Madhya Pradesh Doctors Demand HIV Kits

[Guest guest]

Madhya Pradesh Doctors Demand HIV Kits

Following the exposure of three doctors to an HIV-positive patient

in a government hospital here, the Junior Doctors Association (JDA)

has said its members would not perform any surgeries unless they

were provided kits to protect them from the disease.

" The JDA is of the opinion that it should be made compulsory for

suspected patients to undergo the test for determining the HIV

infection to avoid such incidents in the future, " Madhya Pradesh JDA

general secretary Anand Rai told reporters here today.

" However, the guidelines set by the National Aids Control

Organisation (NACO) and an apex court judgement in this regard

prevents medicos from forcing a person to undergo the blood test for

checking for HIV as long as he or she is not willing, " V P Pandey of

M Y Government Hospital said.

Rai said earlier too, various persons were exposed to HIV during

such incidents in the absence of proper kits in hospitals and these

cases had affected them mentally.

He warned the doctors would not perform surgeries if they were not

provided the kits within three days.

In the present case, the surgery was performed in an emergency

situation and though the patient was aware of the HIV infection, the

test could not be conducted for verifying it and three doctors and a

technician were exposed to the virus, Rai said.

" This situation could have been avoided if the doctors and

supporting staff were provided with emergency kits in time to deal

with the situation, " he said.

Source:PTI News

http://www.medindia.net/news/view_news_main.asp?x=12736

[Guest guest]

Dear FORUM,

Re: Madhya Pradesh Doctors Demand HIV Kits

Did these doctors have " exposures " to mean that they had a cut while performing

a procedure on these patients or do they mean that they were not aware of the

patient's HIV status before surgery?

I would like what kinds of special kits are used to protect oneself from

" exposure " to HIV during surgeries? Following Standard universal precautions

while treatinmg all patients would help to prevent not just HIV but also other

far more fatal blood- borne

viral infections- Hepatitis B for instance.

Standard precations is not just to protect doctors but also to

prevent cross- infections from the doctor to other patients. In fact hand-

washing is particualrly important to prevent cross- infections. But is rarely

considered a precaution. I wonder is it because it does not involve any " high-

tech kit " ? Further there

is PEP available in case of 'genuine' accidental exposures.

Well, one should not only increase awareness about standard precautions but put

in place systems to access to PEP and improve availability of protective gear

such as gloves, apron and so on.

Akhila Panchamukhi

e-mail: <akhila_punch@...>

[Guest guest]

Dear Forum member

Is Any one know any manufacturer who make special kit as demanded by Indore

Junior Doctor Association?

Many time this demand came in our Hospital by defferent surgeons but we are

unable to provide any special kit because of their poor knowledge about

manufacturer.

As I know universal precaution is best and only way to prevent HIV and I always

tell it to our Doctors, finally they agrred on it.

I am surprized about Indore JDA Demand. I am thankfull to knowledge of

Jabalpur Doctors who are able to understand the need to adhear to universal

precautions.

Dr. Kasar P.K.

JDH & Superintendent

NSCB Medical College Hospital

Jabalpur Madhya Pradesh

e-mail: <kasarpk@...>

[Guest guest]

Dear Forum,

The article about Madhya Pradesh doctors demanding 'HIV Testing Kits' either

speaks of the ignorance of the Junior Doctors in Indore or misrepresentation by

the person who reported the story.

As some of the group members have already mentioned no HIV Testing kit can

'Prevent' anyone from getting transmitted with HIV.

Universal Health Precautions are the only and simple way to prevent transmission

from health professional to patient or vice versa. So if

the Junior Doctor's Association of Indore is actually demanding for testing

kits, as reported in the news article, then I think they need to undergo some

capacity building programme on HIV/AIDS.

But there is also a possibility that they are misquoted and are in fact asking

for Post Exposure Prophylaxis facilities. It is not quite unusual that even

after proper precautions and adherence to

Universal Health Precautions some 'accidents' do take place and hospital staff

including doctors, nurses, and helps do get exposed to HIV (here I mean body

fluids with enough HIV concentration entering into blood stream).

