HIV and AIDS: India's Hidden Epidemic
August 30, 2006, —
In India, there is a longtime tradition of silence when dealing with HIV and AIDS. And that's if people are willing to know their status.
For decades, the disease has been spotlighted in Africa and the Western world. But quietly as it has spread, the disease has also taken its toll in India, where sex and drug use are not openly discussed topics. And young women, men and innocent children remain ostracized by stigma so rigid that nurses make house calls in plain clothes. Children are not told they are infected, but are left to wonder why they are taking daily medication.
Bearing the brunt of stigma and isolation are infected women, who in addition to living with the debilitating disease are responsible for tending to their families and maintaining their homes and livelihoods after their husbands have died.
This cycle of condemnation and burden leaves Anand Singh, the HIV and AIDS coordinator in Catholic Relief Services India's Northeast States office, questioning why HIV and AIDS are treated differently from other diseases.
"It's a small world and everyone is going to go. It's just a matter of how and when," says Anand through his tightlipped smile.
Anand, who coordinates a CRS AIDS-prevention program in India's underserved northeast region, attended the International AIDS Conference in Toronto in 2006. He came back re-energized to help affected individuals and families stabilize their lives and combat stigma.
Preventing AIDS in Northeast India
Though the effects of HIV and AIDS are felt throughout the country, Anand explains that the largely Christian northeast region has its own assortment of problems.
Wedged between China and Myanmar, the northeast is largely neglected by the wider Indian society, and because of its foreign borders, it is laden with drug use, prostitution, socioeconomic ills and ethnic clashes along with natural devastation.
CRS implemented the Preventing AIDS in Northeast India program in 2004. Now in its second phase, which lasts through 2008, Preventing AIDS in Northeast India will continue its holistic, multidimensional approach of prevention, care and support, and advocacy and networking.
Yet, combating the HIV and AIDS problem could not have been accomplished by targeting the disease alone.
Anand says that the problem is also a cyclic "developmental crisis" that sees women and young girls turn to the sex trade when faced with the fallout of ethnic violence, famine, and natural and man-made disasters. With the help of CRS and other programs in the region, these women are empowered and offered training on community-based disaster preparedness and emergency response initiatives.
As of July 2006, the program had reached some 173,126 people through a host of projects, including counseling, training advocacy workers, community sensitization, registering adults and their children for care, treatment of opportunistic infections, home visits, prevention, and education via schools, books and brochures.
Anand says changing the self-images of those infected is key to changing the wider culture's perception of the disease.
The results, however, are seen not in the statistics alone, but in the actual people who have resolved that they are going to live.
"I don't try to portray HIV and AIDS as different from any other disease," says Anand, who marvels over adults, children and even infants who arrive at the clinics in very poor "shabby condition," then after treatment, regain their strength and mobility.
"They have hope today in life. It's very encouraging," says Anand, whose office is located in the city of Guwahati.
In India, aspects of HIV and AIDS awareness are incorporated into CRS and its partner network's wide range of long-existing relief and mitigation efforts in 11 dioceses and 287 parishes. The network extends across seven states and 64 districts in the northeast.
Early results of these efforts show improvement in the health of intravenous drug users — one of the program's main targets — along with their spouses and children who are living with HIV. Future planning for Preventing AIDS in Northeast India entails establishing better relationships with the state government in hopes of obtaining greater resources and recognition of the population's needs.
Church, CRS Champion the Cause
Battling the issues in the northeast, especially the outbreak of HIV and AIDS, was no simple task. According to Anand, it was an issue not many churches were willing to tackle.
Seeing the great influence that the church might have, especially in the area of dispelling stigma, Anand says the shell was broken after local churches were encouraged to "mingle" with other nongovernmental organizations. After years of maintaining these successful relationships, church leaders are now some of the foremost champions for people living with HIV and AIDS. In 2004, the Archbishop of Imphal, of the northeast region state of Manipur, led the World AIDS Day rally.
Anand also credits his close-knit staff at CRS — some of whom relocated back to the northeast — with a high commitment to the mission of helping those in need. Some staff of CRS' local partners also live with the disease and, through their work, have a renewed purpose of helping others.
For example, an educator for a CRS partner had three kids to fend for after her husband died. She is also HIV-positive and had no income or job when her in-laws attempted to throw her out of the house.
"She got in touch with one of our partners, and got the courage to fight for her rights," Anand recalls. Today she is working as a peer educator, reaching out to others who find themselves in similar situations.
Access to Drug Treatment
Though Preventing AIDS in Northeast India and similar programs have made major inroads in the fight against HIV and AIDS in India, Anand says that a major obstacle for the people there is not having access to government-issued antiretroviral drugs, despite the fact that India is the largest manufacturer of the generic forms of these antiretroviral medications. Only 4 percent of those who need drug treatment actually receive it, he says.
Compounding the problem is also the limited capability of humanitarian organizations to reach rural areas, where there is little HIV testing but an increasing death rate.
This is an area which Anand hopes to reach through future outreach. "If we have the resources, we're willing to go far and wide," he says.