Monday, August 28, 2006

To hell and back… most of the time

Permission to reproduce this article has to be obtained from Hindustan Times

The Kripa Foundation has been trying to save those on chemical dependency and the AIDS afflicted for the past twenty-five years. Thankfully, the good news outweighs the bad

Shevlin Sebastian
Mumbai

His body is still and his face is turned sideways on the pillow. It is the eyes that are the most arresting feature: it has a far-away look; a touch of serenity mixed with fear. Rajan Athavankar is receiving treatment at the AIDS centre of Kripa Foundation at Papdy, Vasai. “Athavankar is at a terminal stage,” says Dr Hitendra Desai. “His body has become a vegetable. I am sorry to say the virus has reached the brain.”
Is he aware of us, I ask.
Desai leans forward and asks, “Do you know where you are? Do you recognise me? Shake your head if you can understand!”
But the head is immobile and the eyes continue to stare unblinkingly into the distance. “I don’t think he is aware at all.”
Suddenly, we hear the sound of weeping. A woman, dressed in a yellow polyester saree, and wearing a red bindi, has come silently into the room. It is Athavankar’s wife, Meera.
She looks at me, and assuming I am a consultant physician, asks, “Will my husband live?”
I don’t know what to reply. I look to Desai for help and he tells her I have come on some other work.
Athavankar, 56, used to work as a clerk in an office and contracted Aids through having multiple partners. But he does not look the adventurous type at all. “Promiscuity has definitely gone up in the lower classes,” says Purvi Shah, project director, Kripa Foundation. “They don’t have many modes of entertainment, hence, they tend to indulge in risky behaviour. Most of them don’t like to use condoms.”
Meera, 51, thankfully, is HIV negative. “She is not aware of his past,” says Desai. “In fact, she has a lot of faith in him.” The couple have three children, two boys and a girl, with the eldest, a son, being 30 years old. Being of the lower middle class, the free treatment at Kripa has come as a boon.

Sustained dedication
The Kripa Foundation celebrated its silver jubilee on August 15. It was started by yoga expert Fr Joe Pereira in a small room in the Mt. Carmel church compound in Bandra. Today, there are 46 facilities in 12 locations in India and is the largest NGO in the ministry of social justice and empowerment.
Initially, the focus was on chemical dependency but, three years ago, AIDS centres have also been opened. In Vasai, there are two wings. One is for the Aids afflicted and the other is for chemical dependency. There are two dormitories and single rooms for those who are willing to pay a daily rent. At the back, there are spacious canteens for patients and the staff alike. And right behind, in the large courtyard, are a group of ducks quacking away, untroubled by the tragedies of human life unfolding a few yards away.

Here is a story of a troubled human life. “There was a 22-year old Aids patient, Rahul Gupa, who was in a bad condition,” says Bosco D’Souza, Western region programme director of Kripa. “The doctors were pumping blood into him while he was bleeding from the rectum. His mother, Geeta, was present and Rahul was abusing her. He was angry at the declining state of his health. When Geeta tried to feed him an egg, Rahul spat it back. “When I walked into the ward and saw this, I told him, ‘What you are doing is wrong,’” says D’Souza. “I know you are in severe pain but you are not in a hospital or a jail, you are in God’s home.’”
The next day when Bosco went to see Rahul, he was reciting shlokas from the Bhagwad Gita. Then he asked his mother to put a tikka on his forehead. And he was continuously praying. “I told Rahul I was going for lunch to a Chinese restaurant,” says Bosco. “And he told me, ‘Tata,’ and then said, ‘Bata, Kata, Lata’, he was rhyming with the words and was smiling. I went out and within five minutes, I got a call on the mobile from the resident doctor who told me Rahul had died. By the grace of God, he had died smiling.”

