Urgent Need to Solve: Two Disturbing Stories

By M H Ahssan

The best efforts and mechanisms of NACO, state and district AIDS Control Societies and various NGOs are clearly not being enough to deal with the insensitivity and discrimination that HIV-positive patients continue to be subjected to in various Indian hospitals.

It is still not uncommon to hear about Indian hospitals refusing to admit or treat HIV patients in gross violation of a Supreme Court order— stating that doctors in Government and private hospitals should not refuse treatment to People Living with HIV/AIDS (PLHA).

In a shocking incident last month in Swaroop Rani Nehru hospital, a state-owned hospital in Allahabad, the hospital staff not only refused to treat a HIV-positive patient but in a dastardly act pasted an 'HIV' sign on the wall behind the bed of the HIV patient (admitted in surgical emergency ward). The hospital had earlier relented to admit the patient only after the Allahabad Network for People Living with HIV Positive (ANP Plus) took up the matter with the district magistrate.

Even as the HIV sign was removed after intervention from ANP Plus, the hospital's apathy and cruelty did not stop. The staff then wrote ‘ART’ (Anti-retroviral Therapy) on the wall and tied a red ribbon, indicating NACO and thus HIV patient, on the drip stand. The doctors also refused to treat the patient, stating proper medical kits were not available in the hospital. According to NACO and WHO guidelines, every hospital has to have a basic protective kit for doctors for treating HIV positive patients. The hospital management had later informed that medical kit was available.

In the same state, around two years back, two doctors of Lala Lajpat Rai Memorial Medical College, Meerut, were suspended by Uttar Pradesh Chief Minister Mayawati because of denying to assist in the delivery of a HIV-positive woman. Instead, the doctors had asked the patient's husband to deliver the baby. From the Allahabad hospital, however, there has been no news of any action against the insensitive staff.

From a case of insensitivity to a case of grave error— the damage done to a patient is no less. In another incident in Mumbai last month, an Integrated Centre for Testing and Counselling (ICTC) issued a false HIV-positive report to a pregnant woman. When the couple did the test in a private lab, the test showed negative result. But the damage was done— the lady underwent stress-induced miscarriage of her seven-week-old foetus.

According to experts, the laboratory should have done the screening test with two different kits and if the diagnosis was positive with both, then the laboratory should have suggested reconfirmation with Elisa and Western Blot. The ICTC did no perform more than a single test for a person from a low risk group. With 90 lab technicians and 120 counsellors across 74 ICTC centers in Mumbai, it is shameful that such an incident has occurred— causing such irreparable damage.

Though it is commendable that the Mumbai District AIDS Control Society (MDACS) had acknowledged the mistake, deemed it 'inexcusable' and taken immediate punitive action by issuing memos and transferring the two employees behind the error, it is not enough. In a PIL filed last year, it was alleged that NACO has used sub-standard HIV kits in second national AIDS control programme— posing a potential danger of transmitting HIV to unsuspecting patients through blood transfusion. So, there is a need to check the quality of the kits.

There is also an urgent need to ramp up awareness campaigns to educate and sensitise the medical fraternity and hospital staff in dealing with HIV patients. If explaining does not work, then action stricter than mere suspension of staff needs to be taken. We also need to ensure that HIV kits are available across all hospitals and health centres.