Access to ART: The ground Realities

[Guest guest]

Dear all,

This is about my personal experience in government ART center, Gandhi Hospital,

Hyderabad trying to access ART. I am living with HIV past several years and was

getting satisfying treatment in YRG care, Chennai. Due to my career, I shifted

from Delhi to Hyderabad and approached ART center at Gandhi hospital, Hyderabad.

The first day, I went to ART center on the 21st Feburary2009, where I approached

clinical staff for my registration. The clinical staff directed me to the

counselor for registration. When I approached counselor with my CD4 count (old

and new), he asked me for the AIDS report. I said, I don't have a VCT report,

but you can find a VCT number in the CD4 report. Then he said, No we accept only

ICTC report with three photographs and address proof. Without all those

requirements we cannot registered you.

Then I requested the clinical staff to arrange to meet the senior medical

officer and she directed me to the doctor. The doctor supported well and asked

me to bring my latest YRG prescriptions and address proof and meet him tomorrow.

The second day on 23rd February, I went again to the ART center and met the

counselor and submitted my latest YRG doctor's prescription and address proof.

He took all the documents from me and went to the doctor's room for discussion.

After the discussion he came out and asked me to meet the doctor. The doctor saw

the prescription and said, Here, ICTC report is essential for registration, so

first go and get the HIV test in the ICTC and bring the report.

The third day on 28th, again I went to ICTC, but it was closed. I asked some

people in the ICTC, and they said that all the counsellors went to the training,

so come again on 3rd March.

Finally the test was done on 7th March at the ICTC and tested again HIV positive

and went to the ART center with my report at 2 pm. To find the ART centre

closed. Finally I sent my wife to the ART center on the 9th March to collect the

ART medicine. She also went and met counselor and requested to get registered in

the center.

The first question the counselor asked my wife was, where is your husband?. She

replied, he went to the office. The second question counselor asked was, how

much is your husband's salary? She replied, I don't know. Finally he said, If

your husband wants to live, he has to come, doesn't matter what he was doing.

First bring your husband to the centre only then I will do the registration. She

asked him, that she has all the required documents with her, and what is the

problem to provide medicine. After all the unwanted, irritating discussions, she

got medicine for a month.

This is how the counseling session went between client and counselor at the ART

center. One of the wonder is, still am not accessing ART from this center.

Now I am putting all my concerns to this forum at least to mobilize voices for

People Living with HIV.

Why photographs? Why address proof? Why Counselor?. If the government wants to

collect this information from the client, appoint a clerk or support staff. Why

counselor?

For my understanding counselor is more than the doctor. He/She has the role of

facilitating the client to access life.

Secondly coming to the photographs and address proof, the NACO - ART guideline

does not ask for any address proof and photographs. But, the ART centers are

making local guidelines for people' lives and putting into the deadlock. Who has

given the right to these people?

People can explain that all these efforts are taken by the ART center to ensure

adherence. Without my concern how can you send someone to my house? For me, I am

the right person to monitor my adherence by myself. If I am not taking care of

my health, who else will take care? If I am not returning back to the center,

for any reason, what you are going to do? Do you have any human resources to

monitor the adherence of the clients? Your answer should be No.

Again you will pull the NGOs /Network people or other service providers to

track. Finally we will be showcased for all service providers in Hyderabad.

Coming to the timings of the ART center, as of now the functional timing of the

ART center is 9am to 4pm according to guidelines. But what is the reality? If

the ART center timing is flexible put it on the board or inform people not to

come after 2pm. I know it is everyone's commitment and interest.

At the same time some monitoring mechanism should ensure that whether the

systems are functioning or not without any justification (like Saturday, less

OP, festival and training).

The ICTC No Comments, It is closed through out the week in whole Hyderabad

without making any alternative mechanism. Can you imagine how many people are in

queue to know the status? I never heard that people are waiting for HIV testing

in INDIA.

Few things I want to say here, the first one is before placing a counselor at

the ART center, kindly shape the counselors first in attitude and technical

knowledge and then place them in the center.

I am talking here about shaping not training.

We as PLHA are not concerned if the person is MSW or PhD. We look for a

counselor who cares for us… and the secondly, the medical officers. How will

one medical officer treat 200 patients in a day?

The government also needs to understand that he is also human being. The NACO is

talking about expanding the ART rollout, I am addressing the issue of keeping

people alive.

Finally I want to say here, you people (ART clinical team) are responsible, you

people are shaping the lives of people living with HIV. All the concern I am

voicing here is, your attitude should be change.

This is not blaming you or some one. It is my responsibility to raise my voice

for people living with HIV. At the same time, positive network is also part of

ART team. They have to address such issues at the right time.

Why is the network not raising these issues? I know networks are thinking about

the healthy coordination with ART team. I am thinking about the health of the

Nation.

This is my kind request to all network people; raise your voices at least for

our community. BE ADVOCATES for the community and not

SERVANTS OF THE SYSTEM.

Kumar

Kumar Nagarajan

e-mail: <kumarnagarajan86@...>