NUAPADA HIV+ WOMEN DENIED HOSP DELIVERY

Sunday, 26 March 2017 | AJIT PANDA | NUAPADA | in Bhubaneswar

    

Hema (name changed) is happy that the birth of her baby in the District Headquarters Hospital (DHH) of Balangir on Friday was normal. She had been undergoing severe mental torture for last ten days after she was denied admission to the Community Health Centre (CHC) at Khariar in Nuapada district for institutional delivery. The cause of denial was shocking.

“Dr Mahanand denied treating me when I revealed that I was HIV positive. He was even scared to touch me after my revelation and immediately referred me to the DHH (District Headquarters Hospital) at Nuapada,” says Hema.

Hema is a poor dalit woman of Khariar town. The meagre income she and her husband earn from daily wage hardly helps their family have two full squire meals a day. It was not possible for them to hire a vehicle to proceed to the Nuapada DHH, 70 km far from Khariar. Furthermore, they were unsure whether the DHH after knowing the truth that she was an HIV-affected woman would allow her admission.

So, she decided to stay home to face the destiny. “But of the help from the SAI organisation, I would not have survived,” adds Hema. Jitendra Pattnaik, coordinator of SAI, reported about the matter to the Nuapada CDMO and ADMO on March 18. Hema was shifted from her house to the DHH at midnight. But, unfortunately Dr B Mishra, the DHH gynaecologist Nuapada DHH even had the same mindset. Instead of taking up the responsibility, he referred her to the Balangir DHH. It is learnt that the DHH at Balangir was also trying to refer her to the VIMSAR, Burla, but due to intervention of the Odisha State AIDS Control Society (OSACS), she was kept their for institutional delivery.

Hema was detected HIV positive in the year 2012. Tests were also subsequently conducted at the Integrated Counselling and Testing Centre (ICTC) at Khariar on her husband and children. Unfortunately, all of them were detected positive. They were referred to the ART (Anti-Retroviral Therapy) centre at Balangir for treatment. But one of the three children could not survive although on ART.

Hema wanted to terminate her fourth pregnancy when she knew about this on October 24, 2016. “That was the second month running, but Dr Mahanand (the gynaecologist of Khariar CHC) did not agree to conduct the abortion,” she says. Jitendra Pattnaik, a social worker of Kharir town had talked to the CDMO of Nuapada about this matter, but the CDMO even said the termination could not be done on the ground that the woman was HIV positive.

“I wanted termination because I did not want to face the problem during delivery,” says Hema. “I am still unsure whether the newborn child is free of HIV,” adds she.

The case of Hema is not an isolated one in Nuapada district. There are many others who have undergone the same kinds of discriminations at the hand of the health service providers.

Sukhmani (name changed) of Nuapada block was referred from the Nuapada DHH to the Balangir DHH when she was found HIV positive. She delivered her child on the way to Balangir. On her second pregnancy, however, Sukhmani did not reveal the truth. She posed as another woman for blood test and submitted the negative report to the doctor of Nuapada DHH. Not knowning the truth, the doctor conducted the delivery without hesitation.

Likewise, in 2008, Dr B Mishra as the gynaecologist of Khariar CHC had conducted the delivery of a HIV-positive woman of Boden block without knowing that she was such a case. He had conducted five deliveries one after another on that particular day (one of the women says it was without cleaning or sterilising the equipments) and the last one was of the HIV-positive woman. It is learnt that the doctor had conducted his own CD4 count (a lab test to detect HIV infection) after knowing the truth about the woman, fearing that he might have been infected with the virus.

According to Government data, 450 persons of Nuapada district have been tested HIV positive, out of which 62 have died till now. These are the cases which have been tested in different ICTCs of the district. But the cases found by the Mission Hospital of Khariar and others who have tested outside the district are not available, which, if included, may put the total figure at more than 1,000. Only 300 of the total detected cases have gone for CD4 count and are on ART. The HIV-positive people have always the fear of social ostracisation due to the stigma attached to the HIV infection, and it is more difficult for women to come forward to reveal the truth.

“Women like Hema and Sukhmani are very few who have the guts to face the society by telling the truth. But to give them support and courage, the mindset of the health service providers has to change,” says Pattnaik.