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A protective prescription

india Updated: Apr 12, 2007 01:07 IST

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There is always a sense of dismay over reports of Aids patients or the HIV positive being turned away from hospitals by healthcare workers (HCW). In the most recent incident, a resident doctor at Delhi’s Safdarjung Hospital refused to admit an HIV positive patient after conducting preliminary tests. The patient and his family were told that admitting a patient is a hospital’s prerogative and that the patient would die anyway. Clearly, the manner in which the case was handled leaves much to be desired. To begin with, it points to the gaping lacunae in the basics of HIV management that healthcare workers must follow. At the same time, to assert that the response of healthcare workers stems from callousness would be inaccurate. The reaction is appalling, but it is no secret that healthcare professionals are vulnerable to infectious diseases and have limited protection when treating patients afflicted by Aids or suffering from Hepatitis B/C.

Over the years, many nurses have tested positive for HIV. Their cases must not remain mere statistics under the category of Occupationally Transmitted HIV. Hospitals have all the mandatory guidelines in place for the treatment of an HIV positive person. Gloves, double gloves, masks, plastic aprons, gowns, boots and goggles make up the list of protective wear that the healthcare providers are supposed to have at their disposal. But there is hardly any hospital in India that is able to provide its personnel the combat wear. Short supply, rationed supply, out of stock, lack of time, wrong-sized gloves and difficulty to work with are just some of the reasons that have been cited by nurses regarding protective wear. What’s more, basics like soap and running water are also a scarcity in many hospitals. Ignorance about the disposal of hospital waste worsens matters. Tuberculosis is also frequently transmitted to HCW, but being treatable, their protection is not considered a priority. Hepatitis C is more easily transmitted in hospital conditions, but its non-discriminatory nature makes it a silent killer.

It is unacceptable that healthcare workers engage in such discriminatory practices, but for most of them discrimination is their only protection. It is only too easy to point fingers at doctors and nurses for their insensitivity. But how accountable are hospital administrations for ensuring that the staff is adequately protected from occupational exposure to pathogens? Administrators should remember that payment for lifelong treatment is not protection. And the many de-stigmatising drives will achieve little until healthcare workers are sensitised to the disease, made aware of the legal and ethical issues regarding Aids and are given adequate protection.