Ignorance claims lives of more victims than the disease

[Guest guest]

Ignorance claims lives of more victims than the disease

The Times of India 24 September 2001, New Delhi - Kalpana Jain

NEW DELHI: Is it a lack of access to anti-retrovirals-an expensive cocktail of

drugs-which makes most of HIV positive people in India die soon after getting

infected?

Ask Lakshmi, a widow with three children trying to live with HIV in a coastal

town of Andhra Pradesh. Lakshmi's husband died two months ago. But he could have

lived longer even without access to anti-retrovirals.

More than the virus, it was ignorance that killed him.

With little knowledge of the disease and no access to proper medical care, he

was left to the mercy of villagers, who believed the only way to protect others

from multiple infections, was to throw him into a garbage dump. He died

painfully-amid the stench, stray dogs and grunting pigs.

Such horror stories abound in each city, town and village. More than

anti-retrovirals, it is a combination of several factors that are leading to an

early death. Doctors still cannot diagnose HIV early enough; patients start

going to quacks to find some way of getting a cure; drugs are not available for

treatable infections like tuberculosis and counselling continues to be

inadequate, with people being told that they have two more months or so left to

live.

This by itself robs the motivation that is required to live with HIV. In the

initial years of the infection, it is a positive environment, good nutrition and

treatment of all infections that makes the disease manageable and prolongs life.

Those blessed with all these, can live for 10 years or more without recoursing

to anti-retrovirals.

The drug cocktail needs to be monitored well fro side-effects. It also has to be

accompanied by expensive tests to know the state of the immune system. While the

government has initiated a policy to get these tests done at a reduced cost,

very often the equipment does not function. In Manipur, for instance, a state

with the highest prevalence, the equipment did not leave Calcutta dock for over

two years. By the time it did, all the reagents had expired. Patients need to

pay as much as Rs 8,000 for these tests which need to be repeated every six

months or so.

This insensitivity extends to all areas. Often doctors are not even aware of the

combinations that are to be given. Some of these drugs can cross-react if given

in a wrong combination. And this is exactly what is happening in many a case,

says a young doctor at YRG CARE in Chennai, Purnima Madhivanan, citing the

example of an anesthetist, who was put on such combinations.

Few doctors want to care for those with HIV: " When I send a pregnant woman, she

is treated abominably. They do a Caesarean section and leave the placenta

inside, because they couldn't care less, " says Madhivanan.

Anti-retrovirals are useful in checking transmission from an infected mother to

the foetus, but they are not a cure. At best, they can inject a few more years

into the immune system. Some of the serious side effects of these drugs include

inflammation of pancreas, altered sensations in hands and legs, inability to

tolerate foods containing glucose, abnormal distribution of fat, severe rashes

and inflammation of the liver.

(This is the fifth part of a series on HIV/AIDS in India)

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Dr. Jagdish Harsh

François-Xavier Bagnoud (INDIA)

E-mail: jamworld@...

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