Two days ago a family came to meet me. A 32- year-old husband with his wife and 3 year old son. They came to see me regarding a minor fever for the wife. They seemed to be happy, especially the kid who kept on exploring my consultation room for treasures. My thoughts went back to the time they visited me the first time.
They were referred to me by a Gynecologist when a routine HIV screening on the pregnant woman was found to be 'positive'. They were in tears, the husband and wife. They did not want the baby but it was too late to abort. They wanted to end their lives as the husband also turned out to be 'positive'. I tried to talk to them in a positive way. I assured them that with proper treatment for the mother and the newborn, the baby will be negative. I also told them that HIV/AIDS is now a well treatable condition, and they will be able to continue living with a good quality of life indefinitely. They did not want any of their family members to know. I promised that I wont tell anybody.
Next day itself I started Mother to Child infection prevention medicines. Her pregnancy period was uneventful, and she delivered a normal boy by Cesarean section. In case of a 'positive' mother, it is always better to avoid breast feeding if the parents could afford formula feeding. So the paediatrician while giving the newborn the medicines for prevention of infection asked them not to give breast milk. This advice produced a commotion among women members of the family. The guy (new father)called me frantically warning me that both Grand mothers are coming to me to ask me about breast feeding. He pleaded with me not to say anything about HIV.
Meanwhile I called the Gynecologist and pediatrician and discussed with them what to reveal and what not to reveal. We decided that we will tell a lie as per the wishes of the couple. The Grand-mothers arrived in front of me. I told them that a virus that can cause jaundice is there in the mother's blood. If she breast feed, the newborn will get infected with dire consequences. So, it is better to give formula feeding. If they have any doubt they can ask the other 2 doctors. Some how or other, I was able to convince the two women. Later I learned that they did not go to other 2 doctors.
All was seemingly well for a few days when suddenly I heard that the guy was hospitalised for attempted suicide. The young mother one day told her mother all the truth. On hearing that, the husband not able to bear the thought of stigma tried to kill himself but fortunately was unsuccessful.
After 18 months, the couple came to me with the kid. They were very happy. They just got the result showing that their boy is HIV Negative. I asked them how is it with their families. They told me that both parents know the truth and they are very supportive.
Later last year, I referred the guy to the ART centre as his CD4 count was below 200. Now he is on ART for last 9 months. His last CD4 count showed steady improvement.
All these I remembered as I watched the son happily playing with a paper weight on my table.
Then the mother said, 'He has not been given any shots'.
I was shocked. The 3-year-old child has not been given any vaccines for immunisation. How could it be like that?
She said that when they went to the nearest Govt Health Centre for immunisation, they saw the HIV positive status written on the mother's medical record. The doctor there was confused which all vaccines to be given. So he referred the child to a Higher Centre some distance away, but the couple fearing stigma never went there.
I asked them to get the child vaccinated immediately, told them to take ART regularly, also reminded them about measures to prevent further pregnancy and said goodbye.
It was a pleasantly satisfying interview for me.