HIV Tales from my diary-Tale 8

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There are very few Moments of pride in everyone’s life. Most relevant out of such moments can be when a father is recognized by his progeny’s ( son or daughter’s) name. For a learned student ( read doctor) , getting a referral from his mentor / teacher is a matter of pride. People like me also feel proud when one of the seniors ,who is your role models too, poses faith in your abilities. It was one such moment in my life when a role model like senior ( once classmate in school and a dear friend since then) Dr. Kukreja, a renowned physician referred a patient to me. The referral was from a distance of 100 odd kilometers but this was only a small prize ,compared to referral by him , ( after all I was one of the only ten twelve physicians all over the country , who started treating HIV patients). Seeing his referral slip, my joy knew no bounds. But the effervescence of joy settled soon in vapors of hesitant worries, when ,I realized that a eunuch was in front of me with a positive HIV report (on preliminary testing). Some unknown fear scared me while trying to counsel and enquire about her history ( personal family and sexual )which is important for we the doctors. The path of my search for mode of transmission of HIV in her was laden with speed breakers. After all this was my maiden experience of this sort. 
It is estimated that there are 50,000 to six million eunuchs in our country and they mostly live in Mumbai, Chennai, Kolkata and Delhi. 

Historically , the 

 legend in the Mahabharata ,is that ,Aravan was the son of Arjuna and Nagakanya. Aravan offered himself to be sacrificed to Goddess Kali just to ensure the victory of the Pandavas in the Kurukshetra war. 

The only condition that he made was to spend the last night of his life in matrimony. Since no woman was willing to marry one , who was doomed to be killed, Krishna assumed the form of a beautiful woman called Mohini and married him. The hijras of Tamil Nadu consider Aravan their progenitor and call themselves aravanis. 

The hijra community is divided into seven houses, each headed by a `nayak’ who appoints gurus or spiritual leaders to train their wards or `chelas’ in badhai and protect them. Hijras in South India do not have the same cultural role as their counterparts in North India and most of them take up sex work as a means of earning a living. 

Kothi is a term used to describe male homosexuals who take on the female role; Many kothis marry owing to family pressure but continue to have same sex relationships. 

Eunuchs have ambiguous backgrounds. Some of them are intersexual; others are born male and fail to develop. Gay men and transsexuals also are included in their ranks, according to experts who have worked with the community. Contrary to popular belief, most are not castrated, says Ashok Row Kavi, president of the Humsafar Trust in Mumbai, a male sexual health. 

Eunuchs ( also known as Hijras or khusras or third gender )used to scare me otherwise also , ever since my childhood for some unknown reason. Until the day of my brother’s marriage when they came asking for Shagan. Their demand was beyond the limits of my parents supply of currency annually. An argument erupted and it soon acquired threatening proportions and one of them threatened to do a naked dance ( routine method employed by them to fleece and scare ordinary people) in case their demand was not met with. By now , I had , however graduated as doctor and was posted in civil hospital, Jalandhar. I thought of scaring them with my Daktari and challenged them to do a cabaret as I was not scared to see naked bodies .Female folk of my house didn’t like that and ultimately the feud ended with some bargaining on both sides. 

The drama ended with scope of replay after an interval later in life and leaving a strange taste in mouth. Answer to the question “How many years later it will happen “, was hidden in the uterus of mother future. 

The delivery will occur in the name of Neelam twenty five years later was not known to me. In that moment of my pride was hidden a moment of fear too. In a bid to postpone the fear, I looked for an escape route and asked for some more tests including confirmatory tests of HIV. Not only that I requested her to meet me in Pathankot itself ,where I was to visit seven days later , to address a gathering of doctors about my experiences face to face with HIV. I told her the date of my visit with a thought in the back of my mind that I will use my seniors shoulders to allay my anxiety and fear and examine and take history there only in his presence. Ek se bhaley do, I thought. The time to to see an eunuch naked -had arrived after two and a half decades and there was no chance of any negotiation or threat was possible this time. The week passed by in a jiffy. I reached my friend’s clinic cum residence and found Neelam waiting for me. I shared my fears with Dr. Kukreja and asked him to accompany me to examination chamber for examination etc. He was as reluctant as me. We however gathered loads of courage and went on to just see her reports and her private parts. She had tested positive for HIV confirmedly and had anal warts. Her viral load was high and Cd4 low. Mental barriers got broken and I prescribed her the medicines, which I told will be available from Amritsar only and will be costly. She told me to visit next day for collecting them. Another day to face her was my next challenge but by now I was better prepared mentally. 

