health crisis

Why reticent HIV patients in Ahmednagar are braving stigma to organise street protests

Maharashtra has suffered repeated stock-outs of antiretroviral therapy drugs for the past two years, but the shortage seems to have worsened since March.

It is unusual for HIV positive patients to stage protests. This is because people living with the Human Immunodeficiency Virus usually do not want to be identified, fearing social stigma and discrimination.

But in May, the repeated stock-outs of antiretroviral therapy drugs in government-run ART centres in Ahmednagar, Maharashtra, compelled people living with HIV to organise a protest before the district’s highest authority: district collector, Anil Kawade.

The protest was the culmination of months of anxiety and frustration.

The ART centre at Ahmednagar’s district civil hospital has been facing repeated shortages of ART drugs since March, and organisations working with people living with HIV had written letter after letter seeking to understand what exactly was the problem.

“We decided enough was enough, and decided to protest against it,” said Prashant Yende, president of the Network of Ahmednagar District People Living with HIV, which is part of a larger community of people living with HIV in Maharashtra and India.

Severe shortages

Maharashtra has suffered repeated stock-outs of ART combination drugs for the past two years. But in the last three months, the shortage seems to have worsened. In Ahmednagar, the drug combination Zidovudin-Lamavudine was not available at all from March.

On May 1, Yende wrote a letter to the collector intimating him of the proposed protest. In the letter, Yende wrote that there are 13,972 people, including 709 children, living with HIV who have been affected by the severe stock-outs in the district. He wrote:

“This is a life threatening situation for us. Many of us have no social standing in the community or families. We do not have money to buy ART or check our CD4 [immunity] levels. Only if we get ART medicines can we lead a good life with HIV.

“As a representative of the Network of Ahmednagar District of People Living with HIV, we request you to please convey our agony to the concerned authorities and help us get justice. We request the authorities to provide us the medicines on time and save our lives.”

Yende, who is HIV positive, had not received the Zidovudin-Lamavudine combination for a few months from the state-run centre, but purchased it from Taal, a community pharmacy, the corporate social responsibility arm of the drug company, Emcure. It provides medicines in a few districts in Maharashtra, including Ahmednagar, for half the market price.

“Many cannot afford medicines from outside,” said Yende. “This could develop resistance in a patient, or the patient may develop opportunistic infection because of lack of immunity. This is like slow poisoning of the community.”

On May 3, a day before the protest, Yende along with others in the organisation started calling their network of HIV positive people, many of whom agreed to attend. They also sent a press note to local newspapers. They also also visited the ART centre at the district hospital and asked people to come for the andolan.

The response was good.

In one voice

“We felt that many won’t come forward to protest for a cause like this,” said Sangeeta Darade, an activist with Vihaan, an NGO that works in the area of care and treatment of HIV positive people. “But only for this cause, many who had not revealed their HIV positive status also came.”

Kirtiman, 42, took a day off from work to join the protest. An employee at one of the industries at the nearby Maharashtra Industrial Development Corporation, he has not told his employers about his HIV positive status.

“I lost my entire family to HIV,” said Kirtiman. “Now I have remarried and have a son. I have been getting my medicines, but had been hearing about others who are on a different dose and not been getting medicines. They were tired of coming to the ART centre again and again. I felt I should do something for them too.”

Darade tested HIV positive after her pregnancy in 2006. She and her husband attempted to commit suicide soon after, but she escaped death, and decided to help others as ignorant as she was.

Darade friends such as Kalpana Raut, 42, also joined in. Raut, who does odd jobs in her village in Newasa taluk, took a two-hour bus ride to join the protest in Ahmednagar.

Raut lost her husband to HIV, but all her children are negative. She was forced to buy medicines from Taal after the state-run ART centre ran out of drugs.

“I am fortunate to know about Taal, and can afford it,” said Raut. “How many can afford this drug?”

Nagpur too

On May 4, the group of 70-80 people, many of them HIV positive, congregated outside the district collector’s office and shouted slogans such as “ART aamcha hakk aahe. (ART is our right. We should have it.)”

