Impending AIDS epidemic in Kashmir
Conflict-ridden Indian state of Jammu and Kashmir has another worry now. The state that was until recently largely free of HIV/AIDS is now facing the danger of an outbreak. Illiteracy in the conservative Muslim state remains a challenge in tackling the disease.
Srinagar: Experts have warned of impending 'AIDS epidemic' in the conflict-hit state of Jammu and Kashmir if the killer virus goes unchecked.
It's feared that 40,000 people would be infected with HIV/AIDS in next two years, while the disease is likely to kill 20,000 people in the state by the end of 2015, according to the National AIDS Control Organisation (NACO).
- Dr Mushtaq Siddiqi / Photo credit: Showkat A Motta / OWSA
AIDS was until recently unknown to conservative Muslim-majority Kashmir. But there've been 78 AIDS deaths since 2000 and the number of HIV positive cases is believed to be around 1,600. This is against only two cases of HIV positive reported in 1999.
Since 1997, when anti-retro viral treatment was launched in the Sher-e-Kashmir Institute of Medical Sciences (SKIMS) in Srinagar, the state's summer capital, 193 patients have tested positive for HIV virus. Of them, 85 cases have been detected only this year — an increase of 50% compared to last year. Most of the HIV infected people are in the age group of 15-45, with 65% of them urban males.
But it's presumed the death toll and the number of HIV infected is much higher, given that Kashmiris have, like many other Muslim societies, reservations about discussing the AIDS and reluctance to admit it.
"I would say the number could be much more," Dr Mushtaq Siddiqi, who heads the Immunology Department at SKIMS, said, adding that many patients don't report to hospitals fearing stigma.
"Though 193 is not a big number as compared to 2.5 million HIV positive patients found in India," said Dr Siddiqi, "the existence of the virus indicates that we're no more immune from it."
Jammu and Kashmir had been the only Indian state where HIV virus had failed largely to make inroads. But the presence of around half-a-million soldiers, thousands of migrant labourers, heavy tourist influx in recent years and the concentration of truckers has broken its envied status.
In fact, FXB International, French NGO, conducted a survey a few years ago revealing that nearly 85 HIV/AIDS infected people had died in Jammu's Hindu-dominated Hiranagar district, hence challenging the figures of state-run Jammu and Kashmir State AIDS Prevention Control Society (JKSAPCS).
Over the years, majority of the cases detected in the SKIMS and other hospitals were from India's paramilitary Border Security Force and Central Reserve Police Force—Army has been of late organising workshops on HIV/AIDS for its soldiers and their families.
Dr Siddiqi recalled how a man from frontier town of Uri in north Kashmir contracted the virus after he had sex with an infected woman. It was alleged that a soldier was responsible for passing on the virus to her.
Another Kashmiri villager, it's said, contracted the disease at a local chemist shop where he got injected with a syringe that had been used on some soldiers.
"Only last month a man died in the Valley taking the AIDS toll to eight this year," Dr Siddiqi informed.
Following the Ugandan model
JKSAPCS officials, on the other hand, draw comfort from the fact that they've been successful in bringing down infections among high-risk groups following adoption of a Ugandan model in their fight against HIV.
Since 2006, when the model known as "ABC" — Abstinence, Be faithful and Condom use — was introduced in Kashmir, the JKSAPCS has trained about 900 Muslim imams in their AIDS fight. The imams sermon against fornication in the light of Islamic teachings.
After the success of the African programme — there's been a drop of 0.3 percent in HIV/AIDS prevalence in 2008 from 1.5 percent in 2003—JKSAPCS intends to engage priests of other faiths to spread the anti-AIDS message.
"The Ugandan programme has paid dividends; it's one of the few national missions to have been efficiently used against the spread of the disease," said Dr M.A. Wani, project director JKSAPCS.
Dr Wani, whose department is funded by the NACO and World Bank, however, acknowledged that NACO's projected figures about Kashmir could come true "if we do nothing to thwart the advances of the disease."
He attributed illiteracy, among other factors, to the prevalence of AIDS in the state. "With only 56% literacy," he said, "it's really difficult to spread awareness about the disease."
Also, the NACO guidelines do not provide costing and implementation of the Targeted Intervention programme for migrant labourers that is the second highest risk group after soldiers in the state.
Moreover, there're only seven hospitals — five in Srinagar and two in the winter capital Jammu — that house the facility for blood testing for HIV, leaving the villages, where majority of the population lives, unsafe.
Thankfully however some NGOs like India's Tribal Research and Cultural Foundation (TRCF) have come forward to create AIDS awareness among the large Gujjar population of the state. The TRCF uses Gujjar folk poetry and music to spread its message.
"We've also planned to rope in Gujjar doctors for the programme as the tribal population is usually shy in front of non-tribals," said Javed Rahi, secretary of the TRCF.
"Despite all these constraints, over 70,000 people have voluntarily tested against AIDS across the state," added Dr Wani.
