AIDS Case Brands Indian Village

What the villagers of Chochi know about AIDS, they learned in fear and humiliation.

And the lesson, village headman Azar Singh says, is simple: “It’s a very dangerous disease--and it’s a shameful disease.”

There is not one telephone in all of Chochi, and the trip west from New Delhi, though only about 40 miles, takes two hours along narrow, rutted roads.

But when a bus driver from Chochi reportedly died of AIDS earlier this year, the obscure village of 5,000 people was suddenly thrust into a harsh national spotlight, raising questions about how the government deals with AIDS patients and educates people about the deadly disease.

Experts say HIV infections are rising alarmingly in South Asia, and Indian officials fear AIDS will have a devastating effect on the desperately poor nation of nearly 1 billion people. An estimated 2.5 million Indians have been infected with the AIDS virus, the World Health Organization says.

But educational campaigns to combat ignorance about AIDS are limited, and there are few counseling centers even in cities, let alone rural areas--problems that became apparent in the case of Ranbir Singh.

Singh, who drove a bus in New Delhi to supplement the farming income of his family in Chochi, had been losing weight and strength for weeks when he finally went to the public hospital near his village last spring.

Doctors held him overnight for tests, then discharged him after telling him he had tested positive for HIV and advising him to go to the main public hospital in New Delhi. Singh, who was not related to his village headman, Azar Singh, died two days later.

A few weeks later, a local newspaper, quoting district health officials, reported that not only did Singh die of AIDS, but that he had been receiving injections of bogus medicine from a village healer who may have passed the virus to dozens of Chochi residents with reused needles.

Within days, the village headman recalled, a team from the district hospital descended on Chochi, going door to door with flip charts explaining how AIDS is spread and advising everyone to be tested.

Reporters from New Delhi’s national newspapers came next, followed by television cameras. Chochi was suddenly a pariah.

Gyanendra Singh, a Chochi native who works as a technician at a pharmaceutical plant in Chandigarh, a city 120 miles away, said co-workers who knew his hometown suddenly stopped chatting with him.

“As soon as they read the newspapers, everyone was sure each and every house in Chochi had AIDS,” he said during a recent visit home.

Chochi blamed the outsiders and demanded the hospital withdraw its team of AIDS educators.

“Our honor was at stake. We didn’t need information,” Azar Singh said. As the headman spoke at his home, four villagers sat behind him on a string cot, interjecting supportive hums every sentence or so.

Renuka Chowdhury, India’s health minister, said the district hospital should not have discharged Ranbir Singh without doing more tests. And if they confirmed the initial diagnosis, they should have counseled him about the implications of being HIV positive, she said.

Chowdhury also said that officials should not have released Singh’s name to reporters and that Chochi residents should have been dealt with more sensitively.

She said India’s AIDS campaign, financed by a five-year, $84-million World Bank grant that runs out this year, needs more of everything.

New Delhi, the national capital with an estimated 12 million residents, has only four AIDS counseling centers. Most rural areas have none.

Educational programs using posters, skits and radio and TV ads have to be increased to reach isolated pockets like Chochi and should focus as much on living with AIDS as avoiding it, Chowdhury said.

“Every era has seen a disease that isolated and stigmatized,” she said. “One day, society will treat people with AIDS just like people with TB. They won’t be shunned.”

Purushothaman Mulloli, a social worker from New Delhi who has virtually adopted Chochi, said India’s AIDS system is flawed. Education focuses too much on high-risk groups like intravenous drug users and prostitutes, giving other Indians the impression they need not worry about AIDS, he said.

Chowdhury agreed. “AIDS has permeated all sectors of society . . . and that is because we went into denial. Now we are informing everyone.”

But Chochi residents are no longer listening. When they do speak to reporters now, it is to deny that Ranbir Singh, or anyone in Chochi, had AIDS.

His widow, Kaushalya, will say little more than “it’s a lie” when asked about what has happened to her family and her village. His father, Mange Ram, insists his son died of tuberculosis and worries he’ll never be able to find husbands for his three young granddaughters.

“We still feel ashamed of this whole episode,” Azar Singh, the headman, said. “That is the outcome, nothing more than that. Our village has been branded.”