Siddharta Yadav on changing perceptions of HIV/AIDS

There is a famous proverb in Nepali which says we learn something either by reading about it or by facing it. I prefer the latter because of the everlasting impression that “facing something” leaves, in contrast to the hazy-sketchy memories of reading. I have been reading about HIV and AIDS since my first year in my medical school but never have I really thought beyond my textbooks until earlier this month in Kuala Lumpur at the 22nd East Asian Medical Students’ Conference (EAMSC). It was at this conference that I really saw HIV from different perspectives which changed my own perception of this condition.

The conference saw about 300 medical students from 16 countries, to explore their roles in combating HIV and AIDS in the Asia Pacific region. To achieve this goal, the conference had it all: paper presentations; group discussions; plenary sessions by eminent personalities; field visits and workshops. This was well complemented by good food, excellent accommodation, sightseeing and introductions to local culture.

I have seen many HIV and AIDS patients in my medical school. My imagination of them being bedridden and incapable of leading a relatively normal life came from this experience. This changed when I visited an orphanage as a part of the field visit during the conference. This was the first time so many people with HIV outside a clinical setting. When I saw children with HIV and AIDS playing together, I realised that this condition in itself could not cut down our prospects of leading a good quality of life.

Moreover, when I came to know that they had both HIV infected and uninfected children, including the children of the owner of the orphanage, living together and sharing rooms, I was able to conquer my own fear of people with HIV. It was here that, for the first time in my life, I carried a toddler with HIV on my back without any sense of fear or apprehension.

I had an unfounded fear of this disease. So had one of my medical school friends, who, on hearing that the orphanage had both infected and uninfected children living together, said “that’s dangerous.” I am not sure what he really meant, or if there is any evidence base to support his remark, but to be honest, I would have said the same had I not been to the conference.

In an implicit and unknowing way, what that remark could mean is that people with HIV and AIDS should be seggregated from the uninfected human population. Do we really want to say that?

One very important aspect of the conference was that we heard many stories from people with HIV and AIDS, something we are not used to while working in a hospital setting. I knew that people with HIV are stigmatised. I could even tell you the figures on it. But unfortunately, for some reason, this had failed to convey any concrete message to me until I heard those stories of discrimination and social ostracization from the people who suffered.

This also reminds me of what Alischa Ross, CEO of Youth Empowerment Against AIDS, said during one of the plenary sessions, “Statistics disconnect us from people. I would like to think of numbers as stories that are there to be told.”

In my medical school, there often are programs by the students to create awareness about HIV and AIDS in the general public. What we have, perhaps, missed out is to look inside ourselves. The majority of medical students in Nepal are still not very comfortable dealing with HIV patients. Some of us still see them as moral wrongdoers. I remember one of my friends using the term “guilty” when a patient admitted that he got HIV from a prostitute. Does it really matter to us how a person got HIV? Who are we to pronounce moral judgements?

As future doctors and health advocates, the necessity to keep ourselves free from such moral judgements is obvious. The responsibility to mitigate the stigma against HIV and AIDS rests on
our generation. The best place to start from is ourselves. The 22nd EAMSC in KL has set the tone for this change. Yes, change has just started and I hope it will ripple through Asia, Pacific and the world.

Siddhartha Yadav is a medical student in Nepal and former BMJ Clegg Scholar.

  • Detu

    its nice that you have changed your perspective there, same like what i did, since that conference i lost my fear and my stigma to the one with HIV/AIDS, well i think i’am a bit luckier that u did, because i got that lesson in my early stage of medical study,, but may all of us be more aware, to prevent HIV/AIDS without avoiding the one who had infected.

  • Matiram Pun

    Dear Siddartha,

    This is great news that Medical students are gathering and seriously analyzing the effects of HIV/AIDS in the region and around the world. The perspective from the developing world needs to be changed and young generations should carry the message ahead with their actions in the field.

    Yes the discrimination is there. We have to work out in the field and awareness is necessary even to the doctors who are practicing. Therefore, the conference of the medical students on this is really important.

    That’s great job!

    Keep it up!

    Best wishes,

  • Dear Siddarth,
    Great that you have been given the opportunity to be sensitized to people living with HIV/AIDs early in your medical career.
    We have come a long way… while each small pebble is a stepping stone, it is indeed deplorable that despite the massive roll out of anti retroviral therapy, medical professionals are amongst the leading discriminators against HIV affected humans. We quote any number of reasons to refuse hospital admissions, discharge patients, refuse dialysis, turn down surgeries – all for “fear” within some of our colleagues that seems unreasonable to us working within the field.
    Desensitization is the need of the hour…
    Regards & Best Wishes
    Dr Vijay Prabhu MD

  • Louisa

    Its a great story and very relevant in the UK. I’m in my fifth year and I still haven’t been involved in an HIV patients care or met one for that matter. Where as in sub-saharan africa 25.8 million people are effected and it would be impossible not to incounter it. I look forward to moving past my apprehension when I spend my elective in africa!

  • Its encouraging to hear that your own perception of the scourge changed. There is need to demystify AIDS and percieve it differently from the demon that it has become in many clinical settings. Working in Africa and being an African has indeed shown me the various facets of AIDS which are not known. The underlying experiences cement the truth that indeed ” Aids is a demon that can be cast out out”. As soceity we just have to know the “how”.

  • Atul

    Dear Siddhartha ,
    commendable article indeed .Yes it always better to learn by seeing as it evokes many different feelings than reading a book.I think it is also great that medical students from different parts of Asia had chance to interact with each other ,that`s really great step. i think it only bodes well for the future that medical students from all over the world have chance to interact often and understand each other perspective .I believe that the whole journey would have helped you in many ways .your view points have always been interesting ,keep up the good work.

  • Nicola

    Dear Siddhartha,

    I wish that every medical student would have the same experience as you. I am in my third year of medical school in the U.K. and I am involved in the Stop AIDS Campaign here. Like you said, although we are trying to educate members of the public about HIV/AIDS, I often notice during events that my classmates themselves are as ignorant or judgemental as anybody else and considering that in whatever field they work in in the future they will have to treat patients with HIV/AIDS, this is worrying. How to address this is a difficult question. I feel that a medical degree is seriously lacking a global health perspective, something essential considering the diversity of today’s societies and the potential to work abroad. Hopefully, as awareness spreads, this will change.

  • Hello Sid

    Great conference, fantastic interactions. The next conference in July 2009, the 30th edition of the Asian Medical Students’ conference on Stigmatized Illnesses in Taipei, Taiwan, promises to follow on with 22nd East Asian Medical Students’ Conference in giving awareness, encouraging advocacy and promoting action among Medical Students in the Asia-Pacific region.

    More updates to follow on:

    Cheng CS
    The University of Queensland School of Medicine
    Asian Medical Students’ Association Executive Committee