TIRUCHI
Four years ago, Satya* an HIV-positive woman, was diagnosed at Tiruchi’s Mahatma Gandhi Memorial Government Hospital (MGMGH) with a uterine cyst that required a hysterectomy. Four years later, the middle-aged city resident, beset with heavy and prolonged menstrual bleeding, is still waiting for that operation to take place.
“I started consulting the doctor at the GH when I was 42 years old, for my heavy bleeding problem. I even spent 25 days under admission, when I was tested and given blood drips. Then I was told that I could get discharged because menopause would start soon in two years and the problem would ‘naturally’ stop. But it has only become worse. I have returned several times to the GH, requesting for the surgery to be done, but nobody has heard me out. I feel my HIV status has become a barrier to getting the surgery done,” alleged Ms. Satya.
While the administration of antiretroviral therapy (ART) drugs has been streamlined by the government, management of advanced medical care for AIDS patients in public healthcare is still unpredictable, say activists.
“We feel surgeries are being denied or delayed for people living with HIV/AIDS (PLHIV) at the MGMGH, even though it is illegal to do so. The operations may be available in private hospitals as well, but most of the PLHIV are from economically backward sections; they cannot afford to pay for the procedures that can cost lakhs of rupees, which anyway are available free under the public health insurance scheme. They should be treated on a par with other patients in the government hospital,” A. Thamil, director of Network for Positive People in Trichy (NPT+), told The Hindu.
Ms. Thamil, who is HIV-positive herself, said that NPT+ had registered complaints from at least six PLHIV who had been denied surgery at the MGMGH. The NGO has approximately 8,000 PLHIV under its care in Tiruchi district and 1,000 in Ariyalur district.
“The people who approach us are already facing social ostracism due to the disease. Each case for surgical treatment seems to require a high level of advocacy and paperwork before we get any kind of attention from the authorities,” she said.
Recently, Pandian*, an HIV-positive daily wage worker, came to MGMGH after fracturing his hand in a road accident in a suburban town. “Since the injury seemed to be serious, I was scanned and prepped for an implant surgery, and a note was made about the anaesthesia requirements for the operation in my case file. But the doctors changed their mind when they saw my blood test reports. They discharged me after applying a plaster cast and asked me to return in some weeks. The medicos seemed hesitant to touch me, even though I did not have any open wounds,” he claimed.
Many AIDS patients requiring surgery have contacted private medical practitioners for treatment at concessional rates. “But this is not cheap. My mother pledged her jewellery to raise ₹60,000 for my operation in a nursing home,” said Malathi*, an NGO worker who underwent a hysterectomy in the city a few months ago.
MGMGH dean D. Nehru however has denied the allegations. “We are treating everyone who approaches us with the same care and attention. From July 2021 to July 2022, the GH has treated 47 PLHIV cases. We had 30 deliveries, eight orthopaedic cases, five in general surgery and four speciality cases,” he said.
“In the case of AIDS patients, the medical team has to be extra careful to avoid the chance of viral infections during the operation, so the safety protocol is higher for such surgeries,” he said.
S. Martin Manivannan, Project Manager, Tiruchi district AIDS Prevention and Control Unit, and ART Medical Officer at MGMGH, said that PLHIV cases were being dealt with on individual merit. “Elective surgery can be deferred if the patient’s immunity level is low. If we get complaints about delayed treatment, we do take it up with the relevant authorities.”
*Names have been changed to protect privacy
