Monday, Dec 13, 1999
Why HIV Positive Patients Need Jobs
Man From Matunga"Man from Matunga" lives in Mumbai, India and expresses his angst and pleasures through words |
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On Tuesday, November 30, the Times of India reported on a court ruling directing the New India Assurance Company to give back an HIV positive sweeper lady, the job that had been refused to her on the grounds that she was HIV positive. I don't know how the sweeper lady managed to get the resources to fight the case, but this judgement is reminiscent of the anti-discrimination suit that the Tom Hanks character had to fight in the movie 'Philadelphia', after he had been dismissed from the law firm where he had been working, after he was found to be HIV positive.
Just three years back, private hospitals would refuse to admit HIV positive patients, government hospitals would dump them in 'special wards' and ward-boys and nurses would refuse to handle positive patients and their body fluids. Times are changing, though. These days, hospitals and their employees are on the whole more caring towards HIV positive patients (some hospitals even look at them as a means of revenue and encourage their doctors to specialize in AIDS medicine) and the attitudes of the general public have also improved due to better education and information.
But I am getting away from the point of this article.
More than others, HIV positive patients need employment and a source of reasonable income. To maintain their immunity, most positive patients need to take anti-retroviral drugs, which cost around Rs 25000 (600$) per month (down from Rs 40,000 per month just a year ago). Obviously, less than 1% of positive people are able to come up with this kind of money. The rest have to forego this treatment, unless they are lucky to get into a research project. Anti-retroviral therapy is important because if taken indefinitely, prolonged survival is possible.
A friend of mine, who is positive, needed anti-retroviral therapy. He was earning around Rs 10,000 or so per month at the time and his savings were quickly exhausted in the first phase of treatment, diagnostic tests and consultations. A few friends and relatives chipped in, but that helped him for just another 3-4 months. In the end, he decided to go to the US as a research fellow. He hid his status (looking at him, you would not know that he was positive), got the fellowship, got his visa and managed to get away. And he has been there for over a year and a half now, doing well, taking his drugs (some of which he buys from India to further save costs) and earning upwards of 20,000$ a year, which, coupled with a very frugal lifestyle, allows him to pay for his treatment. Another acquaintance I know applied for a job in Britain. She did not even bother to hide her status and got the job during the anti-racism backlash that had hit England a year or so ago - she was colored, Asian, woman, HIV positive - how much more 'minority' can you get.
For those who can't afford anti-retroviral therapy, the daily costs of maintaining themselves reasonably are still high. Prophylaxis against two major diseases, tuberculosis and Pneumocystis carinii pneumonia still costs around Rs 15-20/day (50cents), which is around Rs 600 per month (15$). Add to this, the cost of reasonably nutritious food and other standard daily needs and we are looking at a minimum expenditure of Rs 1500/month, apart from the expenditure that may be incurred occasionally on doctors and diagnostic tests. And if the individual actually contracts a disease, the expenditure involved in treatment jumps exponentially.
Finding funding is difficult. Though many charities exist in India, hardly anyone is willing to support HIV positive patients, since the general feeling is that they are responsible for their own plight. India has no social security, no insurance for AIDS and related disorders and no other schemes, meaning eventually that each HIV positive individual has to fend for himself/herself.
There are at least 3.5million HIV positive individuals in India, forming about 1% of the adult population. Assuming that only 1% of them (35,000 individuals) can afford the cost of anti-retroviral therapy, there are still 3.15million people who can only afford prophylactic therapy - and I'm sure there are some who can't even afford that. They need a source of income. Hopefully this judgement will make it easier for them to at least maintain their existing jobs, if not to get new employment, thus helping them to help themselves.
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