SOLAPUR: Sumana has the appearance of a 10-year-old though she’s a teenager 11 months shy of 18. Four feet tall and with body weight of 30 kilos, she is at least 25kg underweight and significantly short for her age. Her mental ability is of a kid half her age. She is also hearing impaired.At Solapur’s Palawi-Prabha Hira Pratishthan, one of Maharashtra’s oldest institutions caring for children living with HIV , cases like Sumana’s are not an exception. At least 60% of the 110 children here suffer from varying degrees of hearing loss. The prevalence of height and weight stunting is more than 70%, while over a third have stymied mental development. Besides physical, the prevalence of mental health problems such as depression is alarmingly high.AIDS-related deaths may have dropped 54% and new infections 66% in India over a decade, but children like Sumana are testimony to the gaping deficit in the national programme that focuses on drugs instead of a comprehensive medical, nutritional and psychosocial model that a complex disease like HIV warrants.An otherwise spirited child, Sumant becomes drowsy and irritable after taking medicines. “I get severe stomach-ache, dizziness, headache and diarrhoea,” he says, describing his plight after taking the daily dose of antiretroviral therapy (ART) medicines. The six-year-old is among the 17 children at the Palawi home who have forsaken ART even though their survival depends on it. Born with the virus, these children need to take 2-6 capsules daily. For additional infections such as tuberculosis, the pill count could run into double digits.“Children go through hell in spite of ART. There is no denying the dramatic shift in HIV care today, but what about those who got the disease at the turn of the century and have spent a lifetime taking medicines? We know little or nothing about what the virus or ART does to each child,” said Palawi’s 65-year-old founder Mangaltai Shah. She says most children in Palawi grapple with everyday health problems ranging from skin rashes, oral and vaginal yeast infections, pus accumulation in ears, hearing and vision problems to life-threatening infections like TB. “So when medicines meant to heal start giving trouble, they find it easier to discard.” Moreover, she adds, institutions like Palawi neither have adequate funds nor support from government hospitals to tackle the unique problems of each child.Sumant is supposed to receive intensive counselling from the local ART centre till his adherence improves, but Shah says the three doctors and four counsellors that cater to 300 HIV patients daily at Solapur Civil Hospital barely have the time.For nearly 3 lakh registered HIV patients in the state, there are less than 1,000 counsellors. Palawi was compelled to start its own school in 2014 as children are denied admission in regular ones the moment Palawi is mentioned. But it’s a blessing in disguise for these children who struggle to sit through more than one or two classes without dozing off.Palawi, which has been home to 250 HIV-positive children since 2001, has lost 40 to the disease.