You just can’t beat the ingenuity of low-level government functionaries
in Bihar who want to shirk responsibility and foil attempts to bring them to
book. No matter what promises and undertakings the Bihar Government has made to
the Patna High Court, people living with HIV are still at the receiving end of
discrimination, abuse and neglect, caused by the very people being paid to
assist them.
In 2010, the then health minister of Bihar had told them
‘why should we bother about you’? Left with no other option, Sanjeet Singh and
other doughty HIV positive people, with the help of public spirited lawyers,
moved the High Court at Patna. Hearing after hearing, and one by one, each
judgement brought some relief, as the Bihar government and BSACS acknowledged
their responsibility to provide treatment and relief to people living with HIV
[PLHA], especially those from the labouring classes.
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| Sanjeet Singh: soldiering on... |
The State government committed that the supply of
life-saving ART drugs would be maintained faithfully, that the ART centres for
HIV positive people would be made hygienic and equipped with toilets, that
special schemes for children living with HIV would be formulated. Four years
on, with the assurances given to the High court remaining largely on paper,
with HIV positive patients still being ridiculed, discriminated against and
even refused treatment by government medical service providers, activists are
wondering whether the fight would have top be taken to the Supreme Court.
“What does one do when the entire establishment is in some
sort of a conspiracy?” asks Singh. “Refer
to the High court judgement where the BSACS project director and principal secretary Health assured the
court that the government would supply ART (anti-retrovral treatment) 365 days and
they were to ensure stocks of two months’ advance supply to avoid shortages.
The reality is that for the past one month the essential drugs in the ART
regime are not being dispensed and the patients are frantic. The government ART
centres run short of the drugs. The situation is such that there is a tacit
understanding within the department that no correspondence should be generated
on the matter so that there is no paper trail, in order to duck accountability
and escape ‘action’ later.”
Singh, a member of Bihar Network of Positive people and
attached to CHMU (Community Health Medicinal Unit) alleges that BSACS functionaries are refusing to register more
HIV positive persons for ART, in order to avoid ‘complications’. The logic
being ‘There’s no stock, if we register them, from where will we get the
medicines?’ These unfortunates are running from pillar to post.
Functionaries at the government ART centres hand out ‘prescriptions’ on scraps of paper and the patients are told to buy the drugs elsewhere. There is a
provision that in the case of shortage, the patient may be directed to buy ART medicine
from a private pharmacy, and the record is kept in the ART book, so that the
registered patient be reimbursed. (These drugs are available at very high rates
in the open market). BSACS had given an undertaking to this effect in the court.
The ART functionaries in gross violation, merely give the patients a scrap of
paper with the name of the drug written on it. Evidently, this scrap of paper
is not valid for reimbursement.
The situation is such that, even those patients who were
lucky to have their purchases recorded in the ART book previous months, have
not been reimbursed. Daily wage earners with a hand to mouth existence can’t
afford to cough up for medicine that costs in the range of a thousand rupees
every time, says Singh.
Singh’s own commitment to the cause has been the loss of his
infant son to AIDS related complications largely brought on due to the
negligence, apathy and dysfunctional State Aids Control Society services.
“What’s to be done? Do we have to start another agitation?
Do we once again knock at the doors of the Court?” This is a question that a
coalition of NGOs may soon be taking up. Watch this space.
Author: Frank Krishner
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