Newsweek article: A Deadly Passage to India

[Guest guest]

http://www.msnbc.com/news/835539.asp

A Deadly Passage to India

More than 20 million people could be infected with the AIDS virus by

2010. A journey to the heart of a suffering nation.

By Geoffrey Cowley

NEWSWEEK

Wonder, degradation, hope—it's all on parade on a torrid summer

night in Kolkata's Kalighat district. Pilgrims are swarming in the

jasmine-scented mist outside the Dakshineswar Kali Temple. They've

come from all over India to pay homage to Kali, the fear-some Hindu

goddess who continually devours whatever life the earth generates.

The lane leading up to the temple is a joyful riot of rickshaws,

mopeds, stray goats and street vendors. Inside, the mood approaches

ecstasy as worshipers burn incense and lay garlands and balloons at

the feet of Kali's statue. But the scene grows darker, and death

more mundane, as you wander the torch-lit lanes that extend behind

the temple to the bank of the Hugli River. Pigs for-age freely at

the waterfront for garbage and funeral-pyre leftovers (open fires

make imperfect incinerators). Men lounge on cots in front of small

huts while, inside, their wives perform sex acts on strangers for a

few rupees. Kids play on the pavement amid pimps and johns who

hunger to put them to work. The AIDS virus thrives in places like

Kalighat, and Asia has many of them. That's one reason the region is

now in such peril.

As the vanguard of what the CIA has dubbed the " next wave " of the

global AIDS crisis, India and China could have 40 million HIV-

positive people by the end of this decade—the same number the entire

world has today. The CIA predicts that India alone will have 20

million to 25 million infections, up from 4 million today, " even if

the disease does not break out significantly into the mainstream

population. " That's not to say that disaster is inevitable. Despite

its widespread poverty, India has a growing economy and the

rudiments of a health-care system. It also enjoys substantial

support from international donors such as USAID and the Bill and

Melinda Gates Foundation, which last week announced a new $100

million India initiative. But it will take more than money to stop

this juggernaut. The challenge, says Dr. Helene Gayle of the Gates

Foundation, is to create a national network of AIDS prevention

programs to reach all those in need. As anyone traversing this vast

country soon learns, that is a tall order.

AIDS has varied faces in a country this vast, but those of the women

stand out. As I discovered in the Tamil town of Namakkal, a

monogamous woman can earn her in-laws' contempt by getting infected

by her husband. With their bright saris, almond eyes and shiny black

hair, Chitra, Selvi, Suganda, Selvamani and Vanilla look more like

college girls than widows. When the girls were in their late teens

or early 20s, all five married truckdrivers and, in keeping with

tradition, stayed home to care for babies or in-laws while their

husbands plied the highways. All five are now HIV-positive, and all

but one have nursed their mates through their own illness and death.

The women still wear their wedding necklaces, still care for their

young children. Yet each is now reviled by her in-laws. " The family

always blames the wife, " Suganda explains matter-of-factly. " Very

few husbands will admit their own responsibility. "

It's easy to feel for Suganda, harder to sympathize with whatever

truck-stop prostitute propelled the virus into her life. Then you

meet her, or someone like her, and realize what a small role that

choice has played in her life. Pattamal is one of 500 young women

working the trucks that stop for gas or repairs on a 30-mile stretch

of road outside Chennai. She is not a derelict, not a party girl;

she's a mom. Seated on a stool in the roadside office of a service

organization called Santoshi, she strokes the hair of her quiet 6-

year-old daughter and explains her strategy for keeping the child

fed. When a driver propositions her on the roadside, she secures a

commitment of 100 rupees ($2), then gives him 10 minutes behind a

bush or in the cab of his truck. If the driver pays up, she makes as

much as she would from a day of scrubbing floors, and hardly has to

leave her daughter's side.

How did India get into this mess? In many ways the country has been

an AIDS disaster waiting to happen. Poverty and illiteracy are rife,

and the commercial sex trade is huge. Women have little if any say

in their sexual and reproductive lives. And a well-developed

transportation system ensures that a sexually transmitted virus will

spread widely once it arrives. When HIV arrived, in 1986, it had

been battering other countries for five years, and its dynamics were

well known. But instead of mobilizing to contain the virus, public

officials blithely asserted that India's " moral character " and

conservative sexual mores would keep it from spreading. The virus

quickly defied that prediction, racing through red-light districts,

infecting both sex workers and their clients. So the police started

rounding up sex workers for mandatory blood tests, sometimes jailing

the infected instead of promoting safer sex. Hospitals took a

similar tack, using blood tests to expose and evict infected

patients.

The political landscape is more hospitable today. The leaders of

both major parties now acknowledge the urgency of the threat, and

the country's AIDS-control agencies have won worldwide acclaim for

their work with high-risk groups such as sex workers and street

kids. Unfortunately, many average Indians are still living with more

risk, and less protection, than they realize. Some 7 percent of the

nation's adults harbor sexually transmitted infections—and nearly

four men in 10 recall at least one homosexual encounter, according

to surveys conducted by the Delhi-based Naz Foundation Trust.

Sexuality was once —a major theme in the culture. Tamil Nadu's

temple sculptures offer elaborate taxonomies of sensual pleasure,

both for couples and for trios ( " One lady, two gents, " as my guide

politely observes). But the Kama Sutra spirit is not much in

evidence today. Sex is largely absent from the Bollywood cinema, the

mass media and casual conversation.

