Tackling AIDS his forte

By Ruhanie Perera

His area of specialization deals with an epidemic that has held up a mirror to society. An epidemic that has made people confront issues considered unpleasant. Acquired Immune Deficiency Syndrome (AIDS) which has also left many lives as mere statistics.

But for Dr. Bruce Trigg who is the Medical Director of the Sexually Transmitted Disease Programme at the New Mexico Department of Health in the United States, AIDS is very much an everyday issue.

Having been awarded a fellowship from the Fulbright Commission and the Pai Foundation (India), he took up the post of lecturer at the Kasturba Medical College in Manipal, India. The fellowship was for Dr. Trigg, an ideal opportunity to travel, meet people and exchange ideas and experiences. And to study the situation regarding sexually transmitted diseases (STDs) in the region, Dr. Trigg decided to visit Nepal and Sri Lanka as well.

Dr. Trigg believes that controlling STDs plays a major part in preventing the spread of the HIV virus.

"The programme I run provides for a population of 700,000. Since we deal with somewhat different and rather difficult issues like sex, drugs, reproduction etc., back home, the clinic is designed to make people, who need treatment feel comfortable about coming in for help."

There are many clinics offering similar programmes to treat STDs all over the United States.

These clinics don't insist upon appointments, they require that their staff is non-judgemental and sensitive to the delicate issues involved with regard to STDs, teenage pregnancy and contraception. "In accordance with our laws, in such cases a young person has the right to medical care without the consent of his/her parents."

But to many it's the cost that matters. As a result all treatment, tests and medication, even vaccination when necessary, are free of charge. "They need help, as do the teenagers who can't take the chance of going to the private sector and risk having their bills sent home," he says.

Of the many programmes conducted at the clinic 'contact tracing' is a plan of action for further elimination of STDs. "We interview people who come in for treatment about their partners and arrange treatment for them too. If they are not the patient's usual partners, we then set about tracking them so that they can seek treatment, thus ensuring they are not instrumental in spreading STDs."

The biggest problem is the large number of drug users who contract the HIV virus by sharing syringes. "This problem is present in Asia as well," says Dr. Trigg. While in India, his research involved gathering information on STDs, the HIV virus, public health and speaking to NGOs and also delivering lectures.

He speaks with respect about the "dedicated doctors, who are faced with some very difficult decisions" in India. A person who is HIV positive could easily wipe out his entire family financially.

On a positive note with regard to Sri Lanka, he said STD clinics, similar to the one he runs, are conducted here as well. "The challenge would be to keep things the way they are - in control."

South Asia's biggest drawback, in Dr. Trigg's opinion, is its lack of finances and as a result, inadequate access to drugs and other forms of medication to combat these epidemics.

"The price is always too high for developing countries. But these are ethical issues that the world has to deal with. We live in an interesting time. The generations of the future will judge us on how well we have dealt with such issues," he says somewhat philosophically.

Travelling with Dr. Trigg are his wife and children. This is more than just a "family affair", insists wife Elizabeth Matthews, smiling.

She too is a doctor and when her husband got the chance to broaden his professional career she promptly decided to join him and do the same.

Dr. Matthews is a paediatrician who works in a development programme for physically and mentally challenged children.

Under the 'Preschool and Infant Evaluation Programme', children with difficulties are identified at a very young age and started on programmes to enable them to reach their full potential. "Unfortunately we have experienced many financial cutbacks recently and can't give the kids as much as we were previously able to. So we have had to rethink our strategies," she says.

Dr. Matthews feels that community-based programmes help children in a very creative way and such successful efforts in this part of the world have inspired her.

In such a programme in Nepal therapists, health aides, parents, teachers and even local craftsmen (when their services were needed for making wheelchairs etc.) joined hands to help the children in their community. "Unfortunately, there simply wasn't enough time to do everything I wanted," she says, adding with a laugh that she is determined to be the next in the family to apply for a Fulbright fellowship.

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