A man masked as a doctor infected at least 40 people in Unnao district, Lucknow with HIV using contaminated syringes and needles. Uttar Pradesh Police on Wednesday arrested unlicensed, self-proclaimed and fake doctor.

The bicycling doctor offered his patients couldn’t turn down, medical cures for just Rs 10, or less than two dimes. 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.

Police in Uttar Pradesh tracked down Rajendra Yadav, who provided cheap door-to-door medical services to poor villagers, after a filing a criminal case against him over the spread of the infection in Uttar Pradesh’s Unnao district. Yadav had been going around northern India, supposedly treating poor villages for coughs, colds, and diarrhea, the reports said.

Sushil Choudhury, the official, said police were looking for Rajendra Yadav, who fled Bangarmau, a small town in UP after the HIV infections were detected in December last year. The villagers said they rarely saw Yadav changing the needles. Choudhury said that probably led to the spread of HIV.

A sudden spike in HIV cases in and around Bangarmau was detected in December, alerting state officials. An investigation showed that almost all of them had taken injections from one person,” Choudhury said. “This was an important lead. We set up special medical camps in villages in the area and checked 566 people, and 40 were found to be HIV positive.”

With India’s healthcare system facing a massive shortage of doctors and hospitals, millions of poor people seek fake doctors for cheap treatment. India had 2.1 million people living with HIV at the end of 2016, according to a UNAIDS report. Of those, 9,100 were children under age 15.

Mehtab Alam, a project manager for Raza Husain Memorial Charitable Trust, said that one way to differentiate fake doctors is that they use glass syringes instead of disposable ones, using one needle for hundreds of patients. The charity works with HIV and AIDS patients in northern India. Alam said, “Villagers are ignorant about hygiene.”

HIV or the human immunodeficiency virus is transmitted through blood transfusion, use of infected needles and syringes, unprotected sex, or from mother to child. It weakens the body’s immune system, making it susceptible to various infections. Over time, an HIV infection can develop into Aids, a progressive failure of the immune system that leaves the body open to life-threatening infections and cancers.