Lisandro Moises Enrique has a mix of warmth and seriousness about him that is instantly likeable. The 48-year-old from Argentina moved to Barcelona, Spain, 4 years ago, and loves the city’s beach, its vibe and the quality of life that it offers.
“Life is relaxed, and freedom and diversity are respected. We’ve got everything here, including food from everywhere in the world,” he points out. Although he admits, smiling, that he misses his country’s meat. And his grandma.
Lisandro was already living in Barcelona when COVID-19 hit. It was not an easy situation to cope with, he says. Then, last June, he got infected with mpox (monkeypox).
“Fear. That was the first thing I felt when I found out that I had mpox. Fear for the people around me, fear for people who had visited me [before the diagnosis] and touched surfaces I had also touched,” he recalls.
“Having mpox made it impossible for me to work or carry out other professional obligations. I had to isolate for almost a month. This affected my social life, my finances and more. It was complicated. It was also very hot, so it wasn’t an easy situation.”
Lisandro adds, “But the infection was detected soon, so at least the symptoms were not that severe. Unfortunately, this was not the case for the person from whom I caught mpox. He had a lot of lesions and his symptoms lasted much longer. Mpox ended up affecting his self-esteem, and he was worried about losing his work.”
While he was in isolation, Lisandro received daily calls from staff at Barcelona Checkpoint, a community-based centre that supports gay, bisexual and other men who have sex with men (GBMSM), and transgender women. The centre focuses on the detection of HIV and other sexually transmitted infections.
Lisandro had been volunteering at Barcelona Checkpoint before the mpox outbreak, and he continued the collaboration, albeit online, when he was down with the virus. The staff would ask him how his symptoms were evolving and what support he might need.
Through Instagram, Lisandro also started talking about his mpox experience and posting information (a “complete guide”, as he calls it) on how to avoid catching and spreading the virus. Once vaccines against mpox became available, he posted information on where affected communities could access vaccination and who was eligible.
Having lived with HIV since 1994 (his Instagram account is called “LisandroPositivo”), Lisandro also shared information about the risk of mpox for people living with HIV. When information on mpox was scarce and many questions remained unanswered, Lisandro’s posts could have been a lifeline for his nearly 10 000 followers.
“As migrants, we always have rights”
Referring to his work with Barcelona Checkpoint, Lisandro admits that without the support of the centre during the COVID-19 pandemic and his struggles with mpox, his life in his new city would have been very different.
While he felt supported and got the care he needed, he notes, “I know a lot of migrants in Barcelona. Some of them have arrived recently and had mpox. They were afraid to go to the public health services as they didn’t have papers or a European Union passport. They preferred not to ask for support out of fear of being rejected or found out.”
He adds, “As migrants, we always have rights. This is something that’s always important to clarify. It’s important that migrants learn about their rights from community-based organizations. As for mpox, the sooner mpox cases are detected and treated, the better it is for everyone.”
Lisandro has a clear message for health workers: “Prejudice or stigma never helps. Diseases are diseases and should be treated with respect and care regardless of who has them.”
He continues to volunteer for Barcelona Checkpoint, which works closely with the local health authorities and offers mpox vaccination on its premises to everyone who is affected – including migrants who may or may not have a medical card.
WHO/Europe’s call: reach all underserved communities with mpox health advice, testing and vaccination
WHO/Europe is calling for sustained resources, increased vigilance, and lower barriers to testing and vaccination so that mpox can be controlled and eventually eliminated in the WHO European Region. It is spreading this message through its mpox campaign “Eliminating mpox: Placing affected populations at the heart of our response”, which runs from May to September 2023, as well as its risk communication, community engagement and infodemic management toolkit for mpox elimination (May 2023), and its latest mpox policy brief (April 2023).
In particular, WHO/Europe is urging countries to reach all underserved groups, including migrants. Reaching and building trust with groups commonly left behind – such as migrants, who might not be connected to the formal health system – is an ongoing challenge. More needs to be done to help them access mpox health advice, testing and vaccination.
WHO/Europe’s compendium of case studies on community engagement in the response to the mpox outbreak, launched as part of the “Eliminating mpox” campaign, has increased understanding of how to tackle mpox. The lessons it identifies, including on how to reach underserved groups, are crucial if we stand a chance of eliminating mpox in the Region.