Médecins Sans Frontières - Healthcare barriers for PLHIV in Patna, India (INT)

Unique Identifier Code / URN MSB207860

Date taken / Date Recorded 03/10/2024 12:05 PM

Country India

Commissioning section MSF-INDIA

Photographer / videographer / producer Harpreet Singh

Copyright Harpreet Singh/MSF

Usage Rights (MSF) Advertising Campaign, External Media, MSF Fundraising, MSF Publications, Social Media

Formal Consent Copy available yes

Editor's rating ★★★ (F)

Video format h264 (Main) (avc1 / 0x31637661)

Duration 7m20s

Maximum Size 1920px × 1080px 541.94 MB

Additional Information / Shotlist 00:00 – 00:36 – Dr Shreyas Murali, Medical Activity Manager, MSF Patna Advanced HIV Project – “After acquiring the HIV virus, if the person falls sicker and sicker and if he/she starts to acquire multiple stage three and stage four diseases, then we call it as an advanced HIV. MSF in collaboration with the state(government), has implemented a program called as advanced HIV in the district hospital. And we see critically sick and unwell patients being referred from antiretroviral treatment centers. When the patients arrive to this facility, there are series of investigations that we subject the patients to undergo and based on the investigations, we diagnose some of the diseases and we treat them.”

Text on Dr Shreyas’s byte
00:14 – 00:24 – Since 2019, MSF has been supporting people with HIV through ‘ Garima Ki Kiran’ clinic at Guru Gobind Singh Hospital in Patna, Bihar.
00:24 – 00:34 – It is important to acknowledge the challenges that we continue to confront during these tough times.

00:36 – 00:45 – Manju Devi, HIV patient – “My treatment is going on since 2016. As soon as we both got to know about HIV, we started our treatment.”

Text on Manju Devi’s byte
00:36 – 00:45 – Manju Devi is an HIV patient from Samastipur, Bihar. She and her husband have been on treatment for the last 7 years.

00:45 – 00:56 – Kishor Paswan, patient’s grandfather – “He had got rashes all over his face, and they were big too. His foot had also become swollen.”

Text on Kishor Paswan, patient’s grandfather byte
00:45 – 00:56 - A 6-year-old child, Prince contracted HIV from his parents. He comes to the MSF clinic with his grandfather.

00:57 – 01:01 – Ram Bihari, patient’s nephew – “When he doesn't see me at home, he looks for me.”

Text on Ram Bihar’s byte
00:57 – 01:01 – Ugam Jhadav (65 years old) has HIV and comes to MSF clinic with his nephew, Ram Bihari (50 years old)

01:02 – 01:10 – Keola Devi, Surender Kumar’s wife – “From less than 30 kgs of weight to 45 kgs to 55 kgs, I have saved my husband.”

Text on Surinder Kumar’s wife’s byte
01:02 – 01:10 – Surinder Kumar’s wife has been a constant support in his journey towards recovery. He came to MSF in 2021.

01:11 – 01:19 – Vijay Kumar, patients grandfather - “She plays very rarely, she is mostly ill, and at times down with fever.”

Text on Vijay Kumar’s byte
01:11 – 01:19 – 2-year-old Nandini contracted HIV from her parents. Her grandfather has been struggling for her medicines.

01:20 – 01:33 – Himdari, Project Coordinator Support, MSF Patna Advanced HIV project – “We are getting pediatric patients and when we are trying to get their history, we get to know that their parents are not being tested or mother is not being tested while she was pregnant.”

Text on Himadri’s byte
01:20 – 01:33 – Parent to child transmission

01:34 – 01:45 – Vijay Kumar, patient’s grandfather– “The doctors here advised us to have my son's (Jitender’s) wife and kids checked for HIV.”

01:46 – 02:02 - Himdari, Project Coordinator Support, MSF Patna Advanced HIV project – “We see many pediatric patients who got infected from their parents. This is preventable if we systematically implement PPTCT (Prevention of Parent To Child Transmission) guidelines in antenatal care. Thereby, every pregnant woman should be offered counseling and HIV testing for early detection and prevention of HIV transmission.”

02:04 – 02:17 – Dr Nitesh Tiwari, Medical Activity Manager, MSF Patna Advanced HIV project – “Queues are very long outside the outpatient department. So, we have to send the patient at 8 o’ clock, and then the doctor will see them at 12 o’ clock. Then they start admission by 6 o’ clock in the evening, and then we have to start getting the paperwork processed.”

Text on Dr Nitesh’s byte
02:05 – 02:17 – Difficulties in tertiary care

02:17 – 02:30 – Vijay Kumar, patient’s grandfather – “To get my paperwork processed, for four people, I had ran for 15 days. There were so many formalities, I used to run around all the time. I had no other option but to do all that.”

02:31 – 02:39 – Surender Kumar, patient – “I went to a private doctor. He told me you have got infected with HIV and the treatment for that is only available at government hospitals, not in private.”

02:39 – 02:49 - Dr Shreyas Murali, Medical Activity Manager, MSF Patna Advanced HIV Project – “They are coming from a very low socio-economic strata and they have no idea about when to access care and whom to reach and what to ask for.”

02:50 – 02:57 – Kishor Paswan, patient’s grandfather – “If I leave my village in the evening, I will reach the hospital by morning, and if I leave here in the evening, I will reach home by early morning.”

Text on Kishor Paswan’s byte
02:50 – 02:59 – Low Socio-Economic Background

02:57 – 03:07 - Dr Nitesh Tiwari, Medical Activity Manager, MSF Patna Advanced HIV project – “These are daily wage workers so going to the ART (Anti-retroviral Therapy) Centre for one day means that they don't eat food because they're going to get medicines and asking them to come back again... It's not really a practical solution, but it happens.”

