6,000 of these patients are on 'live treatment' - which means that they have been started on the Anti-Retroviral Therapy for their HIV. The government provides the medications free (an excellent use of our tax-payers money by the way) and also provides CD4 tests at 6 monthly intervals.
The catch?
There are 3 doctors who service these 6,000 patients. Its little wonder that there are complaints about the service. When we visited to meet the main official, we peeked in and saw one medical officer wearing a mask - and another turned away looking at a wall.
The CD4 machine is also not fully operational. The procurement for vaccu-tainers and needles for the HIV testing has been bungled - so many who need to be tested have not.This is the government set up. And this too in a fairly forward state, in a fairly advanced city, with a fairly well-funded programme to boot.
This is where we would like to help out.
We are applying to become a 'Link-ART' centre.
Among the 6,000 HIV positive people getting their ART meds from the Thane ART centre - are 120 who we follow up in our home-based care teams. We would like to start with looking after these 120. With medicines from the government.
Its a start.
We have not been giving free ART from JSK (though many would have liked it) because we know that if a person with HIV who has been getting meds from us needs to go to another place - the govt. ART centres will not accept him/her since they were taking it from a 'private' (i.e. not-government) source.
As a policy, we have thus been encouraging our Positive Friends to get their meds from the govt. And most have done so.
Becoming a Link-ART centre means that we are partnering with the Govt. ART programme. Patients who come to us will be given their monthly stock at our clinic. Our doctors will monitor the patients' progress in the monthly visits. Our home-based care team will check their adherence (which the govt. does not do) and provide encouragement and counselling in the home-visits. And if a person decides to move - we will be able to transfer their ART treatment to the nearest govt. ART centre to their new location.
We would expect that about 100 or so of our 120 Positive Friends getting their ART from the Thane ART centre would choose to get their treatment from us if given the option. This would mean an immediate upswing in the number of patients that Drs. Sheba and Marise will be seeing. Currently very few of them come regularly to our clinic - because they are already giving 1 day a month to visit the govt. ART centre.
And then...
I think that currently we have the capacity to see about 500 or so people who are taking ART treatment. It would mean a huge challenge for our home-based care team as they will need to follow up so many more - but I think it is possible. And I believe that we must go forward.
Each life is so precious. And we have the luxury of being able to actually spend time with our HIV Positive Friends - instead of what they currently experience - a brief glance and then being sent off to pick up their meds.
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Case in point:Sheba met Roshni day before yesterday. Sheba had gone with one of the home-based care teams to meet a Positive Friend in Kalwa - when who should she see but Roshni.
Roshni's mother had died when she was a baby. Her father married again. The new wife couldn't stand Roshni. She was placed in a Catholic orphanage in town.
Somewhere along the line Roshni got HIV. When she was 16 she left the orphanage to try and make a life. Her father brought her to us. We got her into a 2 year programme for women and children affected by HIV (in Roshni's case she was both!).
Then we lost track.
Sheba went into Roshni's room. A tiny slum shack. She is back to staying with an aunt. After the 2 year programme, Roshni went to a Bible school for a year. For some reason she has returned. Things are not well. Lots of arguements. Roshni is tired of it all.
Sheba asked her about her medications.
Roshni stopped taking the ART meds 2 months ago. Her aunt says that she goes each month to the Thane Civil hospital and picks up her bottles. But these last two months she has not taken anything. The bottles remain unopened. Rs. 2400 worth of tax-payer money. But even more than that - a precious 2 months where the virus could have continued to be keep at bay through the meds.After talking with her - Roshni agreed to come and meet us on Monday. She agreed to start taking her ART meds again.
Why had she come out of her home just as Sheba and the team (who did not know her) were passing by?
Roshni's kitten had got out of the house - and Roshni had emerged from the shack to find the kitten - which is when she saw Sheba.
A God-incidence. One of the many we experience.
From the point of view of the ART centre in town - however - Roshni is a regular patient. She comes on time and takes her meds.
Only she does not. Or at least did not for the last 2 months.
There is so much of who we are that depends on our relationships with each other. Roshni's unhappy situation at home - her insecurity about what will happen next - has been acted out by her refusing to take meds for the last 2 months. Its just so much more than just giving a person a bottle of pills - and expecting them to be taken automatically - even if they are as vital and life-saving a treatment as ART.
We trust that we will be able to start her back again. It will take further follow-up. And prayer. And practical love.
What a privilege to serve.
We have been told that we may be able to start our Link-ART centre by the end of this month. Lets see that it happens...
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