For this 2004 batch Indian Administrative Service (IAS) officer, health care, ecology and technology, comes naturally. A PG in livestock production and management, Dr Birendra Prasad Yadav is also credited with streamlining the National Rural Employment Guarantee Scheme (NREGS) as the OSD with the state Rural Development department. In a discussion with Sarita Yadav of iGovernment, the Bihar State AIDS Control Society Project Director talks about the various awareness and preventive measures that the Society is pushing ahead. Excerpts:
Bihar is reported to be very high on the list of AIDS affected states in India. What is the total number of AIDS patients in the state? As of June 30, this year, the total number of AIDS patients in the state is 19,364, which is over 27 per cent of the total number of patients in the country. In fact, it is important to note that Bihar has the highest number of migrant labour in the country and most of them—the men folk usually live alone, away from their wives. Unsafe sex by these migrants is a prime reason for the high rate of HIV infection in the state.
Besides, three important highways-the East West Corridor, the Golden Quadrangle and the Grand Trunk (GT) Road-passes through the state, make it an unsafe sex zone.
Surveys reveal that the area around the three major check posts on these highways have a large number of hotels and dhabas and a high concentration of sex workers. Truck drivers passing through Tamkohi at Gopalgunj and Mohania sub division (Bihar-UP border) and Rajouli in Nawada district on Bihar-Jharkhand border have often been found to be indulging in unsafe sex in these bordering areas.
Given the severity of the problem, how does Bihar State AIDS Control Society planning to handle the situation? We are attempting to arrest the situation through a series of initiatives. While the Society has set up 207 Integrated Counseling and Testing Centres (ICTC), we have also set up AIDS treatment centres and the state government is actively considering bringing in a regulation to make blood banks safer in Bihar.
The Society is also engaging the non government organisations (NGOs) for spreading awareness and free distribution of condoms in the high risk areas. In fact, there are two components of any programme for AIDS control-one, creating awareness, and second, physical safety against the HIV virus by way of use of condoms and blood testing.
So far as running social awareness is concerned, we have about 50 NGOs working in this field. Our technical support unit is further evaluating over 430 NGOs for the various programmes.
Where are these ICTCs and AIDS treatment centres located and who is responsible for managing them? As I said earlier, presently we have 207 ICTCs across the state, of which some of them are functioning from the PHCs and some important hospitals and medical colleges. However, all Sadar hospitals in the state have these counseling and testing centres.
Each of these counseling and testing centres have one AIDS counselor and we soon plan to provide them with materials like DVDs, TVs, and other advertisement materials to assist them in counseling and creating awareness through use of audio-visual tools. We are also planning to appoint more counselors to cover the so far left out areas soon.
What about the AIDS treatment centres? Yes, presently we have four such centres at the medical colleges in Patna, Bhagalpur, Darbhanga and Muzaffarpur. These centers provide anti-retro viral drugs. We are also going to establish 11 link AIDS Rural Treatment (ART) centres to facilitate treatment of HIV+ patients in the remote areas.
You also mentioned that the state government was working towards bringing in a regulation for providing safe blood transfusion. What steps are you taking to make blood transfusion safer in Bihar? Blood transfusion and syringe injection are two of the major factors of HIV infections. Presently we do not have any legislation to regulate blood banks and blood transfusion in the state. Although, the Government of Bihar has issued instructions and directions in this regard, but in absence of a legislation, sometimes the wrongdoers escape unscathed. We are, therefore, going to come out with a comprehensive legislation in this matter. A proposal on this will be sent to the government shortly.
The proposed legislation will have provisions to check and monitor blood banks on a regular basis. Stringent punishments would be proposed for violators. Habitual and commercial donors pose serious threats of spreading infection; therefore, steps would also be taken to tackle the problem.
Good quality blood for remote areas is another big challenge. How do you propose to handle this issue? We are going to set up 78 new Blood Storage Units, which would be located in all Sadar hospitals and in some PHCs. This will help a great extent in making safe blood available for the patients in far flung and rural areas.
Free distribution of condom has been a key component of all AIDS campaign across India. Has it really helped? It is true that the condoms are the cheapest and the safest way of protection against HIV. Right now condoms are available with every counseling center, PHCs, health sub-centres, medical colleges and other important medical hospitals free of cost. We are also planning to distribute it through PDS shops, Aanganwadi centres and liquor shops.
As you know that it is the female who is in-charge of Aangnawadi centre and hence with the help this system we can reach out to females in each and every village of the state. Liquor shops are the next target. We are going to take up this matter with the excise department. The idea is to give a pack of condom free with every one bottle of liquor purchased.
How do you propose to involve other government departments in these initiatives for adopting an integrated approach towards handling this problem? We are planning to integrate other government departments by way of mainstreaming units. We have held discussions with Railways, departments of Tourism, Rural Development, Urban Development, Panchayati Raj and ICDS (Social Welfare).
Railways have agreed on principle to have catchy AIDS awareness advertisement lines printed at the back of tickets. They have also given their nod to open ICTC at railways hospitals. We have also got some good response from the Tourism Department that has agreed to place advertisement materials at the booking counters of all hotels and few punching lines on the visiting cards.
Training of all Aanganwadi sewikas and sahaikas would be done by dept of ICDS for HIV awareness and condom distribution.