Friday, July 14, 2006

The Middle Path

During my medicine posting in my internship training program, I was posted in an exclusive HIV unit. Almost all the patients admitted in the unit were in various stages of the disease resulting from HIV infection.A very scary experience indeed . Being a doctor , I know that touching these patients wont give me the disease , but I also know what a tiny error in judgment while collecting blood or inserting an intravenous line or handling these patients' samples , can do .I mean , there were times when I'd see these patients and then try to think , how would I react to being told that I have this disease that is definitely going to kill me and that I will live for only a few years from now , and the number of years , too can be anything from three yrs to 8-10 yrs.
The number of HIV positive patients in Mumbai is mind numbingly high. Tuesdays (new cases) and Thursdays (follow up) are the HIV OPD days in KEM Hospital. Each Tuesday meant at least 100 new cases in KEM alone.
Consider this scenario : A person hailing from UP (or usually Bihar/TN/Kar) , leaving behind his wife in his native place , comes to Mumbai ,in search of a job.. . . lands up with a menial job as a taxi driver or something even less satisfying - financially . During his long lonesome stay in Mumbai , he succumbs eventually to temptation and visits a CSW (commercial sex worker/prostitute) , gets infected with the virus ; months later gets his wife and kid back here , obviously , his wife , in due course gets infected and then they have a child . The child unfortunately is then HIV positive, with of course, an HIV –ve sibling, who will be left all alone in a few years' time.
The surprising thing about this scenario is the consistency with which it presents itself again and again and again . . .I , personally , in my short stint , have seen at least 25 such patients.
And I thought I had seen it all, until I saw this: Champa, Kanaiamma, Rosy – three HIV +ve hijdas in the OPD.
Hijdas are such a mystery. Now I have had these Q&A sessions with all my non medical friends, when we all are having a night out or something like that, where everybody clarifies their myths they have heard and believed in. Sex related queries, weird medical questions ….the works. And believe me; this issue on Hijdas has come up very often. What is a hijda?

I have friends, who are mortally scared of Hijdas. Many of my friends duck inside the car when they see Hijdas on the road (this group includes fully grown men too!). Puzzlingly, effeminate men or ' baylyas*' are ridiculed by being called 'chakka' or 'hijda', but, surprisingly, every hijda that I or my friends have seen or met has always, unfailingly, been more masculine than all my friends and me put together with their thick baritone voice that's high on bass, along with their, incredibly and amazingly loud clap (which comes out loud in the first attempt!) – "Aye Raju". Add to this , a healthy dose of being felt all over by them - and who wouldn't give money to not be subjected to that. I have also been at the receiving end of some rather nauseous, vulgar and stunningly quick, obscene visuals; which of course make the hijda community, collectively, even more repulsive.
The fact, however is that these Hijdas have successfully managed to only isolate them further. These Hijdas are basically either castrated men or hermaphrodites (born with genitilia of both sexes) or just plain men masquerading as Hijdas. They are shunned from society, regarded as the third sex and are given no social rights what so ever. The result being, they have to resort to obnoxious behaviour so that a fear psychosis is built in the minds of the people who then are vulnerable to demands for money at traffic signals, weddings, child births, etc.
But the most disturbing aspect is their disturbing and promiscuous sexual behaviour.
Hijdas work as CSWs .Yes, prostitutes. And obviously the question to ask is who 'does' them?
Well, a lot of people. Hijdas prefer to be passive partners in any form of sexual contact with men, i.e., they are always at the receiving end, literally and figuratively.
So here are these Hijdas who presented with HIV related symptoms, and were clinically investigated and revealed to have HIV infection. They come to the HIV OPD at KEM Hospital.
Now the governments of Maharashtra and India have done this fantastic job of setting up ART (anti retroviral therapy) cells in main hospitals , which provide anti HIV drugs at a massively subsidized rate of about Rs 1200-1300 per month versus Rs 4000-6000 if taken over the counter. This as a one time expense is affordable , but as a life long recurring expense , it is quite a tough ask.
Well , what about loans ? Most Hijdas are unregistered individuals – with no proof of residence , nationality , ration card , driver's license, election card and passport ; they simply don't exist for the government . And the question of actually paying this large sum , every month, for as long as they might live , only for medicines is a tough one to answer given the means this money is earned. Hospitalisation can further complicate issues...
So, sadly, the Hijdas return to their homes, now diagnosed as HIV +ve, resigned to their fate.
These Hijdas however exhibit great understanding of the situation and refrain from any sexual activity, once diagnosed as sero positive.
Where does this leave them?
What is the government doing for them, who are as much a citizen of this country as you or me? Rehabilitation ? Loans ? Insurance ? Apart from the rare headline grabbing event of a eunuch being elected to the local government body somewhere in the interiors of India, absolutely nothing….
At least the next 'aye raju' you hear, evokes not just fear, but also some sympathy

