors. Just very quickly, using this syndemic approach, what we are trying to do is to think about what are the different factors that are specifically contributing to a syndemic of HIV and drugs, and in tourism areas. 
	I don't want to go into this in too much detail, but if you start at the top, pre deportation, the social production of deportability, kind of this chronic condition of being undocumented, people have talked about as a state of deportability. It's the possibility of being deported at any moment, and that chronic state of stress and social inequality that that expresses. That leads to expulsion and the trauma of deportation, stigmatization of new arrivals in the Dominican Republic, the social reproduction of stigma, of deportation, reinsertion into informal labor just as many of them had engaged in informal labor in the United States, they are reinserted into informal labor of drugs and sex back home, home. 
	There is a lack of access to drug treatment and rehab as we mentioned. Many associated mental health sequela that are associated with that, and the worsening of addiction. It's kind of a vicious cycle that contributes to this syndemic. A few key points to sum up and then I'll finish here. HIV, AIDs, and the drug epidemics in the Caribbean have to be considered in light of global patterns of in particular, forced migration if we think of deportation as a kind of forced migration, which it is, and tourism labor. 
	Systems of tourism labor in the Caribbean are connected to the criminal injustice system in the United States, this is something that again I think has not been pointed out. That tourism labor is connected to the deportation regime. Research should document and expose the complex interconnections leading to HIV and drug epidemics at our own doorstep. In other words, when we are all vacationing in the Caribbean, we are not necessarily thinking about how deportation policies contribute to problems of HIV and drugs in the Caribbean, and also in the United States, this is all a global system, so all of it is interconnected. 
	Using syndemic theory permits us to think more broadly about the complexities of health and inequality in the region. Then just a few points about what we are doing in the project, and then I'll finish there. For the syndemics project we have a number of things that we are trying to do at this point. We are developing an HIV and drug intervention, and targeting tourism zones, collaborating with both public and private sectors in the DR. We have a national committee that is working with us to develop on the basis of our findings, to develop an intervention that's focusing on tourism areas specifically which will be piloting soon. 
	We are discussing also reinsertion progams, collaborating with the dominican state to talk about providing particular services for health and social support to those deportees who are arriving. There is hundreds of them that arrive every month. We are also working with policy makers to improve drug prevention and treatment progams in the Caribbean, and disseminating knowledge of the consequences of deportation policies for the region's health and connections to health in the United States as we mentioned earlier. Then finally, we are also doing some training of Dominican researchers to try and help them to be able to explore some of these issues on their own, through their own research projects. 
	I think that we will leave it there. I'm happy to take your questions and comments. Thank you.