In such cases it is right of every employee of that medical setting for Post

Exposure Prophylaxis (PEP). Though several big hospitals in

metropolitan cities of India have PEP available with them I am not sure of the

situation in other cities and smaller towns. One should be empathetic to

employees of who work in the medical setting and by

accident do get infected with HIV.

If the PEP is administered in time they can be prevented from

actually getting infected. If any staff members who come in contact with body

fluids of the patients demand for PEP facility in the hospital it should be

viewed as a valid demand. But at the same time this should not be contributing

the 'demonisation' of HIV.

Universal Health Precautions are very important and if followed properly with

everybody (people with HIV or even otherwise) prevent transmission of several

infections.

Regards,

Shailesh Vaite

e-mail: <shaileshvaite@...>

Phone- 09821224191

[Guest guest]

Dear FORUM,

Dr. Sanjay Dixit (professor Community Medicine) from Indore wrote to me in his

Email in response to my mail

" You are Correct.HIV testig before operation is not recommended by NACO. This is

a contoversal desicion taken by the Acting Dean, Even Blood Bank can not do HIV

Testing. The Controversy is still undecided. Pathology Dept has refused to

under take the HIV testing and Microbiology departmrnt has stated that thsy can

do only between 10 to 1PM There is nothing like special HIV Kit "

Now I am wondering how department of microbiology accepted their demond. PEP is

available in Jabalpur Medical College sine last three year but till now only one

doctor demaneded it who also not taken full course.

Dr. Kasar P.K.

JDHS & Superintendent

NSCB Medical College Jabalpur (MP)

E-MAIL: <kasarpk@...>

[Guest guest]

Dear Forum,

This is regarding the demand for HIV testing before surgeries by doctors. This

is a huge burning issue with many doctors.

In the government hospitals very often we are able to intervene in some way,

sometimes even speaking to specific surgeons, we have cases where a letter has

been sent to hospitals asking for an explanation, which itself has brought

changes among doctors, In some cases positive networks have helped in bringing

about a change by reporting such incidents in the local newspaper etc. To some

extent we are able to handle this issue in Tamil Nadu. But the practice of HIV

testing is happening in many private hospitals that too without the knowledge of

the patients, Large and small nursing homes do testing without counselling or

consent taken by the patient which is a human rights violation as well as a

legal issue when in India, we are committed to Voluntary counselling and

testing.

Trying to look at this issue of testing from a doctor's point of view, the fear

and threat of getting infected may seem very real. One way to address this could

be by giving training to all Health care workers on UWP and Hospital waste

management and ensuring that all the necessary UWP kits are availbale to doctors

as well as ensuring PEP drugs in all hospitals. Not only should PEP drugs be

available but the information regarding its availability and where, with who it

is available should be given to all doctors. This will go a long way in

addressing the fear of doctors and other Health care workers about HIV and will

bring down discrimination of PLHA in the health care settings.

Though we have PEP available in many hospitals, I am also very curious to know

if all the HCW are trained on the guidelines in taking the PEP drugs. Also the

protocols followed in the event of a doctor or any HCW getting injured. For eg.

If a surgeon has cut himself what should he do especially if the cut is deep?

will he take the sample of blood from the unconsious patient and test for HIV?

Is that the norm? What if the patient tests negative? does that mean the patient

is negative and the doctor will not take PEP? does the surgeon go for

counselling? What if the patient tests positive? Who takes responsibility of

telling the patient the result? is it right to tell the injured doctor the

result of the patient? Sometimes one may wait for the patient to give consent

for testing - in this case, if the patient refuses to tell the result can a

counsellor break confidentiality? Also, what if while doing baseline testing for

the doctor and the doctor is found to be HIV

positive? what is the right of the patient?

I would love to hear the views of members of this forum.

Magdalene Jeyarathnam

email: magdalene.jeyarathnam@...