20+ Reasons. Re: Why has India failed to response to 4 million HIV+?

[Guest guest]

This is a fascinating response.

I have been wandering about India trying to find a lot of answers

to the problems faced by +ve indians for almost 12 months now.

The first thing I found out is that stigma, discrimination and

harrassment is killing Indians faster than the virus ever could.

Completely destroying immunity in record time.

The second thing I found out is that COMMUNALISM currently

fostered by the present government for votes creates no capacity

for community building except in very desperate and galvanised

communities and in that respect the police officer in charge in

Assam is setting an excellent example whereas the police forces in

other places are pulling their organisations apart.

The third thing I discovered is that opportunistic infections are

killing people simply because no action is taken for correct and

timely diagnosis and treatment.

The fourth thing I noticed is that doctors boast about doing 20

tubal ligations an hour in some rural parts of india when no

sterilisation of equipment or changes in bed linen between

patients is even contemplated.

The fifth thing I noticed is that when funds are being distributed

the stats of supposedly infected people get inflated on a state by

state competition to see who will get the most funding and some

small agencies with positive staff and direct contact with

positive people are described by NACO officials who should know

better, as 'jokes'

The sixth thing I noticed is that when performance is measured and

rewards are being accorded for good efforts, numbers are seen to

be improved. In one agency I noticed that they even changed the

date of their annual report so that they were only counting

numbers for 8 mths and comparing them to the last years figures

for 12 mths.

The seventh thing I noticed was the territorial covertousness of

positions and the care that is exercised to ensure that no

positive people get trained in case job opportunities in the

sector are lost.

The eighth thing I noticed is that scant regard for universal

precautions in allied health settings are trained for and utilised

so that it becomes unnecessary to know whether a patient coming

for routine treatment is +ve or not.

The ninth thing I noticed is that blood collection units of which

there are about 9000 in India test all purchased blood for the

three Hep's and HIV and if the sample tests positive it is

discarded but the donor patient is not told of his or her

status.

The tenth thing I noticed is that in VCTC there is not much useful

information imparted to people who test positive but soon after

testing everyone who has had any part to play in the testing

process is aware of who tested positive and where they live.

The eleventh thing I noticed is that C.M.'s in some States

describe HIV/AIDS as the enemy of the people and at the village

level you know what you need to do to enemies, seek and destroy.

The twelveth thing I noticed is that people don't understand the

difference between contagious and transmissable when it comes to

disease. Allied Health Professionals including Doctors take

enormous risks with the HEP's which are somewhat contagious and

yet they are scared stiff of HIV which is only transmissable in

three main ways, all of which can be avoided and harm minimised by

the intelligent use of the law.

An example of the unintelligent use of the law is the eviction and

dispossessing of 100's of sex workers and 100's of their children

in Gujarat on the orders of the Police and on those same orders

landlords are being instructed to lock their homes and refuse to

let them back inside.

The thirteenth thing I noticed is that in one of the most educated

States of India, namely Kerala, well children who happen to be

positive are excluded from education even though the likelihood of

unprotected sex or sharing of injecting equipment are totally

unlikely to be a problem in the school and even now we find that

negative children of positive parents are also being excluded

because one or both parents are +ve.

The fourteenth thing I notice is that in the 100's of

conversations I have with ordinary adult Indian's both in India

and around the globe who engage the conversation by asking why I

am in India, no one has ever seen anyone positive, or if they have

they haven't recognised them as such.

The fifteenth thing I notice is that some people are proving that

being HIV positive doesn't mean they are are about to die and many

continue to work but they are the exception rather than the rule

and the reason is that people avoid getting their status checked

until nearly five eights of the available treatment options are

lost to them forever.

The sixteenth thing I notice is that HIV/AIDS affects the GNP for

India by about 4% but the government doesn't think it can do

anything other than preach abstinence and faithfullness in

relationships, many of which are not relationships in any

recognisable shape or form.

