Healthcare students fight AIDS/HIV in India
Ajay Bijoor, WG'06
Issue date: 2/14/05 Section: News
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Every afternoon we found ourselves singing this theme song (to the tune of Biggie's - We Goin Back to Cali) traveling back to our home base in Kakinada. Kakinada is a port city on the Bay of Bengal in the Southern Indian state of Andhra Pradesh. Our team was on a mission to help fight the HIV/AIDS epidemic in a highly afflicted area of India.
The team (consisting of Professor Steve Sammut, Vijay Shreedhar, Felix Tollinche, Jay Komarneni, Terry White, Nikhil Lalwani and Ajay Bijoor) made the trip to India as part of the Wharton Healthcare International Volunteer Project (WHIVP), a non-profit, student-run program with a mission to help improve health care services in developing nations around the world. Founded over a decade ago, WHIVP has a history of successes in South America and Africa, having most recently completed a project in Cape Town, South Africa this past summer. Under the sponsorship of Nobel Laureate Archbishop Desmond Tutu, WHIVP helped improve Cape Town's health infrastructure in its battle against HIV/AIDS.
This is the first year that WHIVP expanded its reach into India. Our group, made up of Health Care Management majors, initiated the project by collaborating with the Bill and Melinda Gates Foundation (BMGF), which has already pledged $200 million over a 5-year period for HIV/AIDS prevention initiatives in India.
Why India? Today, India is home to the second largest population of HIV+ patients, and this number is projected to grow astronomically if tough and creative prevention methods are not rapidly put into place. With this knowledge, the Indian government, along with private sector and non-governmental organizations such as the BMGF, is literally waging war on the disease.
The Wharton team performed an epidemiologic profile of the district of East Godavari for Andhra Pradesh State AIDS Control Society (APSACS). This included compiling demographic and clinical data: age, gender, level of education, occupation, marital status, reported risk behavior, and other characteristics. While APSACS has data on tested patients, they have limited resources available to analyze the data and to make prevention recommendations at the district level. The WHIVP team worked to analyze this data and made a series of recommendations to APSACS to help focus their education and prevention initiatives.
Coming to India
We arrived in Hyderabad tired from our 40+ hour commute from JFK airport. Felix and Nikhil had arrived in India the prior week to meet with APSACS and scope out the parameters of our project.
The evening I arrived, we set off for Kakinada. Luckily, Nikhil had organized tickets for us on a deluxe bus service. We set off on rickshaws (three wheeler vehicles that run about as fast as a riding lawn mower) for the bus station. We soon discovered that Nikhil did not get us the tickets on the deluxe bus... we were booked on a chicken bus, with chickens in cages stocked in the overhead compartments. The 12-hour overnight ride was so bumpy and disturbing that we didn't even realize that we were driving through the Earthquake that shook Southeast Asia.
Glorious Kakinada
Each day we woke up for breakfast at 8 am and gathered for our respective trips to each clinic. Working from 9 to 5 it was critical that we ate a large breakfast to hold us over. Surprisingly, our hotel had a wide variety of breakfast items. We chose from lentils, rice, lentils and rice, or rice and lentils.
The conditions of the first clinic we visited, Kakinada General Hospital, would never pass any U.S. level health standards. Walking up to the clinic, we saw a line of 20 people standing outside. The clinic was a small, dimly-lit room with one counselor. The counselor had to see so many patients each day that it was impossible to give an adequate amount of time to each.
It was also clear that the General Hospital was operating on a very tight budget. The restroom adjacent to the clinic had latex gloves drying in it. Providers would reuse gloves to save on expense and would clean them in the public bathroom.
Most of the clinics we visited suffered from similar conditions. Understaffed and overworked, counselors were not only responsible for documenting patient meetings, but also for analyzing their own data, with varying degrees of success.
APSACS
After two weeks of data-gathering, we had a weekend to prepare our final presentation to APSACS and BMGF. We pulled an all-nighter to create our analysis of data on approximately 7,000 patients. The Wharton team had been briefed that there would be 3 to 4 people in attendance, but on the day of the presentation there were 20 people in the audience.
Our presentation consisted of an epidemiologic profile of East Godavari and recommendations for improving the process of data collection, aggregation, and analysis. The people at APSAC seemed genuinely impressed by our recommendations and were astounded that we had completed our study in three weeks and finished what another much larger team had taken four months to do. All of the hard work - the overnight bus trips, riding five to a rickshaw (they barely fit three), fighting mosquitoes, working in dimly-lit rooms - had paid off.
Exhausted, we set off on our 40-hour trip back to JFK.