How an unknown microbiologist altered the face of HIV research in India

How an unknown microbiologist altered the face of HIV research in India

By SRIJA NASKAR | | 10 September, 2016
Sellappan Nirmala. Photo credit: BBC
Thirty years ago, when HIV/AIDS was considered a disease exclusive to the ‘debauched West’, Sellappan Nirmala, a young microbiology student from Tamil Nadu, carried out groundbreaking research, tracing strains of the virus in patients across India, writes Srija Naskar.
The discovery of HIV happened because of a search for a dissertation topic by a microbiology student in erstwhile Madras. Sellappan Nirmala was 32 years old when she discovered the presence of HIV in Indians while studying at a medical college. Blood samples of six sex workers were found to be positive, but in a country like India, where the movement against HIV was still in its nascent stage in the early ’80s, young Nirmala was reluctant to take up the issue. Encouraged by her mentor, Suniti Solomon, Nirmala ultimately decided to pursue her research in HIV — a seminal work that changed the fortunes of the ones affected in the country.

Meeting sex workers was not easy, so Nirmala visited hospitals and spoke to patients being treated for sexually transmitted diseases. These people helped her find names and an address where she could meet her subjects for blood samples, a place called Vigilance Home, where sex workers were taken in by authorities as punishment.

Nirmala collected about 80 samples over the next few months from these sex workers and then with the aid of her professor, Solomon, set up a makeshift laboratory, where they tested these blood samples for HIV. As suspected, the samples turned yellow after the tests. They had to accept the fact that India was just as susceptible to this deadly disease as the West.

After a lot of hardships, Nirmala made this path-breaking discovery. Unlike metropolitans like Mumbai, Delhi, Bangalore or Calcutta, Chennai had no fixed address for sex workers. It was difficult to even start the project, let alone befriend the sex workers who would be willing to share the blood samples with her. Her husband, Veerappan Ramamoorthi, helped her at every step. Born and married to a traditional middle-class household, the couple had just started out on their careers. But that did not deter them from pursuing the search for this terminal disease, hitherto unknown in India. With zero sanction of funds from the state government, Nirmala relentlessly pursued her passion, with help from her husband, who would drive her everyday to the remand home, in order to save up on the expenses of public conveyance. Neither did they have any state-of-art laboratory with advanced equipment to test the samples after they were collected. Once the sampling was done, the serum separated from the blood samples, in the absence of a better storage facility, Nirmala kept them in her home refrigerator. The results of the test were staring at them in their faces.

Nirmala collected about 80 samples over the next few months from these sex workers and then with the aid of her professor, Solomon, set up a makeshift laboratory where they tested these blood samples for HIV. As suspected, the samples turned yellow after the tests. They had to accept the fact that India was just as susceptible to this deadly disease as the West. 
 
As the news spread, Tamil Nadu responded terribly towards Nirmala, Solomon and her husband. They were threatened and forced to keep their findings under cover. But when it was understood months later, after a group of pathologists went to the same remand room to get the samples and tested it for positive in the US, that millions of Indians were infected with HIV rather than the handful in Tamil Nadu; the sad saga was conveyed to the Indian Council for Medical Research (ICMR), which informed the then Prime Minister Rajiv Gandhi and then Tamil Nadu state health minister, H.V. Hande.

When Hande announced the news in the state assembly, the initial reaction was one of disbelief, some even questioning the authenticity of the tests. Solomon, who died last year, was singled out by the critics since she was an outsider, hailing from Maharashtra. As the BBC quoted her son, Sunil Solomon, saying, “People were really angry, they said a north Indian woman is telling us we are dirty. But everyone was in shock, including my mother.”

Over the years, HIV-AIDS has become an epidemic in India, with government-aided and private advertising companies doing their very best to spread awareness on the same. Today, in India, more than 2.1 million people are reported to be suffering from this fatal disease. They also continue to face social discrimination in various parts of rural India; deprived of education, employment, marriage and so forth. While doctors, governments and NGO’s are still trying to eradicate the most popular myth surrounding HIV — that this is not a disease which gets transferred by touch — the battle is far from won.

Yet the collective efforts of Nirmala, Solomon and Ramamoorthi remain the most valuable contribution to this field.

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