Her next visit to my clinic was a revealing and learning day. Neelam was one of the four siblings of her parents. The whole family knew her reality as she was living away from them but was in regular touch.Money was the common link between separated daughter and the family. She used to literally pour in money for the family , the same family which was reluctant to see her in broad day light because of nightmares they thought may surround them. Her two sisters were married in distant towns and wanted physical and mental distances to be maintained. Parents were aged and ailing. The only brother loved her very much as per her opening introductory statement of her family , to me. But as the wrappings of relations were being unwrapped, the reality which emerged was no different than the true story of modern day relation’s. Pyaz ke chilke utartey gaye, pole khulti gayi, under kuch tha hi nahin ( as onion leaves got peeled off, nothing was inside) . Her brother’s love was all due to money. Neelam was a ” kothi ” and favorite of her Guru. Guru used to have anal sex with her and inturn she will have plenty of money at her disposal. Her sex work will add to her income. Her own requirements, cosmetics of various types were not at all heavy on her heavy pocket but the affectionate brother of hers never forgot to lighten her purse and that too on a regular basis. He could build a house and hefty bank balance despite being unemployed because of his sister’s earnings. After all, his sister was a khusra ( means impotent) and not potent like him. To me, brother was actual impotent in terms of erections of income on his own, whereas Neelam was the potent earner for her brother and his fulsome family of a wife and kids and will always ensure orgasm. 

As the news of Neelam was broken to her brother, he offered all monitory help to her and promised to be her pillar of strength morally and money wise . I put Neelam on Indianavir ( considered potent PI with lesser pills to be taken per day,at that time. This is a drug which is obsolete now, although ) along with Zidovudine and Lamivudine combination. The total cost per month was around 4000 rupees in those days. But money was no issue with her to begin with. She started gaining weight, was happy and started doing well. As a routine , I used to keep telephone numbers of my patients in those days, so that I can remind them about medicines , just to ensure Cent percent compliance. 

Neelam , however refused to give me her number as she apprehended bad name to the whole community of hijras which may lead onto stoppage of their earning by way of sex work. Although she did not give me her telephone no. yet she was regular in her treatment and I hardly needed to remind her , except once , may be after six months of initiation of her treatment. In a bid to contact her , I chose an indirect route and called Kukreja, but he had no clue to her whereabouts. I had no alternative but to wait and pray for her. 

My wait ended after six months when she was back in a worsened state of health. She had stopped treatment as her brother refused to support her and even refused to give her own money back. Even she had fallen from grace in the eyes of her Guru, who was no more a gold mine for her. The sex work stopped. Neelam’s purse became air light. 

Now she wanted me to put her on cheaper medicines. I bowed to her wishes as I thought something will be better than nothing. I started with a combination (Zidovudine,Lamivudine and Nevirapine ) whose cost was less than half of her earlier ART cost (1500 rs. Per month). I wanted to help her live potently. 

Next few months saw not much improvement in her condition. Even my lucky (roll )number 213 ,which saw me enter medical profession and which was also the file number of Neelam in my records,was failing to change her luck. Her visits weaned off in a way no mother weans off her breast fed child, abruptly. She evaporated in thin air. I believe , she must be remembered in past tense by her family by now, if at all they remembered their kamaoo putt( earning son). For me , however , she can never be a past tense as even after her death (?) she left me wiser , freer from fear of eunuchs. The result is that now I face the community more confidently without hesitation. 

May she be a liberated soul

Rakesh Bharti 

( Neelam is a changed name to protect her secrecy and dignity). 

Post script : I was never hassled by Hijras after the marriage of my two sons , may be the community knew that I knew