In this powerloom town, knowledge about HIV is power

[Guest guest]

In this powerloom town, knowledge about HIV is power.

More than 40 lakh people are dependent directly or indirectly on the powerloom

industry in the city of Bhiwandi. Yet literacy levels and healthcare are of the

poorest quality.

Pankajkumar Bedi tells the story of one NGO that battled ignorance and religious

taboos to raise AIDS awareness levels and provide a much-needed service

The city of Bhiwandi in the Thane district of Maharashtra is located 60 km to

the north-east of Mumbai and 15 km to the north-east of Thane city. The economy

of Bhiwandi is heavily dependent on the powerloom industry. The decline of

Mumbai's textile mills spurred the growth of the powerloom sector. In order to

meet the demand for grey fabric, powerloom centres sprang up in various parts of

Maharashtra.

Textile and migrant workers came in droves to find work at these centres.

Bhiwandi became the largest powerloom centre in the country. The state

government estimates that over 40 lakh people are dependent directly or

indirectly on the looms of Bhiwandi.

Almost 80% of the population of Bhiwandi is Muslim, most of them illiterate.

Ishtiyaque Ahmed, editor of a local newspaper, says the area is plagued by

extreme poverty, illiteracy, poor sanitation and water and power shortages. The

condition of government schools is pathetic - 300 students in a class that is

monitored by a single teacher. Private schools are expensive and a loom worker

can only dream of sending his children there.

Public healthcare facilities are no better. So the work of the NGO Rashtra

Swasthya Prabodhini (RSP) is critical.

It works in Thane district to raise the awareness levels on health, provides

healthcare services by way of a clinic and referrals, and promotes condom use as

a means of safe sex and to prevent STD/HIV/AIDS.

The work started in 2001 and it wasn’t easy. Says Ajeem Ansari, a peer educator

and one of the senior staff: “It has been difficult. The community that we

wanted to reach out to had religious beliefs and taboos surrounding condoms, STD

and HIV/AIDS. They refused to listen to us. We were shunted out many times,

abused, and even beaten up. But we knew that it was necessary to talk to them

and make them aware of the risks that the community was exposed to.”

Labour in Bhiwandi is cheap and loom shed owners have exploited the situation.

They pay well below the minimum wage and provide inhuman working conditions.

“Hundreds die of tuberculosis because they inhale cotton lint and many are

handicapped by physical disabilities every year, " says Abdul Hakim who runs a

tailoring business. " There is absolutely no protection for the workers. If you

protest, you can be sacked. In Bhiwandi, it is possible to pick anyone off the

road and they are prepared to work for any amount. "

The daily wage of a powerloom worker is between Rs 60 and Rs 100; frequent power

cuts bring down the number of working hours and this reduces the salary further.

Long days of hard labour and lack of family comforts encourages the men to seek

the services of sex workers.

“Before our project started, their knowledge about HIV/AIDS was based on

religious interpretation. Sab Allah ki den hai (All that comes, comes from

Allah), many would say,” recalls Aslam who owns the Jhankaar cinema hall. The

team from RSP persuaded Aslam to show films on HIV/AIDS during breaks in his

video shows. “Men did resent it, but the medium was effective in shattering many

misconceptions about HIV/AIDS,” says Ajeem.

Ajeem was the first peer educator and helped establish the much-needed

confidence in the community about the project. “They knew only how to run the

power loom machines and paid little attention to any talk about health, HIV and

condoms. Talking about sexually transmitted diseases (STD) was a big taboo!” he

admits, adding that what helped break the ice was that he himself belonged to

the community. “But I cut across both communities – to Muslims I would say,

Salaam and to Hindus Namaste - and only after befriending them would I start

talking about the issue,” he says.

Somewhere, the community knew it needed this information. Since what the RSP

provided as part of the health service package met the needs of the community,

the latter opened up and became more receptive.

Kamlesh, an old hand at RSP, recalls the first concrete steps in winning

community confidence. “All loom workers ate in a mess or canteen known as the

bhisi. Once I was talking to a small group in front of a mess in Gulzarnagar

when the owner of the mess called me in and told me to talk to the men who were

eating in the canteen. That was the first support we got from the community.”

RSP’s AIDS awareness project funded by the Maharashtra State AIDS Control

Society (MSACS) gradually succeeded in raising the level of awareness in the

community and in giving those who needed it confidence to access services like

the clinic, regular health check-ups and condoms.

