GOING BY age-old wisdom ‘every society is judged by how it treats it’s least fortunate’, Indore’s medical fraternity fares poorly when it comes to treating (more importantly operating upon) HIV + patients. The case of a blind HIV + person turned away by a private hospital and later operated upon at MY Hospital last week has brought to fore the issue of attitude, awareness and preparedness of the medical fraternity while dealing with such patients.
There are clear Supreme Court guidelines, NACO protocols and enough universal precautions to be followed by nursing and para-medical staff for preventing not just HIV but any infection, then why should private nursing homes and hospitals turn away HIV positive patients?
The reasons may be anything from financial (as claimed by most of the hospitals owing to the costly disposable kit) or the reluctance of doctors and para-medics due to the social stigma attached to this disease.
Says Dr V P Pandey, in charge of the ART Centre at M Y Hospital here, “They (the private hospitals) come up with such reasons that the patient is automatically forced to shift to another hospital or M Y Hospital.” For example, a corporate hospital turned away a patient saying his surgery could wait for three months. The patient cross-checked with another doctor only to find that he was asked to wait because he was detected with HIV.
Manager of the Anand Hospital and Research Centre, where the 35-year-old patient was first taken and then went to M Y for operation for piles, Huzeffa Kanchwala, says, “It was definitely not because the staff refused. They were aware of it right from day one.”
Dr Vijay Nichani, who was treating the said patient, adds, “The main factor was that the patient could not afford cost of the disposable kit. Another factor is, the doctors are aware of the precautions to be taken and they do not hold any stigma aspect. But it is the poorly trained or untrained nursing staff and the paramedics, who raise the issue of social stigma in case of professional injury.”
All the big hospitals and even medium-sized private hospitals and nursing homes in the City claim to follow universal precautions and the protocol required during treatment of HIV + patients, but not all have actually operated any HIV patients. Says Medical Administrator at CHL Apollo Hospitals Dr Archana Mahajan, “More than the cost of the kit, main reason is in cases where we cannot carry out dis-infection of machines and equipment used in any operation/procedure, we cannot possibly put other patients’ lives at risk.”
The other big hospitals in the City - Choithram Hospital and Research Centre, Bombay Hospital and Bhandari Hospital and Research Centre – too claim to provide regular treatment to HIV positive patients.
CEO of the medium-sized Greater Kailash Hospital K K Sharma says the hospital has trained staff to handle such patients, but they have not yet operated any HIV positive patients.
Says Assistant Director (Hospital Services) at Choithram Hospital Dr Amit Bhat, “We regularly conduct infection control classes for our staff. We have been treating and operating HIV + patients always.” Echoes MD of the 100-bed Suyash Hospital Dr Govind Malpani, “There is an hospital infection committee, which regularly monitors if the laid down precautions are followed or not.”
Dr Dinesh Bhandari, Medical Superintendent of Bhandari Hospital and Research Centre says, “We have our own sterilisation plant so there is no problem of infection spread.” Medical Superintendent of Bombay Hospital Dr Ratnadeep Chaskar agrees to similar practices. But it is the conduct of management, staff and doctors of several other smaller hospitals, which is questionable.
There are more than 200 nursing homes and smaller clinics in the City. Says Shivani, a counsellor at the Prevention of Parent to Child Transmission Centre (PPTCT) at the M Y Hospital, “Private clinics and nursing homes from other towns and cities near Indore too send such patients to us. Not just private hospitals and nursing homes, we get women referred by Khandwa, Neemuch and even Burhanpur hospitals.”
Madhya Pradesh State AIDS Control Society (MPSACS) regularly conducts training for doctors and paramedics at the district hospitals and there is no reason why a patient should be turned away from any government facility, she points out.
Adds Dr Pandey, “Turning away of HIV + patients by doctors is a very bad practice. Doctors need to come forward to change this attitude. What is happening at present is whatever patients are being treated at private hospitals or nursing homes are mostly due to professional compulsions or personal pressures.”
But, slowly the picture is changing, he says and adds, “It took a lot of time to change things at MY. It is quite common, at government facilities and also at private hospitals at Mumbai or Delhi to go ahead with operations on HIV patients. Slowly, others too are joining. There would definitely be a positive change, albeit slowly.”