Re: Denial of ART: Strategies of MOs (2)

[Guest guest]

Subject: Denial of ART: Strategies of MOs (2)

[Editors note: I am personally, out ragged to read this cases of

conspiratorial disregard to the well being of the patients bye a

rogue Medical Officer. When will this Medical Officer will realise

that the patients are not their private chattels?. I would like to

Congratulate Dr. Anil Paranjape and the ICTC Counsellor Sulbha

Waghmare for speaking up for the voiceless. In HIV response in

India, speaking up has become an expensive proposition and many of

the members of the HIV civil society rarely speaks up- to ensure the

continuation of their grants and positions. Many, so called reputed

agencies have even banned their staff from posting messages on this

FORUM. In the cesspool of HIV response, occasionally lotus blooms.

Dear Dr. Anil Paranjape and Sulbha Waghmare, both of you give ample

reasons to keep the faith in human kindness. You have displayed the

sprit of solidarity with the weakest. Thank you.

Please be assured, what ever decisions you and your colleagues may

take in your next support group meeting on Tues 5 Aug 08 we will be

happy to support you. Including, initiating a global campaign in

support of your cause]

__________________________________

Dear Friends,

Re: /message/9075

I had written to the forum some days ago to share the experiences of

denial of ART to members of our Care and Support Group and have

received plenty of responses from members of this discussion group.

The responses assure me that action would be taken against concerned

persons but request me for more details.

I appreciate the concern expressed but am not in a position to lodge

a formal complaint as the victims are extremely marginalised and are

simply not willing. Further they would have to continue utilising the

same centre as they do not have a choice of ART centres and hence

have to live with the present staff. I would nevertheless wish to

share the incidents in order to explain what has occurred and in the

hope that this is not repeated with other clients.

Case One:

Mr A is about 40 yrs old and is a construction labourer. He is

presently not doing any remunerative work as his physical condition

does not permit it. He has been on ART for more than a year and his

CD4 counts are checked every six months. This year in the month of

Jan 08 he went to the ART centre for his regular check and collection

of ART drugs. There he was was given ART and advised to get his CD 4

counts checked and return for his next round of drugs. Mr A

accordingly went to the Blood Collection Centre and gave his blood

sample.

Mr A then returned in Feb 08 for his next check up and drugs as per

his routine. At the ART centre he was asked to bring in his CD4 count

report before he was given his drugs. When Mr A went to the counter

in the ART centre where the CD4 reports are disbursed to the patients

he was told that they had not been recieved from the lab. He went

back to the Medical officer but was told that he would NOT be given

any ART till he produced his CD 4 Report. Mr A then went to the main

lab where he was told that his CD 4 report had been sent on to the

ART centre. He returned to the ART centre to request for his drugs

but was again refused and returned to his home.

Subsequently he attempted on two more occasions to trace his CD4

count but was only given the run around by the hospital and the ART

centre staff. On 18 Feb 08 Mr A again attempted to convince the

medical officer in charge that he could not trace his report but was

told that he would not be given his ART till he got his CD4 counts

assessed. Sulbha Waghmare, Counsellor at our ICTC was there that day

and Mr A informed her of his problem. She accompanied him in and

asked the Medical Officer in charge. The reaction from the MO was

that the MO did not have any memory of having met the client!

Sulbha and Mr A were able to trace the CD4 report and Mr A's ART was

resumed.

Case Two:

Mrs X is a 35 year old woman who used to work as a Helper to the

Anganwadi Sevika. She has been registered with the ART centre for

more than a year now. Her husband is non reactive but cares for his

wife and due to her illhealth and the constant attention she requires

lost his job as a security guard. Mr and Mrs X have three children,

a girl who is fourteen and two boys who are ten and three years old

respectively. Due to Mrs X illness and their financial difficulties

they were unable to look after the children and Mrs X's parents took

the children away to their town to look after them.

Recently in the month of May, Mrs X was found to have a CD4 count of

less than 100 and was started on ART. She was given only fifteen days

worth of drugs and told to get her children tested for ART. Since

they were in a different town she informed her parents and made plans

for them to come over when they had holidays from school. She went

back to the ART centre after a fortnight and was told that she would

not recieve any MORE ART till her children were tested.

She reverted to us and Sulbha was again despatched to resolve the

issue. Sulbha accordingly went to the ART centre but the client did

not show up. The husband later told us that she was feeling very weak

that day and also that she did not feel up to facing the staff at the

ART centre.

During this visit Sulbha did not attempt to speak to the MO in Charge

due to the previous experience but shared our problem with the staff

of the Treatment Counselling Centre managed by the Positive Peoples

Network.

The staff informed her that this approach of pressurising persons to

get their spouses / children tested for HIV and getting their CD4

counts assessed and if necessary withholding ART was adopted by the

centre. They also stated that the ART of the patients was stopped as

a PUNISHMENT for not complying with the orders.

The children, a girl who is fourteen and two boys who are ten and

three years old, were brought back from the grandparents house and

were tested for HIV. The girl was non reactive but both the boys were

found to be positive. When Mr and Mrs X went back to the ART centre,

hoping to have the ART resumed, they were given a new requirement.

They were told that Mrs X's ART would not be resumed till the boys

CD4 counts were assessed. However Mr and Mrs X were repeatedly

lambasted for having made " false allegations " about the staff of the

ART and told that they themselves had misunderstood the instructions

that they were given. They were also told that they had NEVER BEEN

DENIED ART. However we know that Mrs X did not receive ART for at

least twelve days.

Case Three:

Mr and Mrs Z have both been registered with the ART Centre for a few

months now. Mr Z is a labourer and Mrs Z is a housewife. Last month

Mr Z was found to have a CD4 count that was low enough to warrant

commencement of ART. He was told that his ART would be commenced only

after he got his children tested for HIV. Their children are seven

and three years old, have been tested and now we hope Mr Z's ART

would have been commenced.

Sulbha and I are at our wits end and really do not know how to take

this issue further. We suspect there are more cases like this which

have not yet come to light. We shall discuss these cases further

during the next support group meeting on Tues 5 Aug 08 and elicit

information on any other experiences of our members who are on ART.

Regards,

Lt Col (Dr) Anil Paranjape, MD

e-mail: <anilvparanjape@...>

[Guest guest]

Dear FORUM,

Re: /message/9117

This is the height of ART DoctOrs insanity !?.

Dr.Riwari and NACO should immediatly look into the matter as these Doctor act

and operates completely out and beyond NACO's ART opretional guideline.

Case  1 & 2, the practice of these Docotrs denying a person who is already on

ARV is completely unethical and unacceptable. These Doctors and Authorities

should be held responsible for denying ARV, disrupting their Adherence and

also for putting them at risk of developing drug resistence.

 

Case 3; This is also his own guideline.

Does this Doctors in question  knows anything about " Adherence " or " Resistence " .

or that ARV is a lifelong medication??? I seriously doubt.!!

I salute Dr. Anil and Subha for bring up this issues.

 

Yes, i join hands with Editor, if any campaign needed, count on me.

 

Loon Gangte

Delhi Network of Positive People (DNP+).

e-mail: <dnpplus@...>