At around 4 pm, the district collector sent the group a letter saying that the administration would look into the matter.

The group was photographed, and the event was covered in Marathi papers the next day.

A few days later, on May 13, the Nagpur bench of the Bombay High Court heard a public interest litigation on the same issue from Nagpur. The petition had been filed by the Nagpur-based Sanjeewan Bahuuddeshiya Samaj Seva Sanstha, an NGO that works with people living with HIV through their lawyer, Vivek Awchat.

“The shortages began in January,” said Babita Soni, from the NGO. “We went to the collector and spoke of the problem. With no clear solution in sight, we decided to move a PIL.”

The PIL stated that since people living with HIV are discriminated against, they “don’t come forward to put forth their grievance before the authorities with the fear that if their status as HIV infected is disclosed they will have to face discrimination and harassment.”

The PIL, however, attaches 100-odd signatures of HIV patients who support it.

Dr Abhimanyu Niswade, the dean of the Government Medical College and Hospital in Nagpur, which runs the biggest ART centre in the district, filed an affidavit in reply to the PIL in April.

It was revealing.

In the affidavit, the dean admitted to a total stock-out of ART drugs – Efavirenz, Tenofovir-Lamivudine, and paediatric formulations of Lopanavir and Ritonavir. It said that there have been stock-outs in Nagpur since January.

The dean stated that doctors at the centre have been “compensating” by changing the dosage whenever there is a stock-out. This, he said, can be avoided if the regular supply of drugs is maintained.

He held the National Aids Control Organisation, or NACO, and its subsidiary, the Maharashtra State Aids Control Society, responsible for the stock-outs, as they are supposed to monitor, forecast, procure and distribute drugs effectively.

In the last court hearing, on June 9, the government pleader for the Maharashtra body informed the high court bench that inadequate funding was to blame for the stock-outs of medicines in ART centres.

On June 13, the government medical hospital in Nagpur declared a stock-out of Tenofovir-Lamivudine yet again.

The ball is now in NACO’s court. “We feel this PIL should result in a favourable order,” said Soni. “We have not understood from any authority why there have been such stock-outs. NACO, however, will have to reply to the court.”

Note: Names of some patients have been changed to protect their identity.

This is part two of a three-part series.

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Swara Bhasker: Sharp objects has to be on the radar of every woman who is tired of being “nice”

The actress weighs in on what she loves about the show.

This article has been written by award-winning actor Swara Bhasker.

All women growing up in India, South Asia, or anywhere in the world frankly; will remember in some form or the other that gentle girlhood admonishing, “Nice girls don’t do that.” I kept recalling that gently reasoned reproach as I watched Sharp Objects (you can catch it on Hotstar Premium). Adapted from the author of Gone Girl, Gillian Flynn’s debut novel Sharp Objects has been directed by Jean-Marc Vallée, who has my heart since he gave us Big Little Lies. It stars the multiple-Oscar nominee Amy Adams, who delivers a searing performance as Camille Preaker; and Patricia Clarkson, who is magnetic as the dominating and dark Adora Crellin. As an actress myself, it felt great to watch a show driven by its female performers.

The series is woven around a troubled, alcohol-dependent, self-harming, female journalist Camille (single and in her thirties incidentally) who returns to the small town of her birth and childhood, Wind Gap, Missouri, to report on two similarly gruesome murders of teenage girls. While the series is a murder mystery, it equally delves into the psychology, not just of the principal characters, but also of the town, and thus a culture as a whole.

There is a lot that impresses in Sharp Objects — the manner in which the storytelling gently unwraps a plot that is dark, disturbing and shocking, the stellar and crafty control that Jean-Marc Vallée exercises on his narrative, the cinematography that is fluid and still manages to suggest that something sinister lurks within Wind Gap, the editing which keeps this narrative languid yet sharp and consistently evokes a haunting sensation.

