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10 May 2002 By Meena Menon, Maharashtra, India A tuberculosis sanatorium in a hill station in the Indian state of Maharashtra has become one of the few places in the country offering residential care for people with HIV/AIDS. Jointly run by the Indian Red Cross and the Missionary Congregation of the Blessed Sacrament, Bel Air is also a refuge from the discrimination people with the disease face everyday. The silver oaks and giant eucalyptus trees hide the low-roof cottages, home to the residents of the Bel Air hospital and sanatorium. As the sun sets, a breeze blows over the valley below and people walk around the cliff edge, savouring the cool air. Many of the men, women and children at Bel Air sought sanctuary here after being ostracized from their communities once it was discovered that they were HIVpositive. Most have a story of rejection to tell. "Before they come here many patients are on the verge of suicide," explains Father Tomy Kariyilakulam, administrator at Bel Air. "In their communities they are treated as outcasts but here they feel reassured that they are not alone." Spread over 44 acres in Panchgani hill station, Bel Air was originally founded in 1912 to treat tuberculosis sufferers and since 1964 has been run by the Maharashtra state branch of the Indian Red Cross. Since 1995, when the first case of HIV was detected at the sanatorium, it has become one of the few places in the country offering residential care for people with HIV/AIDS, run jointly by the Red Cross and the Missionary Congregation of the Blessed Sacrament. The millions of rupees spent on HIV/AIDS education in India has still not eradicated the stigma attached to the disease and establishing Bel Air as a centre where people living with HIV/AIDS are welcome, has been no easy task. Father Tomy has fought against local residents in Panchgani, who feel that the presence of HIVpositive people will reduce the hill station's appeal to tourists. He has suffered physical and verbal assaults, even spending a night in the local jail for his own protection when an armed mob broke into the hospital and threatened to kill him. His attempts to modernise Bel Air have perhaps been his biggest challenge, but thanks to the tireless fund-raising efforts of the Indian Red Cross in Mumbai, Bel Air now boasts an intensive care unit and a community care centre. "Some people come here having depleted all their resources trying out all kinds of treatment but no one is turned away if they cannot pay," says Father Tomy. Most of the people at Bel Air come from the surrounding hill areas of Satara district but there are admissions from as far afield as Mumbai and even the neighbouring state of Karnataka. Sarita, who was working as a housemaid, had to leave two jobs in Panchgani after her employers discovered that she was HIV positive. "They asked me to take rest. In other words, don't come back," says Sarita. Her husband, an auto-rickshaw driver in Mumbai, died seven years ago. Sarita and her two sons, both of whom are also HIVpositive, were left without any support. Her father, who lives in a nearby village, visits her everyday but her husband's family have severed all contact with her. "I do not know what will happen to my children if I die," she says. Three months ago, her health deteriorated to such an extent that she asked her son to write a letter to her former employer asking him to take care of her children after her death. "She was brought here in a terrible condition and the letter was clutched in her hand," says Father Tomy. The family of another resident, Suresh, do not know that he is living at Bel Air. They think he still works in a hotel in Mumbai. "When I discovered that I was HIV positive I did not speak to anyone. After coming here, I realized there were many others like me and that we can lead normal lives," he says. "Father Tomy holds a monthly meeting here and he gives us a lot of hope and confidence." At the community care centre, the strategy is to involve patient's families in the care process. "Sometimes families go into depression when they hear that one of their loved ones is HIVpositive," explains Kirti Salunkhe, medical social worker at Bel Air. "In some cases this depression has to be treated." Some patients have difficulty accepting their positive status and in addition to their anguish about their condition, they are scared of how people will react when they return home. "There is a fifty per cent chance of rejection but immediate families often accept the situation," says Kirti. "It is the extended family and in-laws who stay away." The number of people admitted to Bel Air with infections related to HIV, have risen from 45 in 1997 to above 300 so far in 2002. Three states in India - Maharashtra, Tamil Nadu and Manipur - account for 75 per cent of all HIV cases in the country. While India still maintains a relatively low HIV/AIDS prevalence rate, seven infections per 1,000 adults, this translates into a huge number of cases given the country's population of one billion. In 2000, India was estimated to have 3.7 million people living with HIV/AIDS, a total that is second only to South Africa. "It is becoming increasingly clear that a key reason for the spread of HIV/AIDS is the stigma attached to it. Individuals who are infected may not know or not want to admit or talk about it," says Dr. Vimala Ramalingam, secretary general of the Indian Red Cross Society. "Some governments refuse to acknowledge its existence. Cultural barriers and beliefs have made the topic taboo, and people living with HIV/AIDS are actively discriminated against. We will work to change people's perceptions, attitudes and behaviour to ensure that those people who are already HIV positive or have AIDS, are able to receive the appropriate care and can live full and useful lives within their communities," she insists. Related Links: 'The truth about AIDS. PASS IT ON...' - global campaign agianst HIV/AIDS-related stigma and discrimination |
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