Providing HIV/AIDS treatment on a motorcycle in Bangalore
Two doctors in Bangalore have adopted an innovative and effective means to provide treatment and care to their HIV/AIDS patients -- they make visits to patients’ homes on a motorbike. From pre-test counselling and taking blood samples, through to drug courses and palliative care, they bring everything to their patients’ doorstep.
Dr D Nagaraj and his wife Deepa Nagaraj, both doctors specialising in HIV and AIDS treatment, are currently treating three-year-old Vinod, his eight-year-old sister Jayashree and his mother Rama, who live in a village near Bangalore, in Karnataka. All three are HIV-positive.
The couple used to treat Rama’s husband at their clinic on the outskirts of Bangalore. He died from the disease last year.
The response from patients has been very positive, as the Nagarajs’ method of providing medical care offers several advantages.
In a country where the stigma attached to HIV/AIDS is huge, isolating sufferers from the rest of society, home visits provide patients with interpersonal contact that is not always easy to come by. According to Rama, the neighbours shun her family, including her mother-in-law who lives with them. Even their relatives have cut them off. Little wonder then that the doctors, who always visit as a couple, are welcomed into their home as friends. Also, the motorbike provides an inconspicuous means of transport. For families whose neighbours do not know they are infected, this discretion proves invaluable.
On a more practical note, Rama’s mother-in-law observes: “There are no travel costs to and from the clinic.” As a result of the regular home visits, the patients have learned to take their medication properly.
Treating patients away from the clinic benefits the physician too. “When we go to their houses, we know the family situation, family background, how they live their lives,” says Deepa. “Patients are more comfortable, they express all their family problems.” Home visits also make it easier to inform non-infected family members how the HIV virus can and cannot be transmitted.
Even in terms of treatment options, the couple complements each other -- Dr D Nagaraj is a general physician while Dr Deepa Nagaraj is trained in alternative medicine. And, their care extends beyond the medical -- they also try and help with financial and employment issues.
For instance, in the case of widows who were previously unemployed. “We try to mobilise funds,” Dr D Nagaraj explains, “and looking at her capacity we try to elevate her, get her a job suitable to her educational status, so she is able to look after her family.” The couple has found people jobs in tailoring and security. They have also helped place newly-orphaned children in homes.
Funds, however, remain a major problem. The clinic, The Good Shepherd Health Centre, is the couple’s only source of income. They do not charge their AIDS patients, most of whom are poor and cannot afford to pay.