Wednesday, July 12, 2006

Mumbai - resilient or indifferent ?

Yesterday was a sickening day . Sickening just doesnt sum it up .I was at my old house at about 6:45 pm when Parag called me up to ask if I had heard of any bombs going off anywhere , I said I had no idea since i didnt have a TV there and that I was going home , so I'd check it there and call him back in a few minutes.He , uncharacteristically and abruptly, hung up.It struck me a few minutes later that i could probably check online on some news site if what he said was actually true, and lo - the first headline on said "Bomb Blast at Khar Road Stn."
I tried calling Parag , and after about twenty futile attempts to get through , I gave up.I left for home and what I saw on TV shocked the devil out of me !
7 bomb blast.
0ver 150 killed
over 700 injured
My first reaction was of denial and then I was just shocked....Shocked , numbed and unable to react to the visuals the news channels kept throwing .
Bodies being strewn , blood splattered train compartment, limbs , torsos lying around.
Panic .Fear . Phone lines jammed(It now dawned on me why Parag had 'hung' up).Helplessness.
You couldnt help but feel for the weary traveller returning home after a tiring day in his/her usual 6:15 Borivili fast , and was jolted , out of the blue ; of all the unexpected things, a bomb! And now not being able to tell people at home that he or she is safe.
What about those who died ?
I tried calling everybody I knew who lived on the Western Line. After innumerable attempts , I managed to trace the few people i knew on the Western line, and thankfully , they were all safe.
And then , the tales of common people going out of their way to help people stranded , injured. . . .
One such tale :
Written by an acquaintance of mine , sent to me by Narsi:
"....."STUNNED" - Mumbai Mirror."7 BLASTS ROCK MUMBAI"- yahoo headlines.Which editor wrote these lines? Which fool had the guts to talk about my mother land, MY CITY being stunned!!! I was there. I was on the train, in the hospital and on the streets and I didn't see Stunned. I saw Stunning...stunning acts of kindness. And nothing rocked Mumbai. No self respecting Mumbaikar can believe that. No. Its not 'blasts rock Mumbai' because Mumbai rocked, man. She simply ROCKED.Here is my story.For those who came in late...I have started working in a tutoring firm at Andheri. So it's the night shift for me since the students are based in the States. So there I was standing at Dadar station. Waiting for the Borivili fast. She came bang on time. After the normal physical exercise routine (in other cities they call this 'boarding a train'...we Mumbaikars know better:) I got in. The train started.
Next stop Bandra...Lots of people got in...some tried to get out. After the usual round of expletives, shouting and 'chod do na yaar...are maramari mat karo' (forget about it, man...don't fight guys) the train started.BOOM!
My first impression was that the over head wire that supplies current to the train's engine had snapped. There had been a flash like a yellow light and then the lights went out. People started panicking. I don't know why but at such times I have the tendency to restore calm....a very close friend had once called this habit...tere mein kida kam nahi hain..(can't translate this one)
Anways, I roared out that people should calm down. Miraculously, they did. Someone asked for the chain to be pulled but by then the motorman had pushed the breaks. I jumped out of the train like the rest of the commuters and saw that the first class compartment ahead of us had blown up.
I moved towards the compartment. People had already started pulling others out. Lots of guys had climbed the harbour line bridge that starts near Bandra station. Slowly, the injured started emerging. The first guy whose hand I held was merely stunned. He didn't have any money left...his wallet was gone I think. I gave him twenty bucks and he went his way. As I turned towards the train, I saw a guy with lots of blood on his face...thankfully none of it was his.

