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On World AIDS Day, Mike Bailey, an aid worker with an international NGO, writes from India about the activities of the Y.R Gaitonde Centre for AIDS Research and Education (or YRG CARE).
Purple onion dances in hot fat, paratha dough is oiled and slapped, rolled and pummeled like flesh in a health farm. Tumeric and chilli powder, salt and garlic-ginger paste are stirred into steaming caldrons amidst the deafening clash of pots, lids and ladles. An inferno of heat and noise, heady with heavenly smells, the Eco-Kitchen is in full swing. It reaches from kitchen and kiosk to clinic and counseling as part of an HIV care and treatment programme.
The Eco-kitchen sets aside an income for health funds at the HIV/AIDS care and treatment center. Fifteen hundred meals a day are delivered to roadside kiosks throughout Chennai in the Tamil Nadu state of India. These meals are sold by women, some of whose lives have been affected by HIV but also women who are abused, abandoned, widowed or are spouses of Injecting drug users. For them this business is their economic salvation.
Margaret is one of these women. She says her husband is a day labourer painting buildings but he does not work every day. The money she makes selling the Eco-Kitchen meals helps her to feed and educate her two children and look after herself and her husband. She serves between 20 and 25 lunches a day and will start a breakfast service next week. Her kiosk is provided and maintained by the Eco-Kitchen. It sits on the pavement in a district of Chennai where small factories and service businesses are part of Chennai’s high tech growth industry.
It's now a year since the Eco-Kitchen, built with a grant from the YR Gaitonde Foundation, started producing breakfasts and lunches for sale in street kiosks. Today more than 20 women in YRG Care outreach teams have been selected and trained. The scale-up targets in the next year are for 10,000 meals daily and 100 roadside sellers, mostly vulnerable women.
Sethu Lakshmi, who manages the Eco-Kitchen, explains that they use high calorific value brickettes made from vegetable waste which gets them carbon credits from the government. The water from washing and cooking is filtered and treated on site in settlement tanks so that it can be reused for floor washing and watering the garden. On the roof an array of solar panels provides energy to preheat the water used to cook the rice and clean the pots and pans. This reduces the amount of brickettes burned and lowers the energy bill.
The Eco-Kitchen that is part of YRG Care’s community outreach work is typical of director Dr Suniti Solomon’s down to earth approach. Dr Suniti Solomon’s story starts on the first day of the history of HIV in India. Her government team identified the first case in 1986.
“The crowd of young people that started to come for information and counseling opened my eyes to the need and I started going out from my laboratory into the community,” Dr Solomon says. She has fought a running campaign ever since then against HIV infection, the illnesses it causes and the discrimination that darkens everything around it and makes both treatment and prevention difficult. At that time hardly any doctor wanted to be involved and most politicians didn’t want to know.
YRG Care now has 11,000 patients in regular follow up, 7,500 receiving antiretroviral therapy. That’s about 1% of all the people receiving HIV therapy in India. It is an impressive achievement for Dr Suniti Solomon who started YRG Care in 1993 when she took early retirement from the government health service. She says she began “With two tiny rooms and a small kitchen which served as my laboratory because no one was willing to give us space for AIDS work”.
YRG Care has always blended excellent clinical care with compassion. “Back when we started the patients cried when I told them they had HIV infection,” recalls Dr Suniti. “ and I cried because it was so sad to see them cry. Now when they are diagnosed and they cry I tell them not to because this is a chronic disease. If they cannot afford the treatment I tell them we will find some way to provide it free”.
Saving energy, saving lives, giving vulnerable people independence and dignity, preventing HIV infection and fighting discrimination are all part of Dr Suniti’s patient centred approach.