Re: On AIDS treatment in India

[Guest guest]

REPLY TO ASHOK PILLAI'S POSTING ON SEPT 28, 2000

Dear Ashok,

I accept all that you say. I want to pursue your thoughts further and

put this disasterous situation in a larger perspective. The issue of

counselling and the lack thereof in India is not new. There are many

other fatal diseases where life style changes can make a difference and

where doctors failed/are failing totally in giving any decent

counselling. These include cancer (which in some ways is very similar

to HIV in its effect on the individual and financial cost to the family,

but not in the stigma and further infections), alcoholism, mental

disorders like acute depressions, ......

Indian health care especially is limited to prescribing medicines or

doing surgery -- not to developing the infrastructure for bringing about

behavior change. Doctors have never been interested in educating their

patients or spreading awareness. In almost all medical colleges public

health is considered a waste of time, and students are taught to develop

a very cynical attitude to it. In any doctor-patient relationship, drug

compliance and effectivity tests have always been hit or miss -- the

patient is given minimal or no information. If a patient goes back

describing symptoms that are indicative of poor tolerance -- the doctor

makes the patient feel stupid or abnormal -- " I gave you the best drug

on the market and I cannot help it if you are not responding " syndrome.

While, the problems you mention are acute and paramount in the context

of HIV, their genesis is much older and much more widespread. We are

faced with changing a whole way of doing business in the medical

profession. Unfortunately, the doctors are, by and large, not

interested in changing as long as there is a line of patients waiting

outside their doors!

The solution in the short term lies in a much more active role for

organizations like INPPLUS and the few good and knowledgeable

counsellors and NGO's. They have to set up more centers and travel to

all clinics/hospitals treating HIV/AIDS patients and provide the

information. Over time one hopes for a wider participation and

sensitivity.

Sincerely

Rajan Gupta

E-mail: rajan@...

http://t8web.lanl.gov/people/rajan/AIDS-india/

[Guest guest]

Dear Rajan,

I know that problem lies in attitude of health care professionals which is

not new. I mean for ages we have establish this system and it is difficult

to break now. Though elsewhere this relationship is changing. Organisation

like INP+ face daunting task of providing support to PLWA and at the same

time doing advocacy for PLWA issues.

India needs coalition as most of us are trying to work in isolation. On

many critical issues we do not work with each other. For example access to

treatment.

I just finished reading a book 'Sex, Lies and AIDS' by Sidhaartha Dube and

it clearly outlines the problems of AIDS in India. It is must for everyone

who has been working/interested on HIV/AIDS in India.

But I agree that if doctors do not change the way they treat PLWA in India,

which seems unlikely due to the problems you mentioned, we will have the

bigger epidemic where we won't have time to even regret. Later or sooner

every body will change but the question is how many deaths we will see more

before changing our attitude and approach.

Sincerely

Ashok Pillai

President , INP+

inpplus@...

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Indian Network for People Living with HIV/AIDS(INP+)

Flat No.6, Kash Towers,

93 South West Boag Road, T.Nagar

Chennai - 600 017

Phone: +91-44-4329580 and 4329581

Tel/Fax:+91-44-4329582

E-Mail:inpplus@...