03:07 – 03:21 – Manju Devi, Patient – “It takes 500 rupees for one person to come from and go to Samastipur. When two of us travel, it would cost us 1000 rupees every day. It is 5 hour long journey, we don’t get a train easily on such local routes.”

03:22 – 03:34 - Kishor Paswan, patient’s grandfather – “When we go to a tertiary hospital, they say we are prescribing the medicines, buy them from outside. If I had to buy medicines from outside then why should I come to you?”

Text on Kishor Paswan’s byte
03:22 – 03:33 – Access to Medicines

03:34 – 03:42 - Surender Kumar, patient – “They only tell us which medicines to take, they don’t teach us about the disease. We are asked to buy medicines from different places.”

03:44 – 03:48 - Vijay Kumar, patient’s grandfather – “They call us often, check the weight...
but don’t give us medicines.”

03:49 – 04:01 – Debashish, Health Promotion Activity Manager, MSF Patna Advanced HIV project – “Not a single citizen of this country should die because of lack of medication. And herein, I must reinforce the accountability should be the first thing that need to be instilled into the system.”

04:02 – 04:22 - Vijay Kumar, patient’s grandfather – “They say, “we can’t give medicines for children below 10 years.” We have to feed her well to manage her weight, and give medicines too... So she gains and loses weight a lot. How can the public change anything? If someone can bring a change, it’s you people and the government.”

04:23 – 04:34 - Surender Kumar, patient – “They never ask us about the problems we face, if there is a need for CD4 test or there is some other complications. They don't check us properly; don’t even ask how we are doing. They don't show any concern”

Text on Surender Kumar’s byte
04:23 – 04:32 – Discrimination in Healthcare settings

04:34 – 04:50 – Keola Devi, Surender Kumar’s wife – ““We will not write anything, go away.” “Since when are you sitting?” “It’s been half an hour...” “Just half an hour, then keep sitting. We don’t care about the time.” They were not polite at all. They were rude. “This man won’t live for many years”, they said. I had got tears in my eyes.”

04:50 – 04:58 - Dr Nitesh Tiwari, Medical Activity Manager, MSF Patna Advanced HIV project – “We need to remember that just because somebody has a chronic condition, specifically in our case, HIV, doesn’t make them any less of a human being.”

04:58 – 05:07 - Dr Shreyas Murali, Medical Activity Manager, MSF Patna Advanced HIV Project – “The healthcare system is overburdened and on top of it because of the stigma that exists towards the HIV population, the care is not easy to get.”

05:07 – 05:14 - Surender Kumar, patient – “Everyone will think bad and negative about us, so we don’t speak about it.”

05:14 – 05:18 - Vijay Kumar, patient’s grandfather – “Even today, HIV is considered a big blot on our society.”

Text on above two byte Surender Kumar and Vijay Kumar
05:07 – 05:16 – Societal Stigma

05:19 – 05:24 - Manju Devi, HIV patient – “We didn't let anyone else know about it. They would have said, “Don’t talk or touch us, stay away.””

05:25 – 05:36 - Debashish, Health Promotion Activity Manager, MSF Patna Advanced HIV project – “Because of the kind of self-stigma they have and the kind of discrimination they have faced, in the community, at the public health delivery system... We have created a safe space for these patients.”

05:36 – 05:50 – Purnima Jain, Mental Health Activity Manager, MSF Patna Advanced HIV project – “One of the beauty of our project is the multidisciplinary approach, where mental health, medical doctors, nurses, health promotion will be working together to provide a comprehensive care to the patient and their families.”

05:50 – 05:56 – Meena Kumari, Lay Counsellor, MSF Patna Advanced HIV Project – “Even when they come here, they have no idea about the seriousness of this disease.”

Text on Meena Kumar’s byte
05:55 – 06:04 – Knowledge about HIV

05:57 – 06:10 – Ram Bihari Yadav, patient’s nephew – “This disease, HIV... I used to have no information about it. I gained all the knowledge about it only after coming to this hospital. We got all the necessary facilities here.”

06:11 – 06:21 - Meena Kumari, Lay Counsellor, MSF Patna Advanced HIV Project – “We try to explain about the virus through these (illustrations). We tell them how it infects the blood and what all can be the causes for it to happen.”

06:22 – 06:30 - Ram Bihari Yadav, patient’s nephew – “No, this does not spread by touching anyone. It is not a matter of untouchability. We should not discriminate.”

06:31 – 06:55 - Purnima Jain, Mental Health Activity Manager, MSF Patna Advanced HIV project – “Had this proper information would have been given to them right at the initial stage, I think the mental distress that the entire family had gone through... Maybe the severity could have been way less than what it was at the onset of the medical condition. That is why we make sure that there are ‘Support Group Sessions’ held on a weekly basis.”

Text on Purnima’s byte
06:38 – 06:46 – Mental Health

06:55 – 07:05 - Dr Shreyas Murali, Medical Activity Manager, MSF Patna Advanced HIV Project – “Without their will power, the treatment, and the counselling that we provide. is not going to work. So, we always request our patients to be strong.”

07:06 - 07:11 - Ram Bihari Yadav, patient’s nephew – “I have never lost my spirit. I will stay hopeful till my last breath.”

07:12 – 07:18 - Dr Shreyas Murali, Medical Activity Manager, MSF Patna Advanced HIV Project – “We are here to do everything that is possible from our side to make their lives better.”

07:19 – 07:20 – MSF logo at the end