It was shortly before midnight, on a chilly January evening, in the mist obscured parts of the tree-lined roads, when Ria met with ‘the’ accident that turned her life upside down. On one of its darkest stretches the road turned and what she remembers thereafter is quite a blur. Apparently, she was found later in the night. By the time she was rushed to the hospital, she had lost a lot of blood. Those two units of blood saved her life then, only to reveal later that she had contracted HIV. As fate would have it, the blood she received was infected with HIV. Evidently, the doctors couldn’t detect the virus. She later found out some viruses have a window period during which the virus doesn’t show in the blood test. So, if a person contracts HIV today and decides to donate blood the next day, the laboratory that tests the blood will not detect the virus in it. The window period for HIV is usually between 3 weeks and three months, depending on the technology used at the laboratory. Even the best available technology in the market right now-the Nucleic Acid Amplification Test-only reduces the window period to seven days. Hence, nothing could have been done.
It’s been two years since that incidence now, she thought sitting at her cluttered office desk. Working at an investment bank can be really tiring. But it was for her ever so supportive and understanding colleagues and seniors that she was able to pull off her work as efficiently as ever. She wondered what the scenario would have been like if she were in the 90’s when the attitude of people towards this disease rested largely on ignorance. In olden days, the general belief that HIV/AIDS is contracted by casual relationships made about 80% people uncomfortable to share their food with or have casual contact with an HIV/AIDS sufferer. This behaviour drove persons with HIV/AIDS underground, with detrimental consequences to the community. Out of fear of stigmatization, they failed to declare their health status and thus were deprived of the drugs, health care benefits and treatment that they so needed. Her train of thoughts was brought to a halt when a close friend of hers popped her head into her cabin and brought coffee for both of them. She remembered Ria’s favourite- hazelnut.
While growing up, what Ria learnt at school about HIV is completely different from how she understands it now. We knew it as an STD, so rendered it contemptible. With such an image in our minds, we ceased ourselves of the opportunities of discussions with our friends, teachers or parents, and understand its true nature. Understanding young people’s knowledge and attitude towards HIV related issues and the provision of HIV education are important for a number of reasons. At present time, HIV can only be prevented through a protective stance and behaviour change. If young people are to reduce their risk from HIV/AIDS and other STDs, it is imperative that they know what risks exist and how to avoid them. Apparently, HIV can be spread by several ways like sharing needles, syringes, etc with someone who is infected. Through unprotected sex. Babies born to HIV positive women can be infected before or during pregnancy or through breastfeeding after birth. There is always a risk of transmission in health care settings via infected needles or sharp objects. But back then, for us, HIV was the result of personal irresponsibility or moral faults. HIV meant death. Ria would still have felt the same if she hadn’t met that old lady.
The moment Ria found out about her condition, all hell broke loose within her. Finished was the word that came to her mind. Finished with her aspirations, plans, feelings…everything. She cried day in and day out trying to figure out what she’d done to deserve this. Tried to keep a brave face in front of her parents, but the look in their grieving eyes made her crumble from within. Misery saw no end for her.
One morning, in the hospital room, going through some old family photographs she heard a knock on the door. The door opened slowly and a remarkably beautiful old face peered in. The lady smiled and said, “Oh hello there. How are you this morning?”. Before Ria could say anything, she walked in and sat beside her. “Chocolates?” she asked as she opened a square tinned box. She took some bead shaped chocolates and handed over the box to Ria. “I heard your mother cry last night. I know what she is going through,’’ she said as though she was trying to remember something. Then she smiled her splendid smile and said, “Believe me, you would want to be braver, not only for her but also for yourself.” Perhaps she knew Ria’s condition. And for the first time then, Ria let her true feelings and fear of death and the life that she will never get to live surface. “It is not the count of days that matter, dear, but the meaning that we add to them do,” the old lady said solemnly. “No point wasting time pondering over something you won’t have. And now that you have comparatively less time, why not focus on the kind of life you always wanted to live?”. She smiled encouragingly and said, “Strive for your goals, reach as high as you can and then reach a little higher still. There you will find possibility. And when prayer becomes your habit, miracle becomes your lifestyle.” Ria was completely fascinated by her. “And as for death,” the lady added, “it feeds on fear. It’s gruesome that way. If you want to make your life and death beautiful, then rise above your fears and when death comes, greet it as an old friend.” She quickly glanced at her watch and stood up to leave. With a smile she planted a kiss on Ria’s forehead and left, leaving behind a flowery fragrance about the room and the box of chocolates. Ria didn’t know why the old lady came to her or who she was. But she knew that she was someone who had seen enough life for she was now a believer. And now, Ria began to understand what she had to do.
