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Facing the Challenge - Page 2

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Dr. Gangakhedkar from NARI said, this has increased more so due to the media also. Media projects sex very explicitly which gives the younger generation a further boost. Even the adult channels show more of sexually explicit scenes and programs based on sex, which would give this issue a further boost.

I was sitting in the blood testing center NARI, Pune. One old village man accompanied by his son daughter –in –law and a lovely child walked in the three of them had been tested for AIDS and had come to collect the results. The results showed that the husband wife and child were AIDS positive. I was taken aback, the doctor didn’t disclose results immediately and asked them to come the next day. The old man was asking the doctor, What is this illness, tell me, I am ready to spend as much as you say! Should I take him to Mumbai? Doctor said, we will see, please come tomorrow. Doctor told me after they left, that this boy had come 3 years back after visiting a prostitute, he tested positive. I had explained to him all the precautions to be taken but he went to his village and got married and now three lives are stake – what can we do in this case? NARI and other institutes working in this area have a rule to tell the person on face about the illness. My friend Dr. Anand Divekar who works here, told me that we tell them the precautions to be taken there after. He has to then decide what he has to do about it. But what if he doesn’t tell his wife. I asked? What can we do about it my friend said there are so many young boys, who come here and test positive. One of them showed me his wedding invitation, I cannot inform my family in any case, I will get married after15 days. The girls life will get ruined. There is nothing one can do in such a case. What if we inform his family I asked? We are bound to maintain secrecy and if we do not do so you know what happens. My friend answered. One village doctor called a meeting and told the whole village that this man has this illness and that poor man was outcaste. Even the news of the diagnosis spreads like wild fire. Some lose their jobs, some their homes, for what all shall we be responsible? I had no answer to this.

Vinita Chitale is a Counselor at a center run by the Tata Institute. I asked her what she would do in such a situation. “I’ll ask him to inform the girl” Vinita said, What if he doesn’t listen? “ I’ll pressurize him? Tell him that if you don’t tell, I’ll tell.” then he would definitely inform the girl. But what if he still resists? I asked she said then she definitely inform and not let the girls life get ruined.

Vinay Kulkarni my skin specialist friend who also works in this area. He also comes across many patients his private practice. At his centre “Prayas”, a boy who tested positive, and was to be married but was not able to inform his wife – The boy himself says you only inform the girl or tell some reason and break his marriage. When I gave them some other reason then,the girls family said we will pay for the expenses admit him in Jehangir Hospital. I used to be in a very awkward position. Similar experiences quoted by my other friends.Some young men who had come to the center reported of having contracted the virus through prostitutes. One of them quoted, I had never done, ‘It’, so I was apprehensive whether I will be able to do ‘it’ and satisfy my would be wife. So I went to prostitute to do it’.

Doctor said this is a very common occurrence in our society. Due to lack of proper Sex Education. Sex Education was an issue laughed at by the masses till date, but lack of knowledge can take the husband and wife to such a dangerous ride? One Doctor in this field quoted due to AIDS, Sex Education has become important these days. Now many schools, institutes invite us for lectures, earlier we used to be asking them then we didnt get good response. AIDS and prostitution is an old equation Prostitutes are mostly blamed for AIDS. Vijayatai has been working with prostitutes for some years. She says these girls (prostitutes) have not got infected by themselves, the men have given it to them, why blame them only. Dr. Ramesh Gaud works in the area of AIDS in Nasik. I visited a red light area called Ganjval with a worker. There was lot of dirt behind the bus stop. We climbed a wall and entered a hut. The whole area was dingy and dark and inhibited by prostitutes. We did not have place to sit but managed to sit. The girl was a simple dark complexioned shy girl. She used to ask other girls to use condoms, and works with Doctor Gauds’ worker. In the meanwhile a lady aged around 50 walked in and asked rather rudely Where have been all night, why are you late? and started using foul language. She and the other girls pointed out to us and said meekly – Sir has come. The lady said what Sir? I don’t know any sir, and picked up the broom and stared beating her. We just watched stunned! The girl who was while enthusiastic till now started weeping. We had to return without being able to speak much her. We then meet one dark and lean girl from Goa, called Julie who was a prostitute in Pune. She and her daughter both were AIDS positive. She had kept her daughter in the home for orphans called ‘Safosh’ in Sasoon Hospital, Pune. Julie said I get up at 4 in the evening and return at 4 in the morning only. We come up with the customer only and if we come up for water the mistress sometimes hits us. Do you insist on use of a Condom? I asked. We suggest, but if the customer doesn’t listen we can’t let the customer go due to it. If the customer goes we have to bear the brunt, so if he doesn’t want to use we do not force. When she came to know I am a doctor, she asked, doctor when we will there be a cure for this illness? She further asked is alcohol good or bad for this? I said its bad, it harms your immune system is it possible for you to avoid alcohol? She pondered and replied it does not seem to be possible as every customer comes with a bottle and we have to give him company or he gets displeased. She further said I am ready to die, what we will happen my daughter?