Schools offer little or no sex education. And homosexuality is not

only a moral offense but a legal one under Section 377 of the Indian

Penal Code. If sex has become a difficult topic for ordinary

Indians, AIDS is often an impossible one. Groups providing care for

patients or orphans risk eviction if their landlords or neighbors

discover their true mission. In several recent instances, local cops

have detained or harassed outreach workers for distributing the

government's own safe-sex education materials.

Where, then, is the basis for hope? A mom with other options would

not turn $2 tricks on a roadside. A wife with other options would

think twice about waiting on her in-laws while sex workers waited on

her spouse. And children with options would surely look beyond the

alleys of Kalighat for their livelihoods. No one—not even Bill Gates—

can create such choices by fiat. But at every level of Indian

society, one sees hints that change is possible. Pattamal may live

humbly, but she learned about HIV in time to avoid contracting it

herself. She has used condoms consistently for the past five years.

As an educator for Santoshi, she now distributes them to her clients

and her peers. In a benevolent pyramid scheme, she then enlists them

to do the same. Similar programs have sprouted in most of India's

red-light districts in recent years, and some have shown dramatic

results.

In Kolkata's Sonagachi district, a grassroots sex workers'

collective called the Durbar Mahila Samanwaya Committee (DMSC) has

held its 30,000 members' HIV rate below 10 percent for the past

decade, even as the rates among other cities' sex workers has topped

50 percent. When members talk about the years before DMSC started in

1992, it's as though they're recalling bad dreams. Manju Biswas is

typical. She was barely 13 when a neighbor in her village brought

her to Kolkata on the pretext of finding her a job and sold her for

$30 to a brothel keeper. Manju's father, a subsistence farmer, had

died and her mother and brother were facing starvation. She was

completely illiterate. " I was kept in a small, dark room locked for

days by the madam, " she told me. " Then one night I was forced to

drink something that made me dizzy, and then this huge, drunken man

was on top of me. I was screaming in pain but I fainted. When I woke

up I was bleeding heavily. The madam told me I was now a fallen

woman and should stop pestering her to let me go home. These men, 10

to 15 a day, would call on me. It was a horrible life. "

Through simple coalition-building, the DMSC gradually transformed

the surrounding district and became a legitimate power broker. " We

have now branches in almost all the towns and cities in West

Bengal, " says Swapna Gayen, DMSC's president. " We now sit across

from officials and discuss matters relating to our health and

welfare. " The group also runs a 24-hour AIDS hot line that offers

free medical and legal guidance to anyone seeking help.

Whatever their circumstances, few sex workers would choose

prostitution for their daughters. While standing up for their own

rights, most also do whatever they can to see their own children

liberated entirely from the trade. On that front, too, signs of

progress are easy to find. On the edge of Mumbai's crumbling

Kamathipura red-light district, a group called Apne Aap has created

a safe place for school-age girls (they call themselves " Sparrows " )

to read, paint and socialize. Another group, Sanlaap, runs a similar

operation in Kolkata's Kalighat. Because this district's prostitutes

work in their huts, the kids are essentially homeless from dusk

until midnight. But for the past few years they have spent their

evenings in Sanlaap's two concrete shacks, getting the encouragement

and electric lights a kid needs to become literate. As I sat down

with a dozen of the teens who frequent the drop-in center, its

impact was palpable. All but two are in school. Seven are planning

for college. And any one of them, even the 10-year-olds, can tell

you how to avoid contracting HIV. The Sanlaap kids have recently

launched a campaign to raise AIDS awareness within the red-light

district—and the older ones are now seeking a wider audience. " We

want to be leaders, " says Sushmita, a poised 18-year-old who has

just completed her college-entrance exam. " We want to show people

outside Kalighat that a youth group from this district can make a

difference. "

Small victories add up, but neither the Kalighat kids nor the

Sonagachi sex workers will transform a nation of 28 states, 24

languages and a billion people. It's one thing to get a child

through school, quite another to shatter a legacy of fear, ignorance

and stigma. Fortunately, bigger players are now embracing that goal.

The Gates Foundation has yet to work out the details of its new $100

million program, but its immediate goal is to target the country's

huge mobile population—not only truckers but also soldiers, railway

workers and oil workers. The foundation has the clout to foster

alliances among employers in all those sectors, and the freedom to

cross the public-private divide. One can only guess how all these

efforts will play out. What's clear is that Asia's infant plague

does not have to grow into a disaster.

With Sudip Mazumdar

Geoffrey Cowley

E-mail: <geoffrey.cowley@...>

_____________________________________

[Guest guest]

This is in resposne to the article " A Deadly Passage to India "

Which says " More than 20 million people could be infected with the AIDS virus

by 2010. A journey to the heart of a suffering nation " .

That's all? Only 20 million? Oh, heck, even if it's 50 million, why should

the government care. First, they're mostly poor. A goodly number are women which

is even less important. Others are distasteful minorities like Tamils or

homosexuals, drug users, sex workers. Probably a bunch in Manipur are muslims.

And after all, 50 million is only 5% of the whole population--heck it probably

won't exceed 2.5%.

So why should the government waste any time on this HIV thing? They've got

SECURITY concerns in Jammu and Kashmir to worry about. And maybe a little pocket

lining on the side. OH! Now THERE'S a damn good reason to worry about HIV. UN

money. Windows to the world.

Is this post too cynical? The horror, too....these words coming from a

white American homosexual. How DARE he. Especially cause we all KNOW that

America's best and has the best foreign and domestic policies, like

abstinence only and prosecuting a war on some drugs that has done so much

to put 2 million people in jail, mostly minorities.

Yes, my poor dear brown little brothers, follow in the footsteps of the

compassionate approach of my country and you'll do just fine !.

M.

E-mail: <gmc0@...>

________________________________