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The CHES Story: Rescuing Children With AIDS

By Deepa Kandaswamy**

Dec 06, 2005

In 2005, India received the dubious distinction of having the largest HIV infected population  in the world overtaking South Africa.

While trials for HIV vaccines are going on in Pune, India and in other parts of the world, it is important for the world to understand that what was illiterately and ignorantly known as the “gay plague” in the early 1980s in the USA, is now proving to be the fastest growing killer disease in the world.

Life is a struggle for many Indians. But for children who are HIV positive, have full blown AIDS or whose parents died of AIDS, they are unable to defend themselves against the social prejudices. Fear and cruelty that exist due to the lack of awareness and the social taboo surround the words “HIV/AIDS” in India. Have you ever wondered what happens to these children? Manorama Pinagapany did and decided to do something about it.

Mahatma Gandhi once said “You must be the change you wish to see in the world.” It appears Manorama decided to follow it to the letter. A doctor by profession, Manorama was the assistant surgeon in the Pediatric Gastroenterology Department at the Institute of Child Health —a hospital for children in Tamil Nadu, the Indian state which recorded the first AIDS patient in India. In 1993, two orphans were admitted because they had Hepatitis B and who also tested positive for HIV. Once the two children were known to have HIV, the orphanage which was caring for them didn’t want them back. When the other doctors hesitated to treat the children, Dr. Manorama became angry. She says, “I decided to rear both these children because they were discriminated so badly.” After six months, she quit her job to take care of the children full time. At her friend’s suggestion, she formed an NGO to care of not just these two children but other children who are discriminated against or don’t receive proper health care because they either tested positive for HIV or were AIDS orphans. She called her NGO—CHES (Community Health Education Society). Seeing the children get better with the tender loving care she showered on them, CHES got more referrals and over 20 children in the first year itself.  

With the increasing number of children, Manorama couldn’t manage to attend to all the 20 children. Hiring others to take care of the children was not an option as CHES was not funded at that time. So she came up with an innovative idea. Dr.Manorama says, “We took in women who were HIV positive, destitute and thrown out of families. We made both ends meet. The women were offered shelter and food and in return they took care of the children. This worked well.”

Manorama Devotion  

Helping children with AIDS is a full-time job, yet Dr. Manorama seeks to promote awareness for everyone

Born in Chennai, the capital city of Tamil Nadu, the southernmost state of India, the younger of two children, Manorama became interested in medicine at the tender age of six. According to her, “When I was in the second standard, my father showed me a front page newspaper clipping of a doctor from Madurai called Manorama who got first class in M.B.B.S. [Bachelor of Medicine/Bachelor of Surgery], which was rare those days. He also told me the story of Florence Nightingale. Both of this inspired me to do medicine.” Unlike many children who give up their dreams as they get older, Manorama persisted and became a doctor. Today she is Dr. Manorama, M.D., DCH, DM (Gastro).

She chose to give up her lucrative practice as a pediatric surgeon to take care of socially stigmatized children who didn’t receive proper medical care. Why? Because the doctoral profession is all about saving lives and community service, mainly to those who are sick and dying. “The best aspect about my job is when I bring back a life from deathbed and provide quality life till he/she dies—a death with less pain and suffering and with dignity,” says Dr. Manorama.

However, Manorama Pinagapany was not satisfied with just helping children. Some of the HIV positive women she hired to take care of the children turned out to be sex workers. They told her about how they had contracted AIDS due to low condom usage by the male clients as the men refused to wear them. She was irked by this as she realized working hard on helping the affected was not enough and that creation of awareness was more important, which could lead to prevention. 

So CHES began to conduct mass awareness programs in Tamil Nadu, to increase awareness about high risk behavior. They roped in film celebrities for entertainment combined AIDS awareness programs in rural and urban areas. In between the songs and dances, they talked about sexual transmission of HIV. This sort of awareness campaign was unique and the response was tremendous. “After the program, we had a lot of men asking whether they need testing. We tied up with government general hospital for counseling and got many of our staff trained as counselors through the famous Christian Medical College, Vellore.”

As more people came forward for testing, the number of people infected began to grow and CHES soon started a home based care program for children and their parents in the community besides the orphans care program in Chennai in 1997. From then, Manorama has increased the prevention program and as well as the HIV care program, thanks to partial funding from Family Health International and private donations. However, getting funding for orphans with AIDS is still a major challenge she says for according to her many ask, “These children will die soon why we should spend on them regularly?” So she came up with innovative ways of raising funds like the “A Donor A Day” where people can donate small amounts of money on their birth day, wedding anniversary, Independence day, Festival celebrations like Holi, Diwali, Ramadan, Christmas, New year, etc. 

Longing for a Home

Today, CHES not only takes care of over 500 children who are HIV positive and over 680 families in their orphan care and home care programs but are managing to put up the kids for adoption. Dr. Manorama says, “As we started to grow, I realized that children were longing for a family more and more. It was my dream to put these children back in to the community in some way or the other.” So CHES began to look into foster care and AIDS sensitization. They invited community members who wished to adopt children to visit the orphan shelter. Those who visited the home realized the pain and sorrow the children were going through. The way children rushed to them longing for love moved them. Manorama says, “One woman came first to take a child, then came the second and soon we had 22 families willing to take children. We were slow, waiting for them to drop out in case they had made a hasty decision but they stayed.”

However, CHES has a strict screening procedure to ensure that the children won’t be mistreated or abused after adoption. So people from CHES went to enquire about the families, meet with them every day to test their AIDS awareness, counseled the would-be foster parents, etc. In the first adoption of its kind in India, CHES successfully let three HIV positive children be adopted. CHES workers visit them every third day to make sure the children are treated right as all these foster parents have children of their own. Processing is going on for the other 19 families who also sought children.

At CHES, children, 80% of whom are HIV infected are provided a safe space to live in, given routine medical care and treatment of opportunistic infections. All the children are provided education, of which eight children are studying above the 4th class, are going to regular school after informing the school authorities. All children are provided recreation like games, picnics, free medical treatment, and specialized counseling through trained counselors besides love and care. They also go through life skill education sessions to meet the challenges in this world and are encouraged to discuss about AIDS and their anxieties.

Dr. Manorama says her work isn’t over yet. She hopes to get enough funding to provide the expensive Anti-Retroviral Therapy to all her children as this would help increase their life spans considerably and boost AIDS awareness among the masses through a slew of programs right from the school level. Unfazed by challenges, Manorama Pinagapany is determinedly moving towards her goal.

For more information on CHES, you can contact them at:

198, Rangarajapuram Main Road,
Kodambakkam, Chennai 600 024 
Tamil Nadu, India
Tel: +91-44 -24731283

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** Deepa Kandaswamy is an award winning writer, political analyst and engineer based in India. Her articles have been published in six continents and some of her writing credits include ABC News, Ms., Truth Out, Data Quest and Middle East Policy. She is the founder–moderator of the International Gender Lobby which is a global networking platform for individuals, organizations and activists who are interested in working for human rights, peace and development worldwide.

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