In late March 2020, the government of India ordered a nationwide lockdown to curb the spread of COVID-19. Measures taken by the government, such as a ban on public transport and authorization to travel for medical supplies, caused many challenges for people living with HIV – especially those living in the poorest areas. Eldred, Maitri and Loon share their stories on the difficulties faced by people living with HIV in accessing HIV and related services during the COVID-19 pandemic lockdown in India...
I am the Founding Director of the Sankalp Rehabilitation Trust. I started working with drug users on the streets, helping with their problems, in Mumbai over 37 years ago and then became involved with drug rehab work in the early ’80s. Now, I am actively engaged in helping our clients living with HIV, HCV and TB access the medicines they need. We also have a drop-in centre that offers opioid substitution therapy.
The lockdown in India during the COVID-19 pandemic has restrained us in many different ways. Our staff who live in far-flung suburbs are unable to get to work. We can only maintain those activities that rely on our peers on the streets and are within a walking radius of our drop-in centre. Our nurse/counsellor and an outreach worker have kept the centre running. I kept myself available by living in the office since 25 March 2020 when the lockdown started; I am able to do most jobs, including handling emergencies.
“Our street clients are at a major disadvantage: they do not have proper identification because a permanent address is a requirement for most identity documents.”
Our street clients are at a major disadvantage: they do not have proper identification because a permanent address is a requirement for most identity documents. This means that they are unable to get essentials, such as a ration card, bank account and driver’s licence. And this is why they do not qualify for much of the government relief measures in the package announced. Also, with the closure of religious places and railway stations, their ability to earn daily is ruined. We had to try to provide them with things to meet their basic needs, such as meals and soap. Sharing injecting equipment becomes the norm because we are unable to reach those who are further away from our services.
“Sharing injecting equipment becomes the norm because we are unable to reach those who are further away from our services.”
Fortunately, so far, we haven’t seen any of our clients affected by the coronavirus. However, most people who inject drugs are declined treatment because health services are overwhelmed due to the pandemic. Also, many hospitals have become “COVID-19-only” centres.
“Not many people would have believed that the lockdown would be so long and painful. It was quite a difficult time for most people. Many had no work and no savings. ”
Not many people would have believed that the lockdown would be so long and painful. It was quite a difficult time for most people. Many had no work and no savings. Also, we never thought it would extract such a big cost from our healthcare system. Many healthcare workers were directly affected and we already had a very low ratio of health workers per million people. Our clients are mostly long-term migrants who have lost ties with their families at home and have no plans to go back.
In Mumbai, the municipality seems to have done a fairly good job with the resources at hand. There have been limitations, but testing has increased all the time, even if we can’t say the same for the rest of the country.
We are also lucky that Mumbai is a city of people who always rise to the challenge at hand. We have seen it time and again, whether it be disasters like floods or a terrorist attack. The spirit of Mumbai has few parallels.