Hope in the time of AIDS

september 1997. the aids department, talera hospital, pimpri chinchwad municipal corporation (pcmc). suhas mate, 42, mbbs, dvd (diploma in venereal disease) dihc (diploma in industrial health) appointed as medical officer in-charge, aids department, is at the end of his tether. the practising doctor can barely focus on his work. the assignment at hand - counselling and extending temporary belief to hiv-infected and aids patients - needs a dispassionate approach but it is all getting too much for him. “i was constantly in a state of despair,� he explains. “my first patients, a husband and wife, both with aids and with barely a few weeks to live, approached me with their bubbly five-year-old child. the thought that this child would soon be an orphan constantly nagged me. what’s more, my doctor colleagues were not supportive of my taking over the aids department. they kept asking me why i hadn’t joined somewhere else. march, 2002. again at talera hospital. “how did it happen?� mate asks a patient. “aids has to be acquired.� you cannot accidentally get hiv infected. what about your wife? has she had her blood checked? take these medicines...� it’s been a long and dismal path, for mate, who abandoned his flourishing practice to lend succour to over 3000 hiv- (human immunodeficiency virus) infected patients from the pcmc area. the statistics are grim as the findings collated by this aids department, one of the two in maharashtra, reflect that out of 100 hiv-infected individuals, 28 per cent constitute transport-related personnel, 21 per cent are from the industrial belt of pimpri chinchwad, 14 per cent are construction workers, 27 per cent are alcoholic-related and belong to upwardly mobile groups and the remaining are professionals. what’s more, sex-wise classification reflects a majority of 72 per cent males and only 28 per cent females (most of whom ‘acquire’ it at home through their husbands). a more disturbing trend is that 2.5 per cent are pregnant women who are hiv-infected. unarguably, the scenario depicts a reality that is intensifying every day. explains mate, who is a pillar of support to hopeless cases and who has initiated a fullfledged educational campaign about aids, “more than 98 per cent of the cases are sexually transmitted and thus the incidence is the highest among the sexually active age group of 15 to 40 years.� citing a recent case, mate reveals the trauma that is involved in every case. “a college lecturer from pune accompanied her ‘engineer’ husband to my clinic. they were referred to me by a private doctor at pradhikaran after examining the latter’s blood test report. i saw it and understood the reason. most doctors refer such cases to me so that i have to tell the patients the truth and counsel them. the couple was curious to hear the diagnosis. when i mentioned the truth, the man choked with emotion. on further prodding, he spoke of a brief affair about eight years ago. obviously he had contracted hiv then. now, just married for six months, he had unknowingly transmitted the virus to his pregnant wife, who was inconsolable. the husband had full-blown aids.� a person infected with human immunodeficiency virus (hiv) is medically known as an hiv positive person. only a 2 ml blood test can establish one’s hiv status. however, this does not mean that the person is suffering from aids. aids is the end stage (about the eighth year of hiv infection). it is only at this stage that the hiv positive person starts showing distinct symptoms of this disease, notably weight loss, diarrhoea, tuberculosis, constant fever and so on. “this is the point of no return. as of today, there is no cure for aids,� says mate, who chose to dedicate his life to this field where few are eager to venture. his patients come from as far away as ahmednagar and latur. “i vividly remember the first case of aids in pune, in the year 1986 whilst i was pursuing my post-graduation is sassoon,� says mate. “she was a commercial sex worker and was abandoned in a lone room where no one ventured. even medicines had to be wrapped and thrown to her. unable to bear such indifferent treatment, she fled the hospital.� today the attitude towards aids is nonchalant, what with the multitude of hiv-infected individuals, however the social stigma persists. mate works with these patients for more than 12 hours a day along with professional counsellors from the national aids research institution (nari) at talera hospital. his room is strewn with aids awareness posters and publications. “the statistics mentioned are merely the tip of the iceberg, so to speak,� he says. “since hiv and aids are not yet listed as notifiable disease, like tb or malaria, where it is mandatory to inform local health authorities, cases reported with private practitioners are not recorded. this scourge reflects a social phenomena. one cannot be insulated against it. acquiring it takes only a few moments.� and as social workers like mate extend a ray of light to those in the hiv and aids-affected world, the important point is not to preach moral values but to accept ordinary decencies as a national imperative.