Harassment meted out to a pregnant woman in Rayagada hospital last week has brought to light the condition of HIV/AIDS pregnant women in this part of the State.
The case has also exposed the failure of Prevention of Parents to Child Transmission (PPTCT) - an initiative of National AIDS Control Organisation (NACO) - being implemented by State Government for AIDS Control Society (OSACS).
The PPTCT programme is part of a four-pronged strategy that recognises vulnerabilities to HIV through lifecycle. From prevention education to adolescents to minimising risk of HIV transmission in pregnant women, to the continuing care and support of the affected and infected mothers and babies, the strategy aims to focus on risk and vulnerability of the entire lifecycle.
According to the national PPTCT guidelines, besides care and support, government hospitals should be able to provide Nevirapine as antiretroviral (ARV) prophylaxis to HIV-positive pregnant women at the onset of labour. The newborn infant should also be provided a single dose of Nevirapine within 72 hours of delivery.
On February 12, Umashankar Garadia, a resident of Beheraguda village under Kasipur block of Rayagada district had rushed his wife Babuli to Rayagada hospital after she complained of pregnancy-related complications. Both are affected by AIDS.
After a week of her admission to the hospital, Umasankar alleged that doctors did not take any step for delivery of the child. During a checkup last Tuesday afternoon, doctors declared that the baby in her womb had died and it can be removed only after operation.
The doctors also reportedly asked the attendants of the woman to shift her to the district headquarters hospital in Koraput for the operation as there was no anaesthetist in the hospital. At the Koraput hospital, Dr Nirod Kumar Sahu, gynaecologist, attended to Babuli who delivered a baby boy at around 2.50 am on Wednesday without any surgery. Sources said such incidents are just the tip of the iceberg.
There have been many such instances where HIV positive/AIDS-affected women have been denied ART (anti-retroviral treatment) and medical help during pregnancy in the district.
There is no supervision of implementation of PPTCT services at the Integrated Counselling and Testing Centre (ICTC). Besides, there is no way to ensure that targets set for counselling and testing of general patients as well as pregnant women are achieved.
Apparently, the Rayagada hospital has a link with ICTC providing PPTCT services and the doctors were well aware of Babuli’s condition. Although Rayagada hospital sources expressed ignorance about Babuli being affected by AIDS, Umashankar alleged that they knew the case well as his wife availed ART from ICTC there. They said she was referred to Koraput as the ‘dead baby’ could not be removed from the womb without an anaesthetist.
Apparently, although the woman was referred to Koraput hospital with a ‘dead baby’ in her womb, the Rayagada hospital doctors wrote ‘cephalopelvic disproportion’ - the condition in which the baby’s head is too large to fit through the mother’s pelvis - in the prescription.
Meanwhile, after the matter was reported in the media, the Health Department and OSACS have sought reports from the Rayagada Hospital on the issue.