How Nepal coping with HIV & AIDS

[Guest guest]

Teku Hospital coping hard with HIV patients

By Indira Aryal,

KATHMANDU, Dec. 29: The Sukraraj Tropical and Infectious Disease

Hospital (STIDH) at Teku is hard-pressed coping with the flow of HIV

patients. Every month about 50 patients are registered in the

hospital for treatment, hospital sources said.

" The hospital has to bear the pressure of the patients because of

the unwillingness of other medical institutes to treat HIV

patients. "

Other medical institutions think that the Teku Hospital is the only

hospital to look into the HIV cases, said Dr. Suman Thapa of the

hospital.

This hospital alone cannot take care of all the HIV patients and

this burden should be borne by the community as well as other

hospitals if the service related to HIV is to be reached to the

larger section of the people, Dr. Thapa said. There are only four

trained doctors in the hospital assigned to look after the HIV

cases.

Presently, the hospital has been providing the free Anti-Retroviral

Therapy (ART) to 55 patients. Of them, four have died during the

treatment process. The government has set aside fund for 75 patients

for free treatment. Others are waiting for the free treatment as

they are undergoing treatment for other diseases.

But doctors in the hospital said that the free ART being provided by

the government to HIV patients for the last four months has failed

to reach the target groups

But the Department of Health disagreed and said that it was mostly

the people of the lower social and economic group who are benefiting

from the free ART facility provided by the government.

But doctors at the hospital said that the treatment facility was

being used mostly by persons from rich families, who have access and

link to the hospital. " The poor ones and the commercial sex workers

are devoid of the service because they live outside the Kathmandu

Valley and coming to Kathmandu is rather costly for them. "

A doctor on condition of anonymity said that there is a patient who

can travel all over Europe and America on his own expense, but he

has been taking free medicine from the hospital.

Another doctor Dr. Suman Thapa said that if a person is affected by

the disease, he or she should come to Kathmandu for the medicines,

but they have to spend equal amount to come to the hospital. " So,

the medicines should be provided through the local hospitals, " he

said.

The hospital also said that there has been no regular monitoring of

those taking the medicines. Doctors said that the medicines should

be taken two-times a day and at the same time.

Dr. Pulkit Chaudary " Pallav " , senior medical officer at the National

Centre for AIDS and STD Control (NCASC), said that due to this

difficulty, the government had decided to provide the ART service in

all the five development regions.

He claimed people, who have been getting the treatment, are from the

needy groups. " The ART Management Committee evaluates their medical

condition as well as socio-economic situation before referring for

free therapy, " he said.

He said that patients have to meet certain requirement such as less

than 200 counts of WBC or T-cells and the patients must not have

other diseases such as TB, to get free ART service. "

The ART treatment should be closely monitored by trained doctors

because it has so many side effects including infection in liver,

kidney, blood and it may also cause diabetes, he said. " So, selling

the medicines in the open market without full medical check-up by

trained doctors is prohibited. "

People think that the Teku hospital is the only one hospital for the

HIV patients and all the hospital refers the patients to the Teku

hospital if they are found HIV positive.

He said that the hospital is facing the problem due to lack of

orientation of the doctors in other medical colleges and other

hospitals. According to the Department of Health, there are 4,442

cases of HIV/AIDS, including 1,187 in women, identified as of

November 30.

Dr. Thapa said that the HIV could be controlled if a patient takes

98 per cent of the prescribed drug.

He said that the medicines manufactured by Sipra Company of India,

is also a prescribed medicine by the WHO. " But it is difficult to

say about the long-term effect. " The patients have to take the

medicine through the life and it costs Rs. 2,500 every month.

But recently, to make the treatment effective the government has

decided to expand the service from Bheri Regional Hospital,

Nepalgunj, Tribhuvan University Teaching Hospital, Kathmandu and BP

Koirala Health Institute, Dharan. The service will start with within

two weeks with 25 people in the Nepalgunj hospital.

WHO targets to provide free treatment to 3 million people of

HIV/AIDS globally in 2005. Nepal also aims to provide the service to

4,000 people.

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