Anil, a resident of Anand, was recently diagnosed
with second stage oral cancer. Because of the ailment, he could not open his
mouth properly to have food. With a lot of hope he came to Civil Hospital in
Ahmedabad to undergo operation. He received proper diagnosis to begin with but
things changed when he revealed that he was HIV positive.Doctors refused to
operate upon him. He went to Vadodara and on Saturday got admitted to a private
hospital. But sadly, he was again turned away.
“When we first went to cancer hospital at Civil, they
refused to perform the operation. And in Vadodara, too, doctors refused doing
it saying that they don't operate upon HIV patients and advised us to go back
to Civil in Ahmedabad.My brother's condition is deteriorating because of these
denials. We don't know what to do,“ said Anil's brother Manish.
Anil was refused surgery on the excuse that it might
infect the staffs and other patients at the cancer hospital.However after
continuous pleading, doctors told him that CD4 count which indicates the stage
of HIV or AIDS in a patient was low so they couldn't operate upon him and
released him on September 11 of this year.
Dr Rakesh Vyas, Director of Civil Cancer Hospital, said
he was not aware of the case and would be able to comment after he checked the
papers.
Meet Rajendra who has been suffering from piles and
is under medication for two years. When his condition deteriorated and needed
operation, he got admitted to Civil Hospital.When he disclosed to the medical
team that he was homosexual and HIV infected, doctors refused to operate on
him, too. He is planning to go to a private hospital but he doesn't have money
to afford it.
These are but two cases of HIV patients facing
discrimination at hospitals, especially when they go for surgery. Target
Intervention (TI) department of Ahmedabad Municipal Corporation (AMC) receives
two or three cases of HIV every year from each of the 22 TI centres in the
city.
Dr Rakesh Vyas, Director of Civil Cancer Hospital,
said he was not aware of the case and would be able to comment after he checked
the papers.
PVT HOSPITALS EXPENSIVE
There are many like Anil and Rajendra struggling to
get proper medical atten tion. Amit had developed a tumour in neck and needed
urgent surgery. He went to Civil Hospital where his operation was scheduled.
But in the blood test before the operation, he was detected with HIV infection
and discharged without being given any reason. The doctors kept on delaying his
operation for six months. After a lot of struggle, he died, earlier this year,
living behind his wife and child.
“Despite repeated requests, the medical team didn't
operate upon him. And I didn't have money to get the surgery performed in a
private hospital. They kept delaying his operation. He died in front of me and
I couldn't do anything,“ Amit's wife Reshmi told Mirror.
32,500 PATIENTS IN STATE
Meet another patient, Sushma. A resident of
Bhavnagar, she was diagnosed with kidney ailment and needed dialysis. She was
admitted to Institute of Kidney Diseases and Research Centre for further
treatment. When she was diagnosed as HIV positive, doctors refused to operate
upon her. Every week she visited the hospital but was sent back.
According to the data provided by the health
department, there are around 32,500 AIDS patients in the state. They receive
first line of anti-retroviral therapy.
In the case of Sushma, delay in surgery started
affecting her health and became an expensive affair. After six months of
refusal, she died. “We also organised a meeting with doctors but nothing could
be done,“ said Nita Kiran Kabaiya, member Gujarat Network for People Living
with HIV AIDS.
RISK OF INFECTION
More importantly, the discrimination forces them to hide
their HIV positive status which increases the risk of infection to medical
staff.
“As responsible citizens, they reveal their identity
but if they are discriminated against like this, why would they care about
others? Hence, if this continues, people living with HIV will not disclose
their identity,“ said Falguni, a city-based activist working with sex workers.
The highest number of discrimination takes place in
surgical cases where the chances of staff coming in contact with blood are the
highest.
WOMEN WORST SUFFERERS
Citing a few cases, Dr Keyur Shah, HIV specialist
from HCG Multispecialty Hospital, said that women are the most discriminated
against in hospitals during pregnancy. If a pregnant woman is HIV infected,
then she is advised to go for Caesarean which decreases the chances of transfer
of infection to baby by 70 to 80 per cent.
“But due to the stigma attached to HIV, doctors and
staff avoid Caesarean and opt for normal delivery at the risk of infecting the
baby,“ added Dr Shah.
This is often practised in many hospitals, claim
activists. Jignasha Panchal, deputy director of AMC's TI, blamed it on the lack
of sensitivity among the doctors.
“Doctors during their medical training should get
special training to help them overlook this stigma. Once they become doctors,
it is tough to change their mentality. There is a need to socialise them in a
better way,“ she added.
ANNUAL TRAINING
To sensitise the doctors, AMC arranges “Syndromic
case management training“ every year in which around 55 doctors from across the
city participate. People living with HIV share their stories with the doctors.
This helps in providing better understanding of the issue among the doctors.
Most of the cases of discrimination and delay go
unreported as the pa tients don't have evidence to prove their claims. The
medical team keeps on delaying their treatment on excuses which further
deteriorates the health and turns fatal for them.
According to a member of Vihaan project of Abad np+,
an organisation working with people living with HIV, “We have decided that
whenever doctors delay or deny treatment to a patient, we would ask them to
give us the reason in writing. That would help us to file complaints against
the doctors concerned.“
In many cases when doctors illtreat patients in
government hospitals, they go to private hospitals. This burns a big hole in
their pocket. Besides, not everyone can afford paying hefty sum to such
hospitals.
“Just to avoid the patients, doctors ask them to
bring expensive kits or medicines which the poor people can't afford. Using
this as an excuse, they refuse operating,“ said Reshmi.
`NOT AWARE OF THE CASE'
When Mirror contacted Dr H L Trivedi, director of
Institute of Kidney Diseases and Research Centre, he said as the hospital did
not have HIV ward to operate on HIV patients, they were transferred to Civil
Hospital.
Talking about the case of Sushma, he said, “I am not
aware of the case. But would I investigate it.“
However, Dr M M Prabhakar, medical superintendent of
Civil Hospital, denying the allegation said that the hospital took proper care
of all patients and never discriminated against anyone. “Maybe, because of work
load, some patients are kept on the pending list for surgery. But we never refuse
a patient simply because heshe is HIV infected,“ he said.
(Names of HIV positive patients and their kin have
been changed to protect their identity)
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