The seventeenth thing I notice is that HIV/AIDS affected the age

groups of 14 to 49 in skilled industries like mining, manufacture,

construction, hospitality, farming and housewives and mothers and

these skills are being lost at a rapid rate yet I am assured by

some that it is just another answer to India's overpopulation

problem and eventually all will be well. I asked and was informed

that last year India registered 26,000,000 live births last year,

a figure slightly higher than the estimated AIDS deaths.

The eighteenth thing I noticed is that some very capable NGO's

have been recognised as providing a number of useful interventions

yet because they are not three years old they are unable to

legally attract grant funding directly and must have the funds

drip fed via an established agency who take an administrative

commission. One such agency had four staff who never knew when or

how much they would get remunerated. They had the use of a

premises but they weren't allowed to claim and pay rent for it

from the donor despite it being in the budget. They had no

telephone, no computer, no travelling allowance or training

allowances and no office furniture or fax machine. Their staff

were refused training by the accredited NACO funded Counsellor

because it wasn't in her job description to train +ve people to

counsel even though they make the best counsellors because both

sides of the counselling table are equal as far as health status

is concerned.

The nineteenth thing I noticed was that some organisations

capitalised on the prevention funding and held training and

accreditation programs. they paid the bills for accommodation,

travel and food and the training was conducted and the

certificates issued and very few saw a positive person at anytime

during or after the training. In fact it proved quite difficult to

even find an office bearer or contact person to ask for an

evaluation of the program.

The twentieth thing I noticed was that very few of the programs

were focus tested with infected or affected communities before

they were endorsed and trialled.

I could go on but i think that Rajan's thoughful series of

questions and observatons deserved at least some commentary. The

numbers of +ve lawyers, doctors, industrialists, and others in the

wealth classes are not going to go public and put a face to the

epidemic. Why would they? It would be as bad as saying that one

was gay or lesbian or something equally abhorent to the so called

Indian community. Some of us are ready and able to train +ve

speakers so that India can put a face to the epidemic but what

confidence could one offer that their contribution whould not just

make their lives worse.

The worst feature of the epidemic is the " surveillance data " on

which poor India is left to rely on for stats. Most of it is done

in villages where secrets are not usually possible. Most involves

anti and prenatal clinics which produces a higher incidence of

secondary infected females but primary agents are all but ignored.

Sex workers who are the easiest groups to reach and train for

safety are harrassed at every possible opportunity by largely

untrained and uninformed law enforcement officers at all levels

who say that India's attitude to zero tolerance will never change

despite globally, the only countries with a stable and stablising

epidemic are those that have recognised the potential for better

public health by harm minimisation strategies.

There are none so blind as those who refuse to see and despite the

writer's assurances that indians are intelligent, caring and

perceptive there is no way that progress can be made until

communalism is exposed for what it is and communities in greater

numbers discover their common humanity and refuse to live in

fascist narrow minded historical past histories of heros and

blame. Perhaps HIV/AIDS is the one and only thing that the variety

of communal movers and shakers can no longer use to their

advantage because the virus knows no communal boundaries.

Geoff Heaviside

E-mail: <gheaviside@...>

[Guest guest]

Dear forum members,

There are times when one is compelled to take time out and make comments to

other`s observations and this is one such time. If someone thinks that India has

failed to respond to the HIV epidemic and HIV+, it is his or her opinion.

The same need not be true. However much bright the person may be, 12 months are

nothing to understand a country like India. Pointing fingers to others is the

easiest and foulest past time that one can indulge to. Unsought for advice is

not called for. Further this is not a forum to comment on politics. Forum

moderator may please try to keep the forum as scientific and HIV-centric as

possible.

India has made a tremendous fight against the epidemic in the past decade and

with the additional load of other diseases like malaria and TB, we will still go

ahead unhindered. with regards

Dr.Narendra Singh Potsangbam MD

E-mail: npotsangbam@...