Holistic healthcare

Sudhakar Marathe, who is in charge of the project, points out that Bhiwandi has

no all-encompassing healthcare service. The combination of information, testing,

treatment and counselling that the project provided helped the community to

recognise the risks they were exposed to (long hours of work, unprotected sex,

STD) and take precautions.

A clinic started in 2002 provided facilities like STD diagnosis and treatment,

voluntary testing and counselling. The team at the clinic established linkages

with government hospitals in Bhiwandi, Thane and Mumbai and arranged for

referrals. Awareness creating IEC materials, behaviour change communication

(BCC) and events like World AIDS Day and festive occasions went hand in hand

with setting up condom vending machines in the locality. Now there are 12 condom

outlets accessed by the community.

“A small measure of success is the fact that earlier the condom was haraam

(forbidden); some would call it a do paise ki cheej. But now even the women ask

for it,” says Marathe.

Sameer, a young outreach worker, says that all the components - counselling,

referrals to quality healthcare centres and even condoms - brought about a major

shift in the beliefs and perceptions of the people. “People got over their

religious taboos and differentiated religion from health. Even women started

listening to us.”

Another major indication of change is the fact that requests come in from

mohalla peace committees, madat committees, youth committees and even

individuals for a discussion on HIV/AIDS and STDs. On Fridays, the weekly off

for the loom workers, the team has to attend many such requests, some coming

from women’s groups.

Making headway

“Our counselling was put to the test when one couple, the first HIV case in the

community (in 2002), came to us,” says Kamlesh. “They would often quarrel and

blame each other for their situation. At the counselling centre, we first held

individual counselling sessions and then counselled the couple together. We told

them that instead of blaming each other, supporting each other would help them

fight the virus. They became regulars at the clinic and have not faced any

critical health complications so far.”

Ragini (not her real name) is the quintessential success story. Married at 16,

she was expecting her first child at 17, when the family doctor confirmed that

she was HIV-positive. Her husband Kishore was jobless and often resorted to

petty crimes to earn money, a practice she despised and wanted to correct. She

herself is a powerloom worker. She remembers vividly the moment when her mother

informed her about her status. “All of them (relatives) were in profound grief.

I felt as if somebody had died. When my mother told me that I had HIV, I was

shocked. But I did not break down. Somewhere deep in my heart, I decided to face

it bravely and the fight began the moment I heard the news. Had I broken down, I

would not have been here.”

Ragini came into contact with RSP through her mother. Manoj Singh, a counsellor

at the RSP clinic located in the Indira Gandhi Memorial Hospital says the mother

worked at the hospital and “she knew that we work on HIV/AIDS. She would often

come and ask me if there is any remedy for AIDS. One day I convinced her to

share the reason for her curiosity and she informed me that her daughter had

tested positive.”

Ragini was counselled at RSP and was told about the Network for Positive People

formed by HIV-positive people to provide care and support to each other. She

attended a one-day support group meeting at the network’s office in Kalyan.

“That one day changed the way I thought to take forward my life,” Ragini says.

At the meeting she learnt how to manage the situation and deal with HIV. “I

learnt that I can control my life and live as healthy as anybody else. Why

should one feel let down by a health condition which will only go haywire if you

yourself don't attend to it with care?”

Becoming a part of the network was not easy for Ragini. Her in-laws were not

aware of her status, but her husband had let her down by blaming her for the

condition. “My in-laws did not approve of me stepping out of the house. I knew

that my husband was positive and informed him about the network. But he refused

to either come with me or allow me to go and visit the network.”

Ragini had to fight it out and she fought with grit and determination. “I

remember her coming to RSP and telling me – if someone meets with an accident,

he dies immediately. But I am alive and have many more years to live. She was

highly optimistic and her confidence even shook us,” Manoj Singh recalls.

This confidence helped her to leave home with her daughter and come to the

network. “I told Shabana (president of the Thane Network of Positive People

[NTP+]) ‘give me just eight days to stand on my feet and I will take care of

myself’. And I am happy that I did so.”

She was trained to become a field officer and a positive speaker. Today she is a

field officer at NTP+ and looks after her daughter Shyamali, now five years old.

“I do follow-up with the network members and share my experience in the positive

group meetings even at MSACS.”

Away from her husband and in a home of her own now, Ragini dreams of educating

her daughter. She calls the virus a naughty child with whom she has to live. “I

know just how naughty it can get, but I can control it.”

(Pankaj Bedi is an HIV/AIDS worker and works with the Centre for Advocacy and

Research, Pune)

InfoChange News & Features, May 2009

http://www.hivaidsonline.in/index.php/Interventions/in-this-powerloom-town-knowl\

edge-about-hiv-is-power.html

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