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Last Updated: Friday, 10 December, 2004, 17:37 GMT
Return to frontline of India's Aids battle
Aids awareness poster outside hospital in India
Hospitals in India are attempting to raise Aids awareness
Last year BBC World Service's Outlook programme spent a week at the Tamburam Sanatorium in Madras (Chennai) talking to patients, doctors and councillors about HIV/Aids. Now it has returned to see what changes, if any, have occurred.

The Tamburam Sanatorium is one of the largest Aids care centres in India, and as a result is on the front line of the battle against the disease in South Asia.

It is estimated that in 20-25 years, one in four Indians could be HIV positive - over 250 million people. At the Sanatorium, it is clear numbers are on the rise in comparison to last year.

"Yesterday, there was an unprecedented number of 1,588 - it was a lot of strain on us," Dr Krishna Rajaseka, who works treating arrivals at the hospital, told Outlook.

"I really don't know how long we'll have to carry on like this."

Anti-retroviral treatment

The hospital began giving Anti-Retroviral Treatment (ART) in April.

However, Dr Rajaseka added that India remains a developing country, and the hospital is unable to offer ART to all patients.

When the drugs are administered, they do have an effect, Dr Rajaseka said.

Marchers in Delhi hold placards reading
Aids awareness in India is increasing
One patient who had been taking ART for five days said that he felt "quite fresh", adding, "normally I used to lie down, I felt tired. Now this tiredness has gone.

"I feel I'm alright, without any disease."

In one ward where HIV-positive patients are being treated, Dr Ravi Chandra explained that treating someone with ART is a massive undertaking.

"The lifespan on average will increase by about three-and-a-half to four years at least," he said.

"But of course you are postponing the inevitable, and it's a major undertaking both financially and emotionally."

Dr Chandra explained that this is partially because of the expense of supplying ART, and partially because patients on ART live longer - only to develop other complications later on.

Meanwhile, on the children's ward is one young family, all struggling in different ways to cope with HIV.

The mother is very ill, the father and daughter are HIV positive, while the younger two-year-old son is awaiting the results of tests.

"We have nobody to look after us," Veloo the father, said.

We have no relatives to look after us - her mother is dead, my parents are dead, and other relatives are gone elsewhere
Veloo, Aids sufferer

Pria, a worker on the ward Outlook met last year, explained that the hospital was limited in how it could help the family outside of the ward.

"We can help them by giving them some nutritious food - we can partly support them, but not fully," she said.

But what is new in the ward is a bright, colourful room for the children - decorated with posters, with a tiled floor and ceiling, and a television. The children are able to watch cartoons and play video games.

Work on the room began in early April - the same time as the hospital began giving out ART.

Awareness and stigma

The last year has also seen a big increase in the number of councillors working at the hospital - from three up to 13.

"This a great thing - we can share the responsibility and spend more time with the clients," explained Dina, one of the three working last year.

She added that while the benefits of ART were clear after 48 hours, there were still many "myths" surrounding the treatment.

It is estimated that by 2030 one in four Indians could be infected with HIV
In particular, some believed that taking ART made people sicker, and that it was possible to die from taking the treatment.

Samantha, a new counsellor, also highlighted the problems of people sharing their drugs - especially with their spouses.

"If one spouse gets the drugs, he or she will share them with their spouse at home," she said.

"They don't bother to bring the spouse for testing, because they have to spend another bus or train fare to get them to the hospital.

"But this means that neither of them get enough."

Samantha also explained that one of the reasons for the rise in the numbers of patients arriving for treatment is increased awareness.

"Now, they know that Aids is a kind of virus that will lead to death if not treated properly."

However, Samuel - another new counsellor - added that the stigma of HIV remained heavily prevalent in Indian society.

"More awareness needs to be created among the group which are not affected," he said.

"Secondly, the people that are infected will not tell others. We need to change that, because if people are regularly seeing HIV people, then they might get used to this."

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