Death comes suddenly and without warning for those who have Aids. But the good news is that out of 817 patients treated at Kripa, only 30 patients have died. “The antiretroviral drugs are making a big difference,” says Dr Joseph Chettiar of the HIV unit. “We are increasing the lifespan by 10 to 15 years although there is no cure yet for the disease.” Joseph is worried that, despite increased awareness, India, with 5.8 million people, has the highest number of Aids victims in the world.
In Vasai, all the counsellors are former drug addicts or alcoholics or Aids afflicted. One of them is Rajan Welingkar, 43, a former drug addict, who is HIV positive. “There is a relation between addiction and HIV,” he says. “Once you are high, you have little control of your mind and you tend to have multiple partners and refuse to use condoms.” He says that because the counsellors have gone to hell and back, “we serve as an inspiration to all those who are trying to overcome Aids and addiction. They feel that if we can survive with dignity, they can.”

When life goes askew
On another day, I go across to the Bandra unit of Kripa and meet Peter Rajappa, 20. He is a tall, slim man with yellowing teeth and a wisp of a moustache. He has been a drug addict from the age of 13. His father was an alcoholic and there were constant fights in the house. Feeling disturbed, he took to drugs. “I felt an anger towards my father, that was why I wanted to rebel,” he says. He studied till Class 7 before opting out. For the next seven years he went from bad to worse. He begged on the streets, he stole and he also became a pickpocket. Curious, I ask him the modus operandi of the pickpocket.
He tells me to stand up. Then he stands behind me, and tells me to lift up my right hand, as if to hold the bar in a suburban train. “Now,” he says, “pretend the station is approaching and the driver has applied the brakes.” As I do so, I instinctively move forward and, in that instant, with his fore and middle fingers, he nimbly flicks the wallet from my back pocket. “That’s how I stole money and fuelled my drug habit,” he says. He would get caught and be hit by angry passengers but that was all part of the risk. He tried a few jobs but could not hold on to them. “The addict cannot think of anything else except when he is going to get the next dose,” he says. “By the time I was 20, I was tired of taking drugs. I felt hopeless. I hated myself. I used to think, ‘What am I doing?’ My friends, who were addicts, had gone to jail. Some had died because of an overdose while others had committed suicide. I told my mother I was fed up of my life. I wanted to die. I was becoming mad. I feared that I would end up in jail or a mental institution.”
In the end, his mother came across the Kripa Foundation and he was enrolled in May and has been free of drugs for the first time in several years. But the road ahead is rocky. “A lot of the patients relapse,” says counsellor Steven Monteiro. “But Royappa is doing well. I am optimistic. But, essentially, you are a drug addict for life. You have to live one day at a time.”
(Names of patients have been changed)


Interview/ Fr Joe Pereria, Director, Kripa Foundation

‘A condom is not quite safe’


Where do you get your funding from?

The major portion of the funding comes from benefactors in Europe and America, even from NRIs. I go to North America in the fall and Europe in the summer and I teach B.K.S. Iyengar’s brand of yoga. My teaching fees are very high.
How have things changed over the years?
The change has occurred in the different types of addiction. Earlier, it was heroin, now, it is alcohol and prescription drugs like amphetamines. Street children and those in the slums drink cough syrups or whiteners. It is not as strong as major drugs but you get a high and it is cheaper.
What are the treatments that are being offered these days?
Our treatment is a combination of the West and the East. The West brought in the 12 step programme of Alcoholics and Narcotics Anonymous. But I have included the teaching of B.K.S. Iyengar’s on yoga. Which is loving the body back to light. We need to do a lot of asanas and breathing lessons. One should silence the noise in the head and get in touch with the here and the now.
What is the Aids situation in India?
There is a lot of awareness of the disease in certain pockets of India. But the illiterate and the migrant population are the worst affected. Condoms are not working. The ABC formula has to be followed. A stands for abstinence. If you are single, you should abstain from sex. B means to be faithful. If you are involved, be faithful to one. If you are unmarried, be faithful to your partner. In other words, don’t mess around sexually. People are going for parties and are sleeping around. One girl gets the virus and she spreads it around. C: Use a condom. The truth is that the condom is not quite safe. It tears sometimes and that can be dangerous.
What is the recovery rate?
All around the world, it is 2 per cent. In Kripa, it is 68 per cent in the first year. By the time it goes to the fifth year, it goes down to 18%.

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