He had temporarily lost his sense of hearing. Walked with him for a distance. Bandra station was a stone's throw away from the blown-up compartment. He recovered soon and some one took him to the station. I turned and saw four guys carrying a fifth. The injured man was alive but i think, his hand would have to be amputated. A big guy was holding the patient's right shoulder and was shouting for some one to steady the man's head ,which had no support. With nothing else to do, I stepped in.We took him to Bhaba hospital, Bandra. While the journey up till the auto rickshaw was tough ,the journey till the hospital was an eye opener.
Carrying a 90 kilo man over the railway tracks, then over a 2 foot incline near the tracks, then over a railing and through the jam caused by the numerous autos which were ferrying patients to the hospital was tough even when four of us were carrying him. We reached the main road outside the station and got into the auto. The big saand (strong-guy) who had earlier called me for help, literally dragged a fellow who had hired the auto out and we got ourselves in. The big guy was sitting with the auto driver and I along with two others was holding the injured man on our laps.
Then the most beautiful thing happened. The guy to my right told the one to my left to start reciting verses from the Koran and to blow on the man's head. I think it is some Muslim prayer. The big guy said,"Oh lord! Have Mercy on this man!". A few minutes later that injured man who was half awake all this time started saying "Shiv shiv namah shivay namah shivay."
When I think back about that moment I smile to myself. We six of us in that small auto heading towards the hospital had done it. We had defeated the terrorists. Who can say we were stunned...we won guys. We won. We defeated the terrorists' plan by that simple act of helping a fellow INDIAN. We didn't have to invade Pakistan or kill Muslims. We had won. Of course we could have lost if the 2 muslims had walked away from the man knowing that he was Hindu but they didn't. They continued working with me at the hospital for nearly an hour transporting bodies to the morgue, taking patients to the upper floors and providing a little water to the other impromptu volunteers. Going towards the office after all this was over, was probably the stupidest thing I ever did but that gave me the chance to see the City become one. Guys in designer tees, shorts etc. were flooding out of their houses with water bottles. The rick I used was stopped in 4 places...two places for others to get in ( the driver lied saying we were going to Parel.) and at two others, hands full of Parle-G biscuits were thrust in so that we and the thousands of others like us who had been affected by the Western railway system being shut down could have something to eat. The over crowded buses were being given food and water at some signals with people throwing biscuit packets into the bus...even good old Bourbon biscuit...yummy:):):)

All in all a lot happened yesterday but my city didn't budge. We have been hit before, we have been hit yesterday and we will continue to get attacked. The only thing to do is to come together. Together as One. For that is what the terrorists don't want to see. They don't realise that the more they attack us, the closer we become. We cant let ourselves go down so we can't give up.You may think what I did was pretty was may be...but I like so many others wouldn't like to be called heroes. It feels very uncomfortable. If you want to give us a name just call us Mumbaikars. That name is all-inclusive...

I was moist eyed by the time I finished reading this . Cynics , pessimists call Mumbai insensitive , indifferent and what not. But there is no denying that , even though i know , it sounds cliched , and i care a damn that it does , "the spirit of Mumbai just doesnt die . . ."
My gratitude to the thousands who carried the dead and the injured ;
to the thousands who poured on the streets and gave food and water to the stranded
; to the thousands who lined up the hospitals volunteering to donate blood ;
to the incredible never say die attitude of the doctors in the Municipal hospitals (at one point in the night at KEM's ESR -emerg surg room , had more doctors than patients - they couldve handled a war , forget these blasts ;
to the thousands of Ishan Bholes.
Salaam Mumbai .
Jai Hind , Jai Maharashtra.

© 2006 .No part of this article may be reproduced or quoted without the expressed permission of Akshay Gopinathan Nair .