This week, Arlene and I met with someone from an HIV/AIDS network to begin our field research. Upon speaking with this individual, we were shocked to learn of the ways that HIV positive women are treated in the Delhi/Indian healthcare system. Unfortunate stories include the case of a positive woman who had a miscarriage 7 months into her pregnancy, and was referred to 4 different hospitals over the span of 2 days since no doctor would take the case. She died. In another instance, doctors summarily refused to grant a positive woman a caesarean section delivery because supposedly, government policies only allowed for C-sections t be carried out for a woman’s first child. The child was born HIV positive. We listened to these accounts, disbelieving that they were taking place just some kilometers away and within the last few months.

Our disbelief was shattered when we were told of a case where a positive pregnant woman, who had previously been promised a C-section in order to prevent vertical transmission of HIV to her baby, was now being denied a C-section. The doctors said that there was no government program in place which forced them to perform a C-section, and told her to come back another day. Essentially, the doctors were trying to give her the run-around, hoping that she would go into labour outside the confines of the hospital, and that they would not have to perform the procedure.
Making this a highly sensitive matter was the fact that this woman was full term, meaning that she could deliver at any moment, and without a C-section and anti parent to child transmission drugs such as nevrapine, would likely pass on the virus to her child.

We went back with news of this case to our superiors at HRLN who immediately put together a plan of action to help this woman. All systems were go, and I even began to draft a demand letter to the hospital. Unfortunately, the woman contacted the office the night before we were to go to her place and said that her family didn’t want a legal case, and so she refused HRLNs assistance.
Some observations:
1. The hold of the family is particularly strong in India and often times, your ‘client’ is 7 or 8 people. At times, your client will instruct you to act in a manner that is completely at odds with their personal wishes.
2. The stigma associated with HIV in India is so prevalent and so damaging to a family’s reputation, that their fear of disclosure (in this case, within the hospital setting) outweighs the desire to fight particular forms of injustice. This weakened desire in turn, likely stems from a lack of knowledge regarding their rights and the background concept of demanding things from officials. Often times I hear the background of ‘we don’t want to make trouble’ or ‘this will only cause more problems’ from reluctant clients.

-The sad thing, is that this is often true. We as lawyers might imagine ourselves as going into the situation and being the hero, demanding that the other party recognize the rights of our clients; that they must concede, remedy, strike down. We may even win the battle at that moment. But what about the war? We have to remember that even if we get the doctors to agree to perform a C-section, we will not be there during the delivery. We will not be there to make sure that the nevrapine is administered to the baby.

-And so a distinct party of lawyering must include a long term view of what is best for the client. Maybe we might have gone in, caused tension between the doctors and the patient, and still been unsuccessful in procuring a C-section, only to have the client mistreated to a greater extent.

--Still, I cannot believe that inaction is the way. On the other hand, I understand the client’s concerns, and the thought that the legal solution is not always the best way to approach a problem.

I do not know what has happened with this woman, as she will not pick up calls from the office. I hope that our work at HRLN and its activism will work towards creating a greater atmosphere of general legal education, and the conception that rights are not given; --- they inhere in the individual---and can only be taken.