Re: HIV Patient slapped by Coooper Doctor:Patient expires

[Guest guest]

Dear FORUM,

Being a doctor practising HIV medicine I think I should respond to

the postings on this issue. What ever happened is unfortunate and it

should not be repeated anywhere. I generally agree with the postings

by Deepak Dobhal and Dr. Yatin Gadgil.

Let me express few thoughts on this issue by answering few questions

raised

a)Should a patient inform the hospital authorities about his/her HIV

status?

This question has been asked many times with no clear answer. Ideally

it will be of benefit to the patient if he/she discloses the status

(provided there will not be any discrimination from the part of

health care workers). I think it is the duty of the doctor to take

proper history and collect all relevant information from the patient.

It is the duty of the patient to provide the information. But we

don't live in an ideal world.

b)How does one protect the HIV positive patient against

discrimination once his/her status is revealed to the authorities

(intentionally/unintentionally) ?

How are we protecting an underprivileged persons of our community?

How were/are we protecting our poor, people affected with leprosy,

tuberculosis, our commercial sex workers, street children?

It is an ongoing struggle. We should have a multiprong strategy. No

simple solution. But it is possible. I saw the change happening very

slowly in 2 large hospital which I worked.

c)Aren't the authorities to take all necessary precautions in each

case?

Yes. I am working in a hospital which is run by probably less than

one tenth of its ideal budget. We are working in a less than ideal

situation, our doctors are not trained in ethics, sociology,

administration, inter personal relationship, and needless to say HIV

as an epidemic or social problem!

d)Do we have a system to train medical staff against discrimination ?

No. Shouldn't this be part of their curriculum ? Yes

e)If qualified , educated and trained professionals like a doctor in

this case can react in such a manner, what does the average patient

face in his/her interaction with other medical assistants ( Nurses,

ward boys etc)? How do we address this issue? Unfortunately I feel it

is easier to make an attitudinal change in medical assistants than

doctors!

f) Why is it that people from the community ( mostly slum ) are not

eager to go for treatment in STD/HIV to Govt facilities? Why do they

prefer Quacks and non-qualified practitioners ? Is there an issue of

sensitivity in handling such cases ? Why is that people from poor

community (mostly slum ) are not eager to go private hospitals? Why

they are not welcome even in mission hospitals in many parts of India?

I don't think I have answered any questions!

Ajith

E-mail: trc_ajisudha@...

[Guest guest]

Further five messages on this issue: [Moderator]

1) laudable that we take up cudgels for afflicted patients

It is highly laudable that we take up cudgels for afflicted patients

made further vulnerable by conditions requiring surgey. There are

issues here which we at the NGOs need to address

a. How come the patient's positive status remained unregistered in the

statistics of the local NGO serving the area where the patient

resides-which need not necessarily be HOPE Foundation?

b. What is the protection for the hospital staff against patients who

refused to declare their known status of HIV ?

c. What responsibility should we as NGOs working intensively in a

given geographic area with near 100% access to data base about those who

are HIV positive take to be the link between patients needing

advanced medical /surgical attention and the medical fraternity so

that patients are not denied care/treatment?.

Indira

E-mail: [indira@...]

_________________________________

2) Train doctors to address their fears and attitudinal barriers

One of the most effective ways to deal with these issues is to train

doctors and and address their fears and atttudinal barriers. We all

should realise the importance of Training doctors on Infection

Prevention and Dealing with stigma and discrimination at the

providers level. EngenderHealth has training curriculum that address

these basic issues and we have successfully used the curriculum in

South Africa to deal with the issues of providers fears and patients

rights.

We would be happy to share more details with the interested forum

members.

Jyoti Mehra Ph.D

Programme Associate

EngenderHealth, India Country Office

Tel:91-11-26880343, 26880344

Fax: 91-11-26118932

Jyoti Mehra [jmehra@...]

_____________________________________

3) Such doctors who do not care for the sick

It was good that Deepak brought this to the forum. It is most

unfortunate that so called profession dedicated to service has such

undedicated unethical persons. Please let the people know of this

hospital and appraise local people of such doctors who do not care

for the sick

Florence

E-mail: [insaind@...]

______________________________________

4) Serious action needs to be taken against such insensitive doctors.

It is really sad. We are deeply hurt to hear this news. If at this

stage doctors play the role of devils than definitely there will be

more people living with HIV/AIDS dying. Very serious action needs to

be taken against such insensitive doctors.

There is no need for HIV+ people to inform anybody about their status.

Every individual has to take precaution on their own. I have seen many posters

made for precaution of doctors and are available in almost all hospitals. Then

under this circumstances it is understood that doctors are already sensitised.

There are so many doctors who are good with PLHA and take precaution of self and

care of PLHAs.

But I am shocked that this incident has happened in a metro city like Mumbai

where crores of rupees have been spent sensitising the people.

We as PLHA activists would like to know the action being taken by the

Maharashtra Government in this regards and appeal to all PLHA group to take up

this issue aggressively.

In solidarity

Vijay Nair

E-mail: [udaanpanchis@...]

________________________________

5) Such behaviour from health professionals, should not be tolerated

It is indeed shocking that a trained doctor should react in such an outragious

and inhuman manner to a HIV positive person.

Such behaviour from health professionals specially, should not be tolerated. I

will support your stand and can particiapate in activities at the local level

near cooper hospital to avoid such incidences in future.

Smriti Acharya

E-mail: [smriti_aa@...]

[Guest guest]

Dear all,

Outrage is not enough. A few NGO's from Sangli, Kolhapur and Satara, have come

together to initiate a `Patients Rights Movement' to help us address problems

faced by persons who are ill and being forced to access medical treatment from

insensitive medical practioners. We are exploring a Patients Rights Charter and

it is in the draft stage at this point. Since India does not have one we thought

we should at least advocate for such a charter.

This is not for HIV/AIDS alone. Under the Jan Arogya Abhiyan we have decided to

hold a Jansunvai[ people's tribunal] on health related issues basically denial

of health care by the personnel at the govt health facility. This tribunal

initiated the discussions amoung NGO's in this region who felt that we need such

a charter for all patients.

Many medical practioners beleive that they are doing their patients a great

favour by treating them and helping them live better lives. Within this milieu

the concept that the patient has a right to treatment is lost totally. Let us

put our efforts to start this movement and push for a Patients Rights charter.

Those interested please write to me at san_meena@... and we can share

the draft and discuss this further.

in solidarity,

Meena Saraswathi Seshu.

Rugna Hakk Chalwal.

E-mail: <san_meena@...>