Articles
- A doctor's perspective- What it takes to be a doctor for HIV patients!!! - 2009-06-22
Working for patients who are infected with HIV virus is a job overboard. Children and women (PLWHA - People living with HIV AIDS) of Maiti Nepal are real examples of valor. They have survived hell and now they are combating the microscopic virus. With viral overload of more than 50,000 /ml they still have a smile on their face. Everyday, trying not to give up and keeping them self busy with the daily routine are their norms of life.
The age of PLWHA with us ranges from a child who is just 8 months in this world upto an old woman who is over 5 decades. Most of them were infected when they were trafficked, few got infected from their spouse, and few more are cases of mother to child transmission. (NOTE: PMTCT: Preventing Mother to Child Transmission)
With a heart full of queries, hopeful eyes for a future, a teenage girl (also PLWHA) asks me, ?Doctor, has curable medicine for HIV AIDS been invented?? The word ?NO?, was so difficult for me to answer, so instead I said,?hopefully they will soon?. With high aspiration and desire to kiss the acme of success, she is excellent in her studies. I really HOPE for her that HIV & AIDS become curable very soon and all her dreams will be a reality.
My housekeeping staff who has been carrying this virus for more than a decade is another example of such heroic act. She was infected by her spouse and now she is fighting against the disease by taking ART (Anti Retro Viral Treatment) and at the same time working as a clinic assistant, so that she can secure a bright future for her two beautiful daughters (both negative). As a Medical Doctor, I guess it?s natural for me to PONDER about her aspirations and how she can come out with a triumph.
Recently a new girl was tested positive after counseling. She was rescued from a brothel in Mumbai where she was forced to sell her soul for the last four years. She did not know that she was HIV positive. Now here comes the difficult part of telling her about being HIV positve. Being diagnosed with HIV can create a raft of emotions including anger, denial, depression, anxiety, shock and fear of death. During the initial counseling session, as soon as I told her status, tears rolled down her eyes. I assured her not to worry now that she is in Maiti Nepal and will take care of her. But her tears were hard to be stopped. At this time when she must be feeling like being drowned in the abyss, she needed EMPATHY and this is where I feel responsible to comfort her and motivate her for pragmatic realization of better days to come.
Some days back a woman came crying at my door with her child and husband. As I talked to them, her husband told me that he is HIV positive and transmitted it to her wife and son. When I asked the woman why she was crying, she told me that she just knew that some annihilative disease has infected them but did not even know the name of the disease. When I counseled her that it is not as worse as they thought to be and they could live more than 15-20 years if they took the right medicine / health care / positive way of living, she had a sign of relief on her face.
What I have realized in a very short span of time with them is that, only mere treatment with ART is not and should not be the aim of a doctor taking care of PLWHA. Counseling (nutritional & psychosocial support), palliative care, prevention of onward transmission, protection from stigma and discrimination, motivation for positive living, compassion, are some of the qualities required to be their doctor. At this point of my medical profession I think, it emphatically takes HOPE to set them free from the virus, a commitment to PONDER about their aspirations, and EMPATHY to be The doctor for HIV patients, but I am sure I will discover more in the years to come.
Dr.Alish Prajapati for Maiti Nepal
