THRIKKUNNAPPUZHA GRAMA PANCHAYATH: REPLICABLE RESPONSE OF A LOCAL SELF GOVERNMENT FOR THE CARE AND SUPPORT OF THE HIV INFECTED

[BPDU]

Thrikkunnappuzha, a rural village of Alappuzha District in Kerala State has now become a replicable model for other Gramapanchayaths (Rural Self Government Agencies) in the State for providing care and support to the HIV infected without hurting their privacy or secrecy.

Providing welfare opportunity to all citizens, without any stigma or discrimination is the constitutional obligation of all local self governments in India. Hence HIV infected persons are also equally eligible to become part and parcel of all welfare initiatives of Local Self Governments(LSGs). They are also entitled to receive special attention from LSGs as in the same kind as other weaker sections of the Society benefit. However many instances of repudiation or deliberate evasion of the HIV infected have been reported from many corners of the State. Though there are several reasons for these repudiations, wrong moralistic perspective of society towards sex and sexuality play behind denial of such welfare services to the HIV infected.

Albeit there has been a major change of mindset of society to the HIV infected, self-stigma still exists in many of the infected persons. A majority of the infected persons hide their HIV status due to the fear of disgrace and abasement. It is estimated that there are a total of 55167 HIV infected persons in Kerala. However, three-fourth of them is still invisible to the public health-care system. Political leadership of many Gramapanchayaths in Kerala has shown willingness to support their HIV infected people as a result of coordinated mainstreaming efforts by the Kerala State AIDS Control Society.

Some Gramapanchayths sanctioned projects for nutrition support, education support, etc. Many such initiatives have failed, as the real beneficiaries are unwilling to reveal their status before the implementing officials owing to shame, fear of disgrace to the family and possible stigma and discrimination from the neighborhood.

Realizing the situation, Thrikkunnappuzha Gramapanchayath authority has taken necessary measures to ensure confidentiality while implementing a nutrition support programme to its HIV infected persons. The Gramapanchayath has been supporting their HIV infected inhabitants since 2007 as an impact of the ‘Thejaswini’ Programme implemented by KSACS to highlight the sufferings of HIV infected persons to the community. This year the Gramapanchayath is spending `35000 for providing nutritious food for all the eight HIV positive cases among its inhabitants. Of course, the project amount is very small but its unique implementation process ensures accessibility to all the infected without revealing their identity to anyone in the Panchayath.

The implementing officer of the ‘Nutrition Support Project for HIV Infected’ is the Medical Officer of Thrikkunnappuzha Government Homeo Hospital. The Project implementation procedure allows none of the elected Panchayath members or other officials except the implementing officer to meet or interact with the beneficiaries of the project. The Medical officer of the Hospital normally hails from other areas of the State and hence, technically none in the Panchayath are aware about the beneficiaries of the Project. It encourages the real beneficiaries to come forward and receive the benefit of the Project without the fear of revealing their identity and possible stigma and discrimination from the community.

With the support of ‘Prathyasa Kendram’, the Drop in Centre for PLHIVs implemented by KSACS and managed by the ADNP⁺ (Alappuzha District Network of People Living with HIV/AIDS), the implementing officer distributes the nutrition kits to the beneficiaries every month. Prathyasa Kendrams are the Drop-in-Centers for HIV infected persons promoted by KSACS. For convenience, the Gramapanchayath authority transferred the sanctioned project amount to the separate bank account opened by the ADNP⁺. Every month, ADNP⁺ submits the expenditure statement to the Panchayath. They never quote the name and address of the beneficiaries in any of their communication or reports to the Panchayath. Instead, they quote the ART Registration Number of the person in all its documents. The Implementing Officer verifies these registration numbers. Distributing the nutrition support outside the Gramapanchayath, and using ART registration number for documentation and communication, ensures supreme confidentiality to the beneficiaries of the programme.

If all Local Self Governments in Kerala replicate the procedure adopted by Thrikkunnappuzha Panchayath to extend care and support to their civilians, more people will come forward and receive such supports. Gradually it will pave the way for reducing both self-stigma of the HIV infected, and the stigma and discrimination of the community towards them. Such a situation will certainly reduce the invisibility of the infected from the Public Health care system. All of them will definitely come forward and register at the ART Centre for further health care. It also will contribute to the ‘halt and reverse the epidemic efforts’ of National AIDS Control Organization and its National AIDS Control Programme.

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BEST PRACTICE DOCUMENTATION UNIT
IEC DIVISION, KERALA STATE AIDS CONTROL
SOCIETY
THIRUVANANTHAPURAM, KERALA
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Management Support by:
HINDUSTAN LATEX FAMILY PLANNING PROMOTION TRUST (HLFPPT)
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[Rajeenald Tanes Das]

An wonderful gesture ... a replicable one when the people united...
Considering as the first step, the days are not too long to to realize the dream of OUR FATHER OF NATION - "sustainable village/community".