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INDIA: People with HIV Get Dose of Discrimination from Hospitals
By Ranjit Devraj
NEW DELHI, Dec 1 (IPS) - Lalitha's (not her real name) pregnancy was cause
for joy in the affluent Arora family, which quickly resolved to get her the
best private pre-natal care that money could buy in India's capital.
The obstetrician at the large and well-appointed private nursing home,
located in the middle of a posh residential area, was charm itself. That is
until the time she informed the Aroras that ‘routine' blood tests carried
out on Lalitha showed her positive for HIV.
‘'She told me that they simply did not have staff suitably trained to
take on an HIV-infected person,'' recalled Lalitha, who in June gave birth
to a healthy baby boy at her residence with the assistance of a medically
qualified cousin.
‘'I wanted to sue the nursing home but was dissuaded by other members
of the family because of the stigma involved,'' said Lalitha's father, an
influential businessman who confessed to being helpless for once in his
successful life.
‘'All kinds of questions popped up. How did she contract the virus? Was
my son-in-law infected?'' he said. In the end, the Aroras did nothing and
did not even care to go in for further tests. ‘'Let the gods have their
way,'' Lalitha's father said resignedly.
Even the knowledge that private nursing homes are not legally allowed
to test for HIV without a patient's consent, let alone refuse treatment or
care, was of no help.
‘'There is very little regulation on private nursing homes, which make
a killing because government facilities are badly overcrowded,'' said
Lalitha's father, asking not to be named.
But chances are that Lalitha would have been rejected even by the
government hospitals. Earlier this month, the Delhi High Court issued
notice to the prestigious All-India Institute of Medical Sciences (AIIMS)
and other major government-run medical facilities to ensure that
HIV-positive patients are not denied treatment.
Taking notice of newspaper reports of yet another HIV-positive patient
being refused treatment, the court ruled: ‘'Prima facie we come to the
conclusion that the manner in which the patient had been treated on the
grounds that he was HIV-positive amounts to violation of human rights as
well as fundamental rights guaranteed in the Constitution.''
Raj Bahadur, a government employee, had knocked on the doors of several
hospitals to seek continued treatment for urinary blockage. But after blood
tests showed that he was HIV-positive, Bahadur was thrown out of St.
Stephen's hospital in August, with a catheter sticking out of his side to
drain out urine.
‘'They told us they did not have the facilities to handle his case,''
said Bahadur's wife Raj Kumari.
It took the personal intervention of Delhi's Health Minister A K Walia
before Bahadur, his surgical wounds oozing pus, was admitted to the LNJP
hospital, a major government hospital, on Nov 12.
Bahadur was lucky because his case received massive newspaper publicity
at a time when Microsoft Corp's philanthropist chairman, Bill Gates, was in
town with a 100 million U.S. dollar cheque for anti-HIV/AIDS projects.
Unlike Lalitha and the Arora family, Bahadur and his wife had no
problem being identified by name. ‘'If it were not for publicity he may
have been dead by now. We just don't want anyone else to go through what we
experienced,'' Raj Kumari said.
Hundreds of other cases of rejection by hospitals go unnoticed. A
handful end up at the all too few hospices in the capital - themselves at
the receiving end of prejudice and hostility from local residents.
Said Richard Francis, a volunteer at Michael's Care Home, a 35-bed
hospice for HIV/AIDS sufferers: ‘'There are problemsà people don't take
kindly to the idea of living near a hospice like this.''
But Francis says attitudes are improving, though far more slowly than
the rate at which the virus was reported to be spreading. By conservative
estimates, India could have 10 million people living with HIV by 2010
compared to the four million it is estimated to have at present.
Anjali Gopalan, who runs the voluntary agency Naz Foundation (India),
whose 12-bed care centre was honoured with a visit by Gates on Nov. 12,
said the facility faced resistance from neighbours who for instance
boycotted the washerman who did their linen.
Those living in the centre have taken to washing and ironing their own
linen because the neighbours fear that the virus could spread through the
washerman's hot iron.
Such ignorance is not confined to lay people - even medically trained
professionals seem to have a need for specialised instruction on the
handling and care of people with HIV.
At an April meeting,. a group of leading volunteer agencies including
CEHAT (health), the Association of Medical Consultants, the Forum for
Medical Ethics and Women's Centre called for amendments to laws that govern
to private nursing homes and hospitals in order to make it difficult to
reject HIV-positive people.
But the group also recognised the need for the government to conduct
courses on the care of HIV-positive people for different types of medical
care workers, ranging form doctors to attendants. These courses, the
participants agreed, should include social aspects, universal precautions
and the basic duty of doctors and other professionals to people living with
HIV.
Said Samiran Nundy, former head of gastrointestinal surgery at the
AIIMS: ‘'Doctors should know better and it is terrible that they reject
HIV-positive patients especially when they know that ordinary precautions
are sufficient.''
Nundy says doctors are in fact at far greater risk of contracting
Hepatitis-B than HIV in India, but seem generally unaware of this fact.
‘'In any case, rejecting a patient is completely unethical and goes
against the oath of Hippocrates if not the laws of the country,'' Nundy
said. ‘'Doctors who do that should have their licenses cancelled as also
nursing homes.'' (END/2002)
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