Some 160 miles south of Mumbai, one Catholic priest and the Indian Red Cross have created what some say is a model for AIDS care in the developing world.
The combination hospital and community center provides charity care without depending solely on charity itself.
Bel-Air Hospital is an old tuberculosis sanatorium, once famous for its advanced care. It was started in 1912 in a thick forest on top of a mountain.
When Father Tomy Karyilakulam, a Catholic priest widely recognized as "Father Tomy," came upon it about 15 years ago, Bel-Air's 50 or so buildings were crumbling; trees were growing through windows and rooftops.
"As a human being, I just felt bad," Father Tomy said. "I just said, how can one allow such a good institution to go away?"
Father Tomy vowed to save Bel-Air and persuaded the Indian Red Cross Society, which owns the hospital, to allow him and his mission to rebuild it.
"There is no other place these people can get help from," Father Tomy said. "And I think that that is a situation which you cannot allow to happen."
At Bel-Air, Father Tomy has achieved what no other rural hospital in India has done: He has assembled the latest technology and doctors needed to practice sophisticated Western-style medicine. This led to his ability to get access to the government-controlled supply of drugs to fight HIV.
"The way we look at patients and deal with it is with dignity, with love, and with care," Father Tomy said. "We do not have any discrimination against any [HIV] positive person here."
Compassion and Care for All
Even the poorest of the poor can qualify for free AIDS drugs. Those who can pay are charged modest fees.
But by the time they get to Bel-Air, patients can be very sick. They've spent months getting care from underqualified doctors claiming to be AIDS experts, or from outright quacks, Father Tomy said.
The doctors go on writing the wrong prescriptions, Father Tomy said, and they give out vitamins or antibiotics that don't do anything against HIV or TB. This is why the wrong drugs and wrong dosages can create drug resistance and relapses.
"They make a mess," Father Tomy said. "They just make life for people hell. This is what is happening."
Counterfeit drugs are hurting patients, and Father Tomy said there is no quality-control system to keep people from getting bad medicines.
Bel-Air is so unusual that health experts from all over the world come to see what Father Tomy has been able to create. Bel-Air now has 250 beds and four operating rooms. Its staff includes two dozen doctors and 60 nurses.
Father Tomy is a master at fundraising. But, unlike most charities, he doesn't rely solely on grants or government aid; he's setting up several money-making enterprises.
Just down the road from Bel-Air is a brand new, private boarding school, run by Father Tomy's mission. The building has long, cool hallways, spacious classrooms, verandas and fans. The school attracts the wealthy from Mumbai and beyond. Its substantial profit goes to Bel-Air.
That is 12 million rupees annual net flow, Father Tomy said. It's equal to about $300,000 a year.
"Yes, yes, that is the college of nursing coming up," Father Tomy said, pointing to the edge of a nearby cliff.
A four-year college of nursing is rising quickly out of the red dirt. While it may turn a profit, it, more importantly, will provide 80 nurses and students to staff the hospital — nurses that will be needed as the demand for AIDS treatment continues to rise.