On that Thursday afternoon at a leading govt. hospital in Ahmedabad, I was a few miles away from the scene, in a government office, buried under piles of line-lists and Excel sheets. I was State PPTCT (Prevention of Parent to Child Transmission) Consultant under NACP-III, and my world was defined by data-tracking every single HIV-positive pregnant woman in the state to ensure zero transmission to the unborn.
Of the thousands of names on spreadsheet, one story traveled back to me. It was brought to attention by a counselor, and out of sheer curiosity, I began tracking the life behind the line-item.
Let’s call her Kamala.
Based on the counselor’s notes, I can see the scene as vividly as if I had been standing in the corner. The fan cutting through the humid air. The heavy silence. Kamala, seven months pregnant, sitting in the ICTC, draped in a fading Rajasthani sari.
“Ben”, the counselor had said. “The report is Positive.”
Kamala smiled hesitantly. In her world, being ‘positive’ usually meant something good. She didn’t know that here, that word was a sentence. When the explanation came – virus, blood, lifelong treatment – Kamala didn’t cry. She shrank. She physically folded into herself, pulling her pallu over her face, waiting for the world to end.
Then came the question that terrifies every woman in her position: “Where is your husband? He needs to be tested.”
He was waiting outside. Kishan. A daily wager, thin as a reed, face etched by the sun. He walked in, clutching a greasy plastic bag containing two warm samosas he had bought for them.
The test took fifteen minutes. If he was negative, would he leave her? In our society, a woman is often the vessel of blame, even when she is the victim.
The kit showed a single line. Non-Reactive. Negative!
Kamala stopped breathing. She knew the brutal arithmetic of their village; she was now ‘damaged goods’. She braced herself for the anger. She waited for the accusation of infidelity.
Instead, Kishan looked at the counselor and asked in a rough dialect, “So… is she going to die?”
“No,” the counselor said. “With medicine, she will live a normal life.”
“And the baby?”
“We will try our best to save the baby.”
Kishan sat back. He looked at the samosas in his hand, then at his wife, who was shaking. He reached out, took her hand, and placed the food in it.
“Eat,” he said quietly. “The baby is hungry.”
As I tracked Kamala’s case file over the next few months, the ghosts of her past emerged, story that maps the hidden epidemic of our country.
Kamala was from a small village in Rajasthan. She was married young to a truck driver – a man of the highway who returned home with money, but also with sickness. He died within three years of the marriage after suffering from ‘inexplicable’ illness. His family knew, and hers likely suspected, but silence is the currency of honor in our patriarchal structures.
Instead of testing her, they arranged a remarriage. Quickly. Quietly. She was married off to Kishan, a poor laborer in Gujarat who knew nothing of the virus. She was the victim of a conspiracy of silence.
But biology keeps no secrets. The pregnancy unmasked the truth. And now, she was terrified this kind man would throw her out.
But Kishan was made of different stuff.
I watched their adherence data like a hawk. We put Kamala on periodic testing and ART and ensured the delivery was institutional. This was the miracle of the PPTCT program – Nevirapine, and erstwhile protocols. But protocols don’t work without people.
Kishan, who could not read the prescription, memorized the colors of the pills so she doesn’t miss a dose. In a slum where gossip travels faster than light, he stood like a wall between the world and his wife.
Kamala gave birth to a baby girl. We tested the child at 6 weeks, 6 months, 18 months. Negative!
Two years later, another child. Negative!
They were a discordant couple – she positive, he negative; living in a one-room hut in a slum, raising two healthy children.
But life is rarely a straight line. A few years later, Kamala had a stillbirth. The grief was immense. Then, she developed Herpes Zoster Ophthalmicus. It ravaged the nerves of her face, and despite treatment, she lost vision in right eye.
I left that rewarding job as State Consultant fifteen years ago to pursue my family genes of teaching in medical education. But some stories stay with you. I kept in touch, watching them from a distance.
I learned that Kishan isn’t a saint carved in marble. He is a real man. In the dry state of Gujarat, he occasionally finds a ‘potli’ (desi liquor) to unwind after a hard week of labor. He gets loud, he makes merry, he is flawed. But he never left!
I met Kamala recently. She is now in her late 30s, healthy, with an undetectable viral load. Her children are in school, oblivious to the storm their parents weathered.
As we spoke, Kishan walked up to us. He looked older, grayer, smelling faintly of the day’s labor and perhaps a bit of that potli. In his hand, he held a familiar greasy plastic bag. He pulled out a samosa and handed it to her without a word.
It was a small gesture, identical to the one fifteen years ago.
I asked her, “Kamala ben, it has been a long journey. Through sickness, through blindness… how did you manage?”
She took a bite of the samosa, looked at her husband, and then touched the side of her face where the light had gone out forever. She smiled, a genuine, radiant smile that erased the years of pain.
She said, “I lost my eye, but I could still see him standing by me.”
