Lorry drivers shown the route to sexual health

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India's lorry drivers shown the route to sexual health

By Miranda Kennedy in Delhi

14 August 2004

It is 43 degrees in the relentless sun at the Sanjay Gandhi

Transport Nagar, a truck stop just outside Delhi. After weeks of

toiling on India's highways, thousands of lorry drivers pull in for

a couple days of rest, and to wash the layer of dust off their

brightly painted vehicles.

The truck stop's 77-acre lot is dotted with mechanic stalls, barber

shops, chai stands and grimy rooms where a driver can rent a string

bed for a couple of hours. For just a few more rupees, he can get a

girl to lie on it with him, too. One recent morning, a clutch of

lorry drivers gathered around a small steel table in one corner of

the truck stop. They did not seem to mind standing in the sun's

glare: they were listening intently to a young man named Akash in

grease-stained clothes, who was holding up a series of brightly

painted boards. The first was a picture of a helmet; the second, a

raincoat; and the third, a condom.

" The helmet protects you driving, " he said, " The raincoat in the

monsoon. The condom protects you during sex. "

Akash is a lorry mechanic who has been recruited by Population

Services International in Washington DC, which specialises in the

social marketing of condoms, to do voluntary peer education about

Aids. He used rather crude diagrams to depict a " dirty " woman

infecting a lorry driver during sex. He also had a large wooden

penis model, which he decorated with a condom in a series of

explanatory steps. But his greatest tool was his easy, jocular

style. Akash was a natural performer, and his colleagues lapped it

up.

" Do I have to use this condom with my wife also? " shouted one man

from the back of crowd. " It depends how many men in your village

she's sleeping with! " Akash crowed back.

But then he got serious. " I use condoms with my wife, because I

don't want to give her anything I get from visiting

women 'outside'. " He offered to give the drivers tips about how to

convince their wives they were being faithful, even while using

condoms at home. And he quickly put to rest a common myth among

lorry drivers that not having sex would result in death or blindness.

But he did not try to convince them not to go to prostitutes. And

that is the key to the project's success, says Ashok ,

director of the Bill and Melinda Gates Foundation's India Aids

Initiative. The Gates Foundation, set up in January 2000 with money

from Bill Gates' Microsoft fortune, has dedicated one chunk of its

billions to a global health programme. The Gates Foundation recently

allotted $200m (£110m) to HIV interventions and advocacy about Aids

in India. That is the largest amount of money ever given to combat

the spread of the virus in India.

The Gates Foundation gives grants to local groups, and sponsors the

peer education project for lorry drivers. But Mr says even

all that is not enough.

" Right now, there is a window of opportunity to work on prevention

before the numbers get really out of hand. We need a lot more

people - corporations, governments - coming to the table if we are

to tackle an epidemic of this scale. "

There are more than five million people living with HIV in India,

making India second only to South Africa in the number of people

infected. That is still less than 1 per cent of India's population

of about one billion. But the sheer scale of India's epidemic should

be cause for worry, says Mr . Migrant workers, lorry

drivers and commercial sex workers are the highest risk groups, and

it is those groups the Gates Foundation wants to reach.

One driver, Gulmir Singh, a heavy Sikh in a maroon turban, had been

watching Akash's demonstration with interest. He has been driving

trucks since he was 15 years old. He recently saw his friend, also a

lorry driver, die of Aids. " He always had a fever, he was weak and

emaciated, and even though he took medicine, he never got better, "

Mr Singh said.

" He couldn't even get up from the bed. After three years he died,

and now his wife and children have nothing. "

According to Mr Singh, his friend did not visit sex workers any more

or less than the rest of them. The average lorry driver spends about

20 days a month travelling, and it is an accepted part of their

lifestyle.

But now, Mr Singh said, he and his friends were worried about

catching STDs or Aids, and they bought condoms - at subsidised

rates - from machines at many truck stops.

It is not just the lorry drivers - their bosses are getting worried

too. According to some estimates, 10 per cent of India's six million

long-distance drivers are already HIV-positive.

Increasingly, industry is agreeing that Aids is a threat they cannot

ignore. One of India's biggest tyre companies, Apollo, has opened

health clinics for drivers on major routes, where for a annual fee

of 30 rupees (35p), they can get treatment and medication.

At the Sanjay Gandhi Transport Nagar, Dr Bhavan Gall tends to long

lines of lorry drivers. Dr Gall diagnoses one gaunt driver, whose

body is covered in a rash, with syphilis.

Dr Gall says STDs are extremely common among his patients but he

notes one big difference since the clinic opened four years ago:

then, they had to go from lorry to lorry to try to convince the men

to get check-ups. Now, he says, they come in voluntarily.

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