Feature: AIDS and the Army

“The ideal I’m working towards is a zero-AIDS situation. As of now, I know that sounds like moonshine. However, to achieve something, you have to aim for the moon.”

Lt General D Raghunath, Director General Armed Forces Medical Services, is not much given to mouthing moonshine. However, the DG happens to be the man at whose desk the AIDS buck stops, vis-à-vis the three forces. “It is not a comfortable situation,” he admits. “The perception is that the Services is  an isolated entity. But an infection cannot be kept confined, it vaults all barriers.”

As an administrator, he would like to keep the armed forces “an isolated island of good health in a sea of sickness”. However, he knows that is not possible. “So we are doing the next best thing,“ he says, “We are fighting to contain it.”

Typically, the DG is not forthcoming about the current figures of HIV-infected personnel in the Army, Navy, or Air Force. “It is less than a third of the general community of AIDS patients,” is all he will vouchsafe. As the Armed Forces includes 8 to 10 lakh of the Indian population, even the one-third figure is cause enough for serious concern. Reliable sources within the services’ medical community say that currently, the number of HIV-positive cases on record is 251, with ten percent of them being full-blown AIDS cases. Of these, two per cent are officers.

In India, by 2000 AD, an estimated figure of four million will be infected by the HIV virus and 1,70,000 will be full-blown AIDS victims.

The DG clarifies that in the services, heterosexual contact is the main reason for the spread of AIDS. “The circumstances in the services impose its own restrictions. With men separated from their wives for long periods of time, we have to tackle the problem with utmost tact. However, incidents of homosexuality are very low.

To date, we haven’t had one case where a homosexual encounter has resulted in an HIV infection. The same holds for HIV contracted through blood transfusions. Blood and blood-related products are handled with the utmost care in our hospitals and MI rooms.”

Gen Raghunath says that though troops stationed abroad in peace-keeping stints do in some cases bring home the AIDS virus, it is not as rampant as rumours would have one believe. “What is happening all over India is happening within the forces, too,” says the DG, “Except in the case of the
armed forces, the human face to this disease is a far more compassionate one.

There are no attitudinal problems, our nursing staff tend to patients diligently. We have a team of psychologists who counsel and help patients.”

“Our rates of detection are far higher than outside in the civilian set-up,” says the DG, “The cases mostly come to light when infected personnel come for treatment of STDs, voluntary ELISA tests or for blood donations. From then on, we keep them under discreet observation. There is no segregation as in the West. They are sent back to their units but we keep tabs on them.”

When full-blown cases are detected, the men are officially discharged from the forces. However, all treatment is given these men, free of cost.

Under General Raghunath’s supervision, a special Army AIDS Control Cell has been set up, with a budget allocation of Rs. 2 crore, a research department and 60-bed wards in the Army hospitals at New Delhi, Calcutta and Pune.

The Air Force has the lowest rate of HIV cases while the Army and Navy are at par. All steps are taken to ensure that every soldier is aware of the disease.

A full-scale awareness campaign, with the use of posters pamphlets, frequent talks, articles in the Sainik Samachar has been under way for some time now. “The idea is to put them on red alert and then, trust them to look out for themselves. On the whole, though, our men know more about AIDS than the man on the street.”

“Now, it is time for all of us to take our heads out of the sand,” says the DG, “The situation calls for a missionary kind of zeal.”

The HIV virus has broken the traditional picket fences the services puts up. Gen Raghunath concludes, “I cannot and will not deny that AIDS has made its presence felt in the armed forces. The situation is alarming, combat efficiency will definitely be affected. But then, that holds true for the national scene too. When it comes to us, though, we know the extent of our problem and we are engaged in fighting it.”

This ran as an oped in THE TIMES OF INDIA of 28 Feb 1997.

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