Ria joined my work back as soon as she was out of the hospital and her boss was very glad to have her back. She put in extra zeal into her work, and simultaneously enjoyed the extra care and affection that she received from her co-workers and family members. She made a list of books that she had to read and the places she always wanted to visit. She talked more, laughed more.
Ria set out to know more about HIV/AIDS. Starting with history, a pandemic disease, HIV is believed to have originated in west-central Africa during the late 19th or early 20th century. AIDS was first recognized by the US Centers for Disease Control and Prevention (CDC) in 1981.The human immunodeficiency virus that causes HIV infection and over time, Acquired Immunodeficiency Syndrome (AIDS), otherwise known as Slim Disease. HIV breaks down the body’s immune system by depleting CD4+ T cells making us vulnerable to numerous diseases and neoplasms. Right now, it causes about 1.1 million deaths per year.
In India, the departure of 2014, saw 11.50% of all the deaths caused globally by AIDS, ranking India 3rd in the list. The primary drivers of HIV in India are female sex workers, unprotected sex between men and injecting drug users. The National AIDS control programme (NACP), launched in 1992 is being implemented as a comprehensive programme for the prevention and control of HIV/AIDS. Other such active bodies are NACB, PMTCT, NACO, etc. What is more striking is that our Government is trying to reach every single person with the capacities of state and district level units viz. SACS and DAPCUS. And the efficiency with which ASHA, ANM, etc are spreading awareness regarding sexual and reproductive health in villages is remarkable. Plus the government making free condoms available, at the village level, is a big step forward.
The more Ria gathered Information the more she wanted to explore so she attended some Health camps focusing mainly on Sexual health and hygiene organized by our Government, and also volunteered in some. She learnt a great deal about various health programs and the amount of hard work, planning, time, money and material that is being put in these, and how beautifully every step/plan is interlinked. Our Government participates in HIV/AIDS research that includes behavioural interventions, drug development, pre-exposure prophylaxis, post-exposure prophylaxis, circumcision and HIV, etc. It is also a relief that once extremely expensive medicines that were being imported, are now manufactured and are made available at affordable prices. Increased Lab facilities have made it possible for early detection, with the help of screening methods as ELISA, Western Blot, IFA, etc, and treatment of HIV. Antiretroviral therapy (ART) for adults, adolescents and children and ARV treatment and prophylaxis for pregnant and breastfeeding women with HIV, is the Government recommended program. It made Ria very happy to see the amount of hard work our Government and various health workers, together we’re putting in to achieve a common objective. This is what and how she would have wanted things to be. Though a bit slow, we are getting there.
Walking down the paved and beautifully lit lanes of Geneva, Ria enjoyed the feel of the cold breeze on her face and watched the world hustle by. A few weeks back, she read extensively about WHO and it works in the area of HIV/AIDS. It not only funds potential health organizations around the globe but also provides free treatment and drugs to the highly infected areas like The Malawi Township, which the WHO wants to see AIDS-free. They prioritize pediatric and adolescent HIV. Many HIV testing weeks are routinely organized. Within UNAIDS, WHO leads activities on HIV treatment and care, HIV and TB co-infection, and jointly co-ordinate with UNICEF the work on elimination of mother-to-child transmission of HIV. They also provide internship programs and platforms for those who want to volunteer and can contribute their skills and knowledge with WHO. Both, this beautiful city of Switzerland and the internship program caught her attention. And hence, she added Geneva to her places to visit list.
Ria enrolled for an internship at WHO and what she experienced there cannot be bargained for the world. People work for hours back to back and hand in hand selflessly. There is a collection and tallying of thousands of data with uncountable field visits, as well as simultaneous experimentations and trials of medicine. And all of it for one common goal to make the world HIV free. It may be hard and may take a while, but it is not impossible. HIV patients have a brighter future to look forward to. Many people believe that a vaccine and a cure for HIV will become a reality in the next 15 years time. And so is UNAIDS, with its Life Cycle approach towards HIV, determined to end its threat by 2030.
Sometimes at night, when sleep eludes, you hear the clock ticking. It’s like life is ticking. A dreadful feeling. Ria wonders if she would be lucky enough to ever get a chance to heal and to hear the doctors say there is nothing for you to worry about. If yes, then that will be a second life for. This is what she aspires for them all, the HIV patients, in the near future, that they would not have to worry and that there would be a cure for all.
While in Geneva, a particularly colourful and brightly lit restaurant caught her attention. She entered it. It was full of laughter and the chatter of people. She felt a wave of satisfaction and peace passing through. Working for all these beautiful lives, she felt alive. That place had a wooden board hanging, which said something that makes her smile even now:
As Buck beak spreads its wings,
And the Phoenix moves with the wind;
When Thunderbird stirs up rain,
We shall have spring again.
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