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 seasons 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 cant do anything about it. Better access to condoms
isnt 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 cant 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. Thats
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 dont have health insurance, and public
hospitals are not equipped to deal with AIDS patients. Universal safety
precautions are rarely used, as most doctors dont 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,
Towards the end of her talk, Dhaliwal strayed from her prepared speech
to express her disgust at the Canadian governments recent proposal
to test all prospective immigrants for HIV before allowing them into the
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..