Kalyani the ‘Safosh’ Counselor who was standing there said we have orphans coming to us, for whom we can care upto a certain age only and not beyond that. Her child is positive we do not know what to do with her as she can’t be adopted also. These days the number of orphaned children affected with AIDS has increased. We feel the society should only tell us what to do about this. The first association of HIV positive people started in Pune in India, a fair young man of 30/35 runs this association. He said these prostitutes have a lot of problems. The government gives free condoms, some NGO’s distribute free condoms and get publicity. These NGO’s get foreign Aid also but no one knows whether the Condom is used or not. I had once visited one such prostitute, she pointed out to a box of condoms under the bed and said the clients don’t use this what to do with this – you tell me? I felt pity for the women who were otherwise disgusting to even look at. They were in no position to stop the spread this illness either giving it or receiving it. Pinkoo said he had been to one more such prostitute. She didn’t seem to be in the mood to talk. But still upon asking said – What to tell Dada? Yesterday I had 6 clients and I asked all of them to use Condom to which they refused. Now I have shown the path of death to all of them who will give it to their wives – I will be responsible for so many deaths and she started crying. Even though the client is ready to use a Condom there are other dangers in store, if the client is drunk he unable to use the Condom properly and dispose it also. Pinkoo said Govt distributes condom as if it is an obligation for us. When we got the condoms tested from an a Australian agency it was found that 80% condoms were useless. We raised a hue and cry over the issue and now we are getting better condoms. Dr. Sanjay Mehendale of NARI says possibility of getting the infection through sex is 1%.But if its an STD, then the possibility increases by 5%. If the risk is only 1% through sex so why this alarm over the issue.?

The reason is there is frequent sexual activity going on. If a prostitute has to just exist, she has to have intercourse with at least 6 clients everyday that means almost 150 clients per month. She transfers the virus to almost 3 people every month. The virus is further spread to their wives. Dr. Gangakhedkar said we have to launch rigorous AIDS awareness programs. The percentage of AIDS in prostitutes was 1 in 1986 in Mumbai which increased to 8% in ‘88 and further to 34 – 41% in’ 91 – 92. The virus is spreading at a very rapid rate. NARI has a counselling center in Shurakrawar Peth in Pune, where they explain about the virus. The women reply – it will kill me after 10 yrs? I will die of hunger tomorrow!

The highest risk of spread is through blood transfusion and the highest risk group is of thalassemia and hemophilia patients, who need blood transfusion frequently and can’t exist if blood is not given within a specific period of time. Another risk is of kidney patients who take dialysis.The blood is purified and returned to the body in each dialysis.

If the filter is not changed then the patient taking the dialysis afterwards is at risk. Some centers have separate machines for AIDS patients. One of my acquaintances had a kidney transplant through which he got AIDS now both, the donor and receiver are no more. All this took place when AIDS testing was not possible so easily. Even the blood bags available with blood banks is not risk free. Even countries like France, Germany and Japan have reported of cases where the use of tested samples has been responsible for the infection. In 1989 AIDS testing was made mandatory in India. The oldest blood bank in India in Mumbai had to undergo an investigation for having supplied infected blood.

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