Re: Disturbing Stories from hospitals continues

[Guest guest]

Dear FORUM,

Re: /message/10370

Let me thank for bringing this incidence to our notice.

There is no doubt that denial in health care settings is still happening, though

it has definately decreased after availablility of ART and also awareness

compaigns, trainings for doctors.

We have absolutely zero tolerence for all such instances and last month I had

got one such incident in AP investigated and whole facts were shared on the

forum by me.

 

We shall investigate this incident also and take necessary measures in this

regard

 

Thanks

Dr B.B.Rewari. MD,FICP,FIACM,FIMSA,FGSI

Sr.Physician,Dr RML Hospital &

National Programme Officer (ART)

National AIDS Control Organistion,

6th Floor, Chandralok Building,

36, Janpath, New Delhi-110001

Tel; 011-23731954, 43509999(O)

Mobile ; 91-9811267610

Fax : 011-23731954,23731746

e-mail: <drbbrewari@...>

[Guest guest]

Dear Dr Rewari,

Re: /message/10379

Thank you for your efforts. I think only some incidents get reported,

majority of the patients suffer in silence.

I think Provider Initiated Testing (PIT) has made matters worse. Almost all

surgeons insist that the patient tests for HIV and a " no " answer by the patient

is not acceptable. There is a lot of pressure on the counsellor to also get the

patient tested, with the salary of the counsellor tied to the number of test

she/ he conducts.

Even though we are saying on the one hand " HIV testing is not mandatory " in

India, provider initiated testing is translated on the field (even in PHCs) as

all patients must test. And once a patient tests " HIV positive " many many

reasons are given for not providing medical treatment.

For instance - If a patient is told nothing can be done about your ailment, the

patients are not going to report this as discrimination because they do not know

they are discriminated in the first place.

The counsellor may know this but they too keep silent feeling helpless many

often.

We look forward to NACO taking steps on explaining what PIT means to all the

health care professionals - Creating posters, CDS etc for health care

professionals explaining the NACO stand on testing and also maybe posters

displaying patient rights in all government hospitals in the vernacular, while

taking care that our health care professionals have the necessary kit for

protecting themselves will work.

Thank you,

Magdalene Jeyarathnam

--------

Magdalene Jeyarathnam

Director - Center For Counselling

18 Radhakrishnan Salai, 9th Street,

3rd Floor, Mylapore, Chennai 600 004

www.centerforcounselling.org

email- magdalene@...

telephone - 044- 42080810, mobile - 9884100135

[Guest guest]

Dear Forum,

/message/10379

I agree with Both Dr Rewari and Ms Jayarathnam in the points they made.

Stigma and discrimination are slowly decreasing after the scale up of ART and

better visibility of HIV.

It is defenitly a positive change . But The scale up has negative impacts also:

It unfortunately made HIV the responsibility of Govt Hospitals with ART centers

only and availability of ART centers became an excuse for referral

.. HIV test continues to be mandatory and our PPTCT and PITC guidelines

made testing and referral easy ( acceptable) especially from private

centers. We failed to main stream HIV care even after 25 years.

Most of the centers which claim " world standard " care continue to deny HIV care

and refer patients to ART centers with out giving even basic care.

Majority of surgeons continue to do pre-surgical screening (sorry provided

initiated testing) and deny care once found positive. But very few of these

tests are being done in V(I)CCTCs even if there is a VCCTC in the same compound!

VCCTCs fail to attract these clients .

Is it at least possible to get all these pre surgical tests done in ICTCs?

This itself will solve the problem of counsellors. Recent decision to merge

VCCTC and PPTCT testing centers to a single unit may further complicate the

issue.

By doing this we lost a chance to devolop PPTC cenetrs into a

specialised centre for PPTCT and advocay and counselling in side the

reproductive health care environment .

(As part of mainstreaming we are loosing chances to scale up good lessons we

learned from HIV over the last many years.)

I feel what we should do is to attract all (pre surgical provided initiated)

testing (at least from the government institutions) -- to VCCTCs and develop

VCCTC as a nodal centers for advocacy inside the institutions in which they are

located.

We defenitly need to put HIV care in private and referal hospitals mandatory and

part of accreditation system NACO should facilitate ART centers and VCCTCs in

corporate hospitals and specialty hospitals too.

Dr Ajithkumar

--

Dr Ajithkumar.K

Asst Professor In Dermatology and Veneriology

Medical college Chest Hospital

MG Kav,Trichur, Kerala ,India

Ph 04872333322 (res)

9447226012

e-mail: <ajisudha@...>