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Facing the Challenge - Page 3

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DCP Hemant Karkare who investigated the case said there was lot of mis – management there, the registers were un maintained and it was noted that lot of people had been given untested blood. The condition is similar in Jaslok Hosp, Mumbai (Our Food and Drug Administration department is bringing this to light very efficiently) Dr. Gaud said there is more risk of infected blood spreading though unauthorized banks. These bank stores blood and have contracts with Doctors to sell away the blood, these so called Doctors are quacks who then scare some anemia patients who purchases the blood. This is not much helpful to the patient, the main cause of anemia is not taken care of. Dr. Gaud showed a chart depicting use of blood in India. 70% blood is used for anemia remaining in accident/surgery. Our countries’ blood policy is that blood should be transfused the least. The less the blood is transfused the less would be the risk of spread of AIDS. Blood saves lives and should be used carefully. Nasik has many unauthorized blood banks that is what the report we got from patients coming to Muktangan De – addiction Center Pune. These addicts would sell blood to these quacks to raise money for drugs. Anti coagulants have to be added to stop the blood from contracting. But still the blood has to be disposed within 20–35 days. People donate a lot of blood on 26th Jan, 15th Aug, during this time there is an overflow of blood – instead people should donate on their birthdays. Where by there will be a constant supply of blood, said Dr. Vani. Dr. Gaud. suggests that NGO’s should have a list of prospective donors who can be contacted when blood is required. But this is rather difficult says Dr. Vani as Government has made VDRL, Australian antigen, ELISA tests mandatory which require time and so this is not a very efficient idea.

If a patient tests positive for ELISA the blood has to be disposed according to our Government policy for AIDS patients. Dr. Sengupta for NEKO said we have to counsel the patient before and after the test. For which we lack the necessary infrastructure. Dr. Dilip Vani said the infrastructure can be raised but if we have reduce blood transfusion itself – we have to divide blood in groups – eg burns patients needs only plasma – a hemophilic needs factor 8 and some one needs only pack cells but this also needs the money and machinery – which we do not have at present.

He said about the pathetic condition in blood banks – There is untrained staff which is putting our population at stake and the health of a nation at stake. There is also a rampant black market for blood. When a person comes back disappointed he finds a broker setting at the doorstep of the blood bank – and offers him the required blood group the desperate person buys at the quoted rate. There are cases where blood transfusion is a necessity like in case of an accident. The people are now becoming apprehensive about donating blood this is a growing cause for concern. There has to be an organized network between the donor, the blood bank and receiver then only the problem can be solved. There is this case of a man called Johnson is the book called My Own Country. He was given blood during his heart surgery from there he got this virus. He unknowingly give it to his wife. He had a slow and dreadful death and the same happened with his wife. This happened in a developed country like America. What if the surgeon does the surgery efficiently? The risk is still there. The risk of AIDS is very high in drug addicts here. Heroin is available in its purest form. It dissolves in water very easily. In Amsterdam I saw many addicts injecting themselves, with common syringes. The risk of AIDS, its 15 to 2o%. The addicts coming to Muktangan take drugs through cigarattes or through chasing as they got impure heroin. But patients coming from Manipur – Assam Nagaland inject, they get pure heroin from Burma and they also have a very free sex culture. So AIDS is very common there. One rehabilitated patient came to my place one day he was AIDS positive, upon asking how he got the virus he said he didn’t know may be it was to through syringes or any of his girl friends. He then said we couldn’t keep the syringes on our body., as police used to catch us immediately. And as soon as the ‘product’ was to there we used to inject with the available syringe and frankly speaking we never used to be in our senses under the effect of drugs.

Other than semen and blood another factor for spread of AIDS is mother to child. So when a positive woman gets a pregnant she is explained the risks she is taking and then asked to take decision. It is a very difficult decision to make for a woman as motherhood is an experience every woman wants to have. One Zimbabwean woman said – how can you be so sure that my child also get AIDS! I will take care of my child I want my child.

One Canadian woman commented dying is different and dying while caring for my AIDS positive child is different. We don’t even know what emotional turmoil the woman would go through. Even if the child is born negative he is at risk due to breast feeding. There are numerous villages in Africa where you can find only aged and children in the village. In our country also the number of orphans and the number of AIDS infected infants is going to increase rapidly.

To combat epidemic the doctors and workers in this are have to work with full enthusiasm. One of Pinkoos’ friends got intestinal cancer – no doctor in Pune and Mumbai treated him because he was aids positive and he died untreated eventually. In Muktangan we get 2/3 patients out of 100 who are AIDS positive. After their cure we have to look into their problems. One of the patients had a tooth problem and when he told the dentist, he was AIDS positive he didn’t get treatment. Then he got himself treated from one doctor without informing him. Surgeons do not realize unknowingly how many aids patients they must have treated and spread the infection. Surgeons fear ‘needle prick’ but there are ways to prevent it – but still they say why should we take the risk at all?

