NACP III: strenghthening the existing healthsystems and institutions urgently

[Guest guest]

Dear friends,

After a long time, the participatory model is evolving " Or is it just another gimmick?"

In many evaluations and planning sessions, the voice of the

unorganised group was unheard by the noise making lot. Has the time come now to listen to what the youth as well as the affected people have to say.

Did the first two phases serve any of the targets aimed at ?

If money spent is the criteria, may be we would have reached great heights. If it was the number of organisations that got into this field, mushrooming from nowhere, we had achieved a lot. If we look at the plight of the affected and their care givers, are we anywhere near? If dedicated caregivers come forward and try to do their best, perhaps that could give a better momentum stronger enough to attract the affected to professional care-- clinical and emotional- Let us remember that we are talking about a disease, a virus and its implications in the medical sector should not be under estimated. When the Indian (including Kerala) health systems, drug production and distribution systems are appreciated by the rest of the world, why is it that we can not have our own strategies to control the onslaught of this illness and epidemic which has shown signs of weakening in many parts of the globe?

Thinking globally and acting locally is one fine phrase, but can we be better, if we act according to our conscience...? We have to move forward a lot, not only in HIV care, but in developing all health interventions. We still have health professionals, who try to super chlorinate the wells in villages where one HIV infection has been spotted. Let us not forget the doctors too who still cannot have the sight of an infected person in his premises for few hours, so that the person is referred in the middle of the night for "expert care where more facilities are available". Even at many managerial levels, lack of proper orientation by new and changing faces pose lots of problems; unfortunately this happens every now and then. Can we at least in the third phase, expect and try to generate more awareness and "right" thinking in the minds of the health care professionals?.

May be we need not even need a "national" look for this disease, leave alone national guidelines, policy etc... except in certain limited areas. We know that many directions in malaria, tuberculosis, leprosy, water related disorders are modified by many professionals and that too efficiently.

This is being done in many illnesses in any part of India now, and to duplicate this attempt in the HIV disease is all possible too. Our successes are not all dependent on technology or money alone, but more on efficiency, dedication and cooperation. All said and done, the provider must take the lead as nobody else routinely touches the sweat and tears of these people, feels the smell and hears the weeping, twenty four hours a day, three sixty five days an year.

NACP III is obviously going to be better than before, but we should not leave certain things for later. The time is running fast, at least for those who are dying in front of us.

Let us try to put in all our thoughts and help planners generate a scheme more useful to the needy at large. Let us try to normalise this as a disease which the health system has to tackle one day. As has been revealed in many areas, this is quite possible, perhaps only by incorporating novel ideas and practices into the existing set up.

Let us put all our efforts to do this as early as possible.

Let us at least try not to establish efficacy by looking at the amount of money spent alone.

Dr. R.Sajith Kumar

National Trainer on AIDS (NACP I & II)

Chief, Infectious Diseases,

Medical College Hospital Kottayam, Kerala.

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