Sharp Objects is also liberating (apart from its positive performance on Bechdel parameters) as content — for female actors and for audiences in giving us female centric and female driven shows that do not bear the burden of providing either role-models or even uplifting messages. 

Instead, it presents a world where women are dangerous and dysfunctional but very real — a world where women are neither pure victims, nor pure aggressors. A world where they occupy the grey areas, complex and contradictory as agents in a power play, in which they control some reigns too.

But to me personally, and perhaps to many young women viewers across the world, what makes Sharp Objects particularly impactful, perhaps almost poignant, is the manner in which it unravels the whole idea, the culture, the entire psychology of that childhood admonishment “Nice girls don’t do that.” Sharp Objects explores the sinister and dark possibilities of what the corollary of that thinking could be.

“Nice girls don’t do that.”

“Who does?”

“Bad girls.”

“So I’m a bad girl.”

“You shouldn’t be a bad girl.”

“Why not?”

“Bad girls get in trouble.”

“What trouble? What happens to bad girls?”

“Bad things.”

“What bad things?”

“Very bad things.”

“How bad?”


“Like what?”


A point the show makes early on is that both the victims of the introductory brutal murders were not your typically nice girly-girls. Camille, the traumatised protagonist carrying a burden from her past was herself not a nice girl. Amma, her deceptive half-sister manipulates the nice girl act to defy her controlling mother. But perhaps the most incisive critique on the whole ‘Be a nice girl’ culture, in fact the whole ‘nice’ culture — nice folks, nice manners, nice homes, nice towns — comes in the form of Adora’s character and the manner in which beneath the whole veneer of nice, a whole town is complicit in damning secrets and not-so-nice acts. At one point early on in the show, Adora tells her firstborn Camille, with whom she has a strained relationship (to put it mildly), “I just want things to be nice with us but maybe I don’t know how..” Interestingly it is this very notion of ‘nice’ that becomes the most oppressive and deceptive experience of young Camille, and later Amma’s growing years.

This ‘Culture of Nice’ is in fact the pervasive ‘Culture of Silence’ that women all over the world, particularly in India, are all too familiar with. 

It takes different forms, but always towards the same goal — to silence the not-so-nice details of what the experiences; sometimes intimate experiences of women might be. This Culture of Silence is propagated from the child’s earliest experience of being parented by society in general. Amongst the values that girls receive in our early years — apart from those of being obedient, dutiful, respectful, homely — we also receive the twin headed Chimera in the form of shame and guilt.

“Have some shame!”

“Oh for shame!”




“Do not bring shame upon…”

Different phrases in different languages, but always with the same implication. Shameful things happen to girls who are not nice and that brings ‘shame’ on the family or everyone associated with the girl. And nice folks do not talk about these things. Nice folks go on as if nothing has happened.

It is this culture of silence that women across the world today, are calling out in many different ways. Whether it is the #MeToo movement or a show like Sharp Objects; or on a lighter and happier note, even a film like Veere Di Wedding punctures this culture of silence, quite simply by refusing to be silenced and saying the not-nice things, or depicting the so called ‘unspeakable’ things that could happen to girls. By talking about the unspeakable, you rob it of the power to shame you; you disallow the ‘Culture of Nice’ to erase your experience. You stand up for yourself and you build your own identity.

And this to me is the most liberating aspect of being an actor, and even just a girl at a time when shows like Sharp Objects and Big Little Lies (another great show on Hotstar Premium), and films like Veere Di Wedding and Anaarkali Of Aarah are being made.

The next time I hear someone say, “Nice girls don’t do that!”, I know what I’m going to say — I don’t give a shit about nice. I’m just a girl! And that’s okay!

Swara is a an award winning actor of the Hindi film industry. Her last few films, including Veere Di Wedding, Anaarkali of Aaraah and Nil Battey Sannata have earned her both critical and commercial success. Swara is an occasional writer of articles and opinion pieces. The occasions are frequent :).

Watch the trailer of Sharp Objects here:


This article was published by the Scroll marketing team with Swara Bhasker on behalf of Hotstar Premium and not by the Scroll editorial team.