In the medical profession, firstly it’s the nurses who at are the highest risk, secondly dentists and thirdly surgeons. Certain hospitals in Pune do not operate AIDS patients. Doctors give reasons and ask him to leave. This is a case of a Hospital in Pune One ward boy got TB and he tested positive. Doctors nurses, ward boys and his family members all rejected him. Depressed and dejected, he jumped from the 4th floor. No one treated him or even lifted his body, lastly, the interns took him to the emergency room but he died on way. Doctors and patient leave AIDS patients unattended and neglected. It is feared that soon there will be almost 80% AIDS patients in hospitals what would the doctor fraternity do then?

These days disposable syringes are used but we do not have proper disposal facilities whereby we have a racket of picking up disposed syriges from garbage dumps and repackaging as new! The syringes should be properly disposed. What can we do then? I asked Dr. Pujari. (Dr. Sanjay Pujari of Health plus. Pune.) he said take glass syringes and needles and bring the pressure cooker to 3/4 whistles – what else is auto clove? One doctor in a government hospital complained of shortage of gloves and constant auto cloving brings the gloves to shreds.

Dr. Pujari said slowly attitudes are changing among doctors. They are ready to treat the patients. I asked how do family members respond to diagnosis of AIDS? Dr. Pujari said they are every supportive and help the patient in every way. Dr. Vinaya Chitale however said that it is in case of males only – women are usually outcast. One woman coming to our center tested positive with her husband, her in –laws threw her out and parents wouldn’t take in and brother and his wife opposed. So she lived in a Mumbai chawl with a maternal uncle. One of the boys’ staying in the chawl happened to be a ward boy of the hospital where she used to see an AIDS specialist. He informed everyone in the chawl and due to the hue and cry raised she had to leave and now she is a prostitute in Mumbai. A village called Namakkal near Chennai has maximum truck drivers most of whom are AIDS positive and they have transferred this virus to their wives. Now those truck drivers who stay away for long periods from home very often visit roadside prostitutes. They have no other source of entertainment they say. The prostitutes and house wives are the most affected due this AIDS epidemic. They are held responsible for no fault of theirs. The women’s organizations have to raise to face this challenge.

I tried explaining the seriousness of this issue to a friend he said its good – our population will decrease! its nature way to balance! But would these people say the same thing in case of a person in their family gets affected?. India had given a let go like Africa to this issue – today villages and towns have been wiped out due to the AIDS epidemic. Mr and Mrs Ranade who stayed there told me of instances where people would die like a bulb would fuse.

In Zambias’ copper belt district the production has reduced by 65% as many workers have died due to AIDS and this is affecting the economy. So I’d like to tell people who say our population will decrease – that the worst affected age group of 25 –50, is the backbone of a country’s economy. This is a summary from an article by an economist published by UNDP – it says, AIDS will affect people in various ways – like it will be difficult to find efficient workers which will in turn affect production, and that will affect the country’s economy, as skilled labor is required. We will have to spend large amounts for hospitals for AIDS. Orphanages for AIDS affected children. This will be an added expenditure for the country which will again affect the country’s economy. Taking international aid and loans from the World Bank would add more burden to the country. In today’s freemarket economy the gap between rich and poor countries would widen further. This is a shocking picture to face. Africa has seen it. Thailand and Phillipenes are already in the AIDS web.

I got to know about the picture of AIDS in India due to Pinkoo. He runs an organisation called ASSOCIATION OF PEOPLE WITH AIDS (APWA) under its aegis he conducted a day workshop at Pune for aids affected people. When I asked Pinkoo of the day’s program – he said that there is an indoor meeting were only AIDS patients will be there, inshort its our time to cry, – and he started laughing.

I met a dark and robust woman called Nurie who said she is a eunuch. She reported of a problem of the urinary opening contracting for which she has to get operated called (dilatation) quite often. But the doctors refuse to do the procedure as she is AIDS positive. She had started an All India Organisation for Eunuchs. She was its President. The workshop was jointly organized by UNAIDS and NEKO. I was surprised when the lovely UNAIDS representative started with I am positive. They had on their agenda among other things giving jobs to AIDS affected people in UNAIDS. They had representative’s from England and Australia also. When NEKO spokesperson Dr. Sengupta started speaking of Government Policies a group of doctors started discussing something with much anger. I came to know from their conversation that AIDS patients are put in TB sanatoriums to die. I later spoke to them, they gave horrifying accounts of treatment given to AIDS patients. Some are killed and police say good you killed him. The treatment meted out to them is very much inhuman. They are not even lifted after they die. The hospitals call our group and then we go and pick them up and bury them – when I asked them how many patients they had buried?, they said almost 100 had been buried by them.

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