by Jane Shulman

Poverty, poor access to health care and a reluctance to talk about safer sex practices have combined to make India home to about 10 per cent of the global AIDS population.

Dr. Mandeep Dhaliwal, an international public health expert, described the scope of the problem in the first of this season’s AIDS/HIV lecture series on October 12. Originally from Montreal, she did public health and human rights work in India for six years. She is now based in London.

In her lecture, Dhaliwal explained that in a country as big and as poor as India, AIDS has the perfect breeding ground. India is an example of the devastating effects AIDS has in less privileged countries, where 95 per cent of people with AIDS live.

Citing World Health Organization statistics, Dhaliwal said 60,000 people around the world are infected with HIV every minute. In India, where between 3 and 5 million people have the disease, Dhaliwal said that reducing the rate of infection is making slow progress. Most people at risk of contracting the disease can’t do anything about it. Better access to condoms isn’t the answer, Dhaliwal said. The problems are embedded in the cultural and legal structures.

By telling the stories of several people she has encountered through her work, Dhaliwal showed how AIDS has been pushed underground. In her country, marriage is mandatory and people can’t question their partners about their sexual practices.

“Marriage is an excuse to have sex,” Dhaliwal explained. Women are pushed into marriages and they are not allowed to refuse sex. “That’s grounds for divorce.” For 70 per cent of Indian women who have the disease, marriage was their only risk factor.

Once people are diagnosed with the disease, they are swept into an “overburdened, underdeveloped, under-funded health system.” During her fieldwork, she observed that most people don’t have health insurance, and public hospitals are not equipped to deal with AIDS patients. Universal safety precautions are rarely used, as most doctors don’t even have rubber gloves. Doctors are desperately afraid to treat AIDS patients, knowing that if they are infected, they will be shunned, too. As a result, some doctors refuse to treat anyone who looks like they may have AIDS.

Dhaliwal explained that the government had long refused to talk publicly about the toll AIDS was taking on India. She said that the first speech by the prime minister about AIDS was in 1998, almost 20 years into the epidemic. Government silence and long-standing legal policy stigmatized AIDS and drove it underground, where it has torn through impoverished, marginalized populations.

Towards the end of her talk, Dhaliwal strayed from her prepared speech to express her disgust at the Canadian government’s recent proposal to test all prospective immigrants for HIV before allowing them into the country.

She deplored this kind of discriminatory policy from a country that is a leader in medical research and progressive international initiatives. “Policies and practices must be based on good science, sound public health rationale and the observation of human rights,” she said. Dhaliwal asked Canadians to protest the proposed policy by writing to Federal Immigration Minister Elinor Caplan..