NEW DELHI • The bicycling doctor made an offer his patients could not turn down: Medical cures for 10 Indian rupees (20 Singapore cents).
Now dozens of patients in northern India are bearing what could be lifelong costs of HIV infection after the medically unqualified man reused an infected needle, officials said on Tuesday, a grim consequence of quacks and unlicensed practitioners filling in the gaps of a healthcare system struggling to meet the needs of 1.3 billion people.
Rajendra Yadav used a dirty syringe to infect nearly 40 people with the virus that can lead to Aids, said Dr S.P. Chowdhary, the chief medical officer for the city of Unnao, where the patients were infected. Authorities expect to find more victims.
"As of now, he is the one responsible for so many people catching HIV infection. There can be other reasons, but initial investigation puts the onus on him," he said, according to the Hindustan Times. Yadav has yet to be apprehended.
Unlicensed people calling themselves doctors, known as jhola chaap doctors, circulate in poor and rural communities in India. Hospitals and physicians can be sparse in the world's second-most populous country, where there is less than one doctor per 1,000 people, below the standard set by the World Health Organisation (WHO), the government said in July.
About a third of those claiming to be doctors had no formal medical schooling, according to a 2016 WHO report. About 19 per cent of them in rural areas possessed the necessary qualifications, compared with 58 per cent in urban areas.
The problem is so acute that the Delhi Medical Council operates a running list of hundreds of unlicensed doctors it refers to as "quacks", who are distinguished from legitimate alternatives to licensed medical professionals.
Many Indians rely on folk medicine Ayurveda practitioners and shamans in tribal areas.
Warning signs of infection showed up in July, health officials said, when numerous patients filled local facilities complaining of various ailments. A dozen tested positive for HIV, and another 13 were found with the virus in November, according to the Hindustan Times.
Victims range from children as young as six to people in their 70s. In one family, six were infected.
"All of them were treated by him in the past," Dr Chowdhary said, according to the paper.
Government officials promised action; Uttar Pradesh Health Minister Sidharth Nath Singh said a crackdown on unqualified doctors is possible.
According to the Hindustan Times, officials had an opportunity to blunt the actions of Yadav and halt the infection rate.
The paper said on Tuesday that it had obtained documents indicating a top regional official was notified of the problem in July and did not act.
Chief district doctor Rajendra Prasad received letters of inquiry from Dr Uma Shankar Dixit, the medical superintendent at Unnao, and from Dr Chowdhary.
Dr Prasad claimed he did not recall receiving the letters, the paper reported.
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