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.