On World AIDS Day, IWB had an opportunity to interview Dr. Savita Duomai from Shalom Delhi – a non-profit organization that seeks to improve the quality of life of people with life-limiting illnesses like HIV/AIDS, cancer, neurological and organ failure.

Shalom Delhi was established in 2001 to provide care for people living in Delhi with HIV/AIDS and targets those who are marginalized, as they find it harder to access medical care. In a conversation with us, she shared how they are helping transgenders with HIV/AIDS.

Shalom Delhi aims at providing the transgender community with a healthy life. Currently, they have a team of 26 people looking after the medical care of cancer and HIV patients. Along with their in-house patients, they also attend to HIV patients at their home as part of their home care program once a month. They help stabilise them and deal with the social stigma associated with their illnesses. Today, a lot of HIV/AIDS care centres have been shut down because of lack of funding.

Dr.Savita with a patient

Excerpts from the interview:

How do your services improve the health of the transgender community with HIV/AIDS?

A high percentage of HIV groups comprise of people from the transgender community and many of them, who are positive, may not even know that they are. We reach out to these communities ourselves or they are referred to us by organizations dealing with them. So, when we reach out to them, we talk to them about the need to get tested. Once they are tested, we send them to government ART (Anti-retroviral) centres to start the medication.

We guide them to regularly take the medicines because many times, HIV treatment is not taken seriously. We provide outpatient care services and also have in-house care for our patients. Specifically, we take care of the transgender community because they face a lack of care due to the social stigma and discrimination associated with them.

Apart from your team of experts, are there people volunteering for the cause? How does it help to empower the community?

For us, we haven’t been able to link up the transgender community in particular with other volunteers yet. Right now, our social workers reach out to these communities, but we look forward to having more people join us.

Apart from the medical care, we help the transgender community by creating opportunities for them to earn a living. The options available to them are very limited, but we try to make them move away from professions that can be harmful for them, like they may work at traffic signals or are pushed into sex trade. Their issues are very deep and as a medical care facility, we are restricted by means to empower them in many other ways. Though, our social workers link them with organisations which provide them services that cater to the emotional and mental care that they require.

You have a home-based care program. What does it aim at providing?

As a part of HIV care, we visit the transgender clusters for a follow-up care home-based program. We keep a check on them so that they take their medicines regularly and also that there are no side effects from them. We aim at providing them with physical, mental, emotional, social, and spiritual needs that they require.

How does the lack of healthcare access to the transgender community affect the way they receive treatment for HIV? What must be done to get them regular access to ART drugs?

The government gives ART drugs free of cost which are easily accessible. But, transgender community find it difficult to get themselves admitted to the general hospitals for care. Hospitals are often overcrowded and they may not get any attention due to the way people react to them. So, here comes our role where we admit them to our centre and treat them with the dignity and care they require. In HIV, the immunity comes down due which the patient catches infection very frequently, like TB and meningitis. A treatment for these infections is necessary and we look after these medical services.

What are the social barriers that transgender people face in hospitals? How can people be sensitised towards them?

A lot of them have shared with us that people laugh at them in public places and don’t treat them well. As a result, it becomes difficult for them to even reach out for medical help. They require care and treatment like any other individual.

Sensitisation is needed at every level and sensitivity only comes once you know them as people, build relationships and understand who they are at a personal level. Till the time people don’t understand this, the social stigma prevalent about them will not end.

How do you educate people from the transgender community involved in sexual activities to practice safe sex?

Through our home care programme we deal with the topic of practising safe sex and educate them on health issues related to unprotected sex. We also educate them to move away from commercial sexual activities because we want them to be in a productive and safe environment.

What are the kinds of tailored health and human rights programmes that empower the transgender community? 

At Shalom, we empower them by listening to their needs and providing them with the emotional support that they require because they face a lot of depression and rejection due to which there is a deep feeling of loneliness. Amongst their community also they face a lot of social stigma due to which they don’t share their issues. At large, we need to deal with their mental health and emotional issues and also create economic opportunities for them.

A lot of transgender population belongs to the poor sections of the society where there is a lack of access to the basic needs and illiteracy. They face a lot of violence, so we need to create safe spaces in the community and give them better opportunities.

Your Livelihood Program provides opportunities for women affected by HIV/AIDS to reconstruct their livelihood through various activities. Could you elaborate on that?

At the moment, to empower the women we have created employment opportunities that we provide at the centre, though we are working towards creating home-based employment as well. We teach women how to use Juki machines (electric sewing machines) so that they can make bags, cushions, pouches, covers, and clothes, which we further sell and provide them with daily wages.

In regards to the HIV patients, it’s difficult for them to go out to work since the work settings are not flexible for them. They have to go for their medication, they may require extra leaves, so not many places are sensitive to these needs and if anyone knows a person is HIV positive they will not be employed. So, for us, it is important that they are in an environment where they are nurtured well and our centre takes care of all their needs.