Disturbing pointers
S.M. PASUMARTHI
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Infected needles used by quacks could be one of the reasons for the spread of AIDS in rural areas
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THIS IS in response to the Editorial on HIV and AIDS "Distress compounded" (The Hindu, August 9), which spoke about "disturbing pointers to the failure of the welfare system to respond to the basic needs of mass education and healthcare." Let me share one experience that touched my heart and soul and is still lingering.
Recently on Doctors Day, my telephone rang at 6 a.m. "Good morning doctor, this is Venkat (names changed for confidentiality); sorry to disturb you so early in the morning. Today is Doctors Day. I and Lakshmi wish to convey our greetings and thanks for all your help. You may get several greetings from other patients, but we wanted to be the first."
"Thank you, how are Lakshmi and Padma?"
"Lakshmi is okay. Able to move about with routine housework and Padma is also well, getting lessons at home only from her mother. Sorry to wake you up so early."
"Don't worry, I am glad you are all well. God bless you," I said. No other patient of mine greeted me that day.
Venkat hails from my native village and we are fellow migrants to this city (Hyderabad). He comes from a poor family of agriculturists, fairly comfortable in a joint-family set-up. He studied up to intermediate, got a job in a nearby town. He got married to a distant cousin. When Lakshmi was ready for the delivery of their first child, she was taken to a private nursing home. Soon after admission, routine blood samples were collected and Caesarian section was done the same evening. Padma was born. All seemed well.
When the blood report was received, Lakshmi was discovered HIV positive. It was found later that the father and the child were also affected. At home hell was let loose on them literally. They were kept in the veranda. Venkat had to sign on a blank stamp paper and was given Rs. 1 lakh for his share of property and was asked to leave the house immediately. Lakshmi's brother, who was aware of the AIDS campaign, came to their rescue. Reaching Hyderabad, they all landed in my clinic.
Venakat told me the whole story. I saw all the available reports. I never had any experience with HIV patients in my 40 years of surgical practice. I telephoned a skin specialist friend. He gave the addresses of the currently available facilities for HIV patients. I wrote a brief note of introduction to the Medical Officer concerned. I could only give a few encouraging words and that they could always contact me for any help.
After they settled down to the new life of "living with AIDS," he came to me. I had a long chat and some frank questions. He never had any sexual contact with anyone other than Lakshmi, nor had she. I asked about their family doctor for routine illnesses. He said that they went to an RMP doctor who was very popular. Many villagers go to him. He always gives injections, tablets and sometimes IV saline. Venkat and Lakshmi took treatment from him several times.
He was also called `night doctor.' It seems many Casanovas go to his clinic to get PAM injections, long acting penicillin used for the treatment of sexually transmitted diseases such as gonorrhea, syphilis, etc. Perhaps many people still believe that PAM will protect them from AIDS also.
This episode gives much food for thought. How is it that innocent men and women in the villages get AIDS? It is not from prostitution alone. Infected needles used by quacks and RMPs could be one of the major culprits for the massive spread of AIDS in the rural areas of several States in India. Two recent reports from reputed international surveys have confirmed that infected needles used by quacks are an important factor in the spread of HIV and AIDS in epidemic proportions.
There is an unfortunate notion in the corridors of power that the rural poor can be treated by the ANMs, health visitors and quacks. It is grossly unethical and in itself will be a denial of basic human rights. The poor go to the quacks or paramedics for basic health care while the rich go to 5 star corporate hospitals even for a headache or tummy pain. The urban and rural poor have a basic right to be treated by qualified doctors and not paramedics or quacks. Our health policy and future planning must address this fundamental right to provide basic qualified doctors for the rural as well as urban poor.
(The author, a retired consultant surgeon, had two decades of experience in U.K.-NHS and, on return to his native village, a decade of rural health service)
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