Features : Manipur: Conflict Upsets AIDS Work

YOUANDAIDS THE HIV/AIDS PORTAL FOR ASIA PACIFIC

Anonymous Expert HIV/AIDS Counseling

Tuesday, January 06, 2009

Home » Features

FEATURE

Manipur: Conflict Upsets AIDS Work

By Yumnum Rupachandra

Imphal, Sept. 29:For 41 days, after the "June 18" mass "uprising" that left at least 18 dead and several government building including the State Assembly hall reduced to ashes, Manipur reeled under intermittent curfew.

As the state burnt following the Central Government's announcement to extend the cease-fire to areas in Manipur, AIDS workers in Manipur tried hard to keep in touch with their patients, but in vain.Some died for need of immediate care while others went back to their risky old habits. Bandhs and economic blockades that went on for days at a stretch followed these, putting a strain on the functioning of those who are in forefront of the battle against HIV/AIDS.

These however are not new to Manipur, which has been a "conflict zone" for the last five decades. Manipur has seen enough conflicts, both in the hills and the plains, but it has never been a case to study the impact of these on the HIV/AIDS situation which is moving towards a flash point.

Though people have learnt to take in their strides these unwelcome situations in their day-to-day lives, its impact on the HIV/AIDS situation may well prove to be serious, feels several NGOs working in the field. "All our drop-in centres had to be closed for the entire period the city was under curfew," said Raghumani, General Secretary, Life Line Foundation. "The break in the continuity of the services provided by us like Needle and Syringe Exchange Programme can take our works back to square one," he added.

"At one point of time we were so worried about a patient whose prescription was with us for providing free anti-retroviral drugs," Said Ms. Bhanu, also of Lifeline Foundation. " She was in a bad condition and we simply could not reach out to her because of the curfew," she added.

Mr. L. Deepak, Secretary of the Manipur Network for Positive People expressed the worry that people with risk behaviour, they were in touch with, would go back to their old behaviour because of the break in the service. "What do you do if they go back to sharing syringes because of non availability," he asked. "All that we have done to set their behaviour correct will be reduced to nothing if they become positive or get someone positive," he said." Of course, there will be some who will follow the proper safety procedure even if they share the syringe but we cannot guarantee all will take the pains," he added.

"At least one patient died during the curfew as we could not refer him to a hospital on time because of the curfew," said Ingocha, Project Co-ordinator with the Life Line Foundation.

But what worried Mr. N. Vikram, Project Manager of Continuum Of Care Project (COCP) was the impact of the opportunistic diseases like TB. "If a TB patient miss his medication even for a day the chances of developing drug resistance is high," he said.

Describing the recent break as a setback in the battle against the disease Mr. Vikram said, "we are living in the midst of an epidemic and any break in the battle against the virus is bound to have a long term affect. Fighting the disease itself is a giant task. But to fight it with hands tied is rather difficult to imagine. But we are doing what we can," he added.

"This is not the only problem of the AIDS workers face," Vikram added."Because of economic blockade on National Highways stocks of drugs has reduced. Manipur is connected to the rest of India through NH39 and 53. Both the highways were recently closed to economic traffic for nearly a month following call of an "economic blockade" by some groups.

It's the poor who were hit the hardest," said Deepak of MNP. "They cannot afford to buy the required drug at one time. Some of them buy on a daily basis. For them it must have been a difficult moment when the pharmacies were closed," he said."We were more worried about those on anti retroviral drugs and under medication for TB," he added.

Ms. Annie Mangsatabam, Secretary Integrated Women and Children Development Centre which runs a 30 bedded de-addiction centre said: "what we have build up in last three years have almost gone down the drain. This is going to have a long term as well as short term impact on fighting the drug menace as well as HIV/AIDS".

The first seven days when the curfew was on for 24 hours a day non-stop has specially taken a huge toll. The feedback we get post-curfew is alarming, said Jaya Thiyam Project co-ordinator with the IWCDC. "We have got reports of relapse cases and even reusing of the needles and syringes our drop-in-centre had collected," she added.

Most HIV AIDS workers were unanimous in their opinion that Conflict and AIDS do not go together. In fact it is a major constraint and obstacle, said Vikram of COCP. They were also of the opinion that HIV AIDS workers should be recognised as emergency workers so that they could still go ahead with their work.

All those who are directly involved in any given conflict situation, specially the armed forces and police, should realise the importance of our mission and make things easier for us, said one worker.

Ms. Jaya Thiyam is particularly concerned that with the attitude of the police which hampers the AIDS workers in the Needle Syringe Exchange Programme. The police routinely harass workers for possessing the needles and syringes meant for their clients.

"Because of conflict situation the cops carry out body checks for hidden weapon and when they come across our worker with syringe they lock them up thinking them to be traffickers," she said. This is a deterrent factor, she added. We also have hard time trying to convince the cops to let them go and also waste a lot of unnecessary work time.

Police check-points set up outside one of the drop-in-centres also deter lot of our clients and deter other possible clients thus sending them back underground. In areas like Manipur where conflict situation has been a reality for the 5 decades and the population is at a high risk of contacting HIV, the need to formulate a working strategy to handle curfew situations is an urgent need.

The State was one of the firsts to formulate a State AIDS Policy in India to fight the epidemic. It should now be modified with solutions for facing conflict-situations, say most of the HIV/AIDS volunteers.

(Yumnam Rupachandra is a senior journalist based in Imphal. He contributes to leading national and international publications and has been involved in making short video films on various issues in the North Eastern part of India.)