Bringing the Virus Home

WORLD AIDS DAY: December 1

The Hindu, November 26th 2005

SMITA JAIN

Government campaigns on AIDS still target traditionally stigmatised "high-risk" populations but the truth is that the most at risk are women among the general population.

CAMPAIGN TO SENSITISE MEN: There is an urgent need to spread awareness. Photo Courtesy: Breakthrough

IT is a beautifully crafted music video that describes the love story of a happily married couple, enacted by celebrities Mandira Bedi and Samir Soni. The lilting lyrics are by award-winning lyricist Prasoon Joshi, the director is Arjun Bali of Red Ice Films, and the mesmerising voice is that of Shubha Mudgal.

Though it sounds like the perfect formula for the latest Bollywood Indi-pop single, the video couldn't be more different. The message of the video, called "Maati", is one that strikes you squarely in the face: are you the kind of man who wouldn't use a condom for the safety of your wife?

Today, India is home to the second-largest AIDS epidemic in the world (after Africa), with more than 52,00,000 people living with the disease. Of these, nearly 20,00,000 are women, and this number is rising fast. While the prevailing notion is that the majority of HIV-positive women are commercial sex workers, statistics show that they comprise only around one per cent of the total.

Grim reality

Given prevailing gender norms in Indian society, the reality that this points to is grim: the majority of women infected are married women whose husbands or primary sexual partners are engaging in high-risk sexual behaviour outside marriage and are, in effect, "bringing home" the virus.

The Economist magazine predicts that women will soon be a majority of those infected by HIV/AIDS the world over, "with male chauvinism largely to blame". Research has shown that women are more vulnerable epidemiologically, biologically and socially to contracting HIV/AIDS, and young women are particularly at risk. Indeed, it is estimated that women are nearly 2.5 times more likely to contract HIV than their male counterparts.

In a society where discussion of sex is largely taboo, there are currently few avenues for women to get reliable information about HIV/AIDS. "Far too many women do not know how AIDS is spread," notes Irfan Khan of the Naz Foundation. "There need to be more spaces where women and girls can access information about HIV/AIDS, and also engage in open discussions on sexual health and sexuality."

Alarming spread

The rate at which AIDS is spreading among women in the general population is alarming, and the Indian Government is not acting fast enough to check its spread. "I think the situation is pretty much out of hand as far as I'm concerned," says Anjali Gopalan of the Foundation. "We're seeing a tremendous rise in numbers of women who are living with HIV."

Government campaigns still mainly target traditionally stigmatised "high-risk" populations: sex workers, men who have sex with men (MSM), intravenous drug users and migrant populations. Yet the reality is that the new face of AIDS is that of a young, married woman, who may live in a home near you.

Recognising the growing risk faced by young and married women, the video "Maati" is a part of a multi-media campaign entitled "What Kind of Man Are You?" launched by human rights group Breakthrough, to promote dialogue and equality within marriage and encourage condom use among men. "The purpose of the campaign is not to place the blame on men," says assistant director Alika Khosla, "but simply to sensitise them about the issues that women face, and ask them to sit up and think about the needs of a woman."

While men usually contract the disease by engaging in high-risk sexual behaviour, for Indian women, marriage is often the biggest HIV/AIDs risk, with nearly four-fifths of new infections being amongst married women. For Indian women, who usually marry young — it is estimated that nearly 60 per cent of women in rural India marry before the age of 16 — there is an urgent need to spread awareness about AIDS and the importance of negotiating condom use with their partners. Yet AIDS is not simply an affliction only of the poor, rural Indian woman. The number of urban, affluent women afflicted by the disease is rising.

Change in attitude

"It is a misperception that all educated women in our society — married or unmarried — are aware of the disease, and are able to easily negotiate condom use with their partners," says Khosla. "When a woman asks a man to use a condom, men often perceive it as accusing them of infidelity. This attitude needs to change."

For many women, knowledge of their HIV positive status is often accompanied by violence, stigma and abandonment by their families and societies. Meena's husband threw her out of the house after learning about her HIV status, which she had discovered during a pregnancy-related check up. He refused to get himself tested, placed the entire blame of the infection on Meena, and abandoned her along with their three children. He filed for a divorce from her on the grounds that she was HIV-positive, and married another woman.

Usha, 26, found out her HIV positive status two years ago, as her husband lay dying of tuberculosis. "We sought treatment for months and months, and couldn't understand why he wasn't getting better. At a bigger hospital, they confirmed his HIV- positive condition. Immediately after, they tested me."

Her husband is the only person she has had sexual contact with, and she was unaware of his other sexual partners. She has not told her family members about her condition, as she is unsure what their reaction will be. "I don't want to burden people with my pains. Due to god's grace, I have not yet had a reason to think about my condition. I work hard every day, with the knowledge that my daughter may study and have a better life. I want to show people that even we can lead happy, positive lives."

"Women need to know more about AIDS, and myths need to be dispelled. I know that I will never marry again as I do not want to afflict anyone else with the disease. Men need to begin to think the same way."

Indeed, if India is to stem the threatening tidal wave of atrocities against its women — and prevent an epidemic of African proportions — an attitudinal change amongst men is urgent, and necessary.

E-mail the writer at: smitajain2@gmail.com

Choosing Action Over Apathy

Choosing action over apathy (The Hindu, Nov 6th 2005)

SMITA JAIN

Leaving behind the security of their homes and jobs, young non-resident Indians are working to change things in their home country. The Indicorps venture shows the way.

Exploring their relationship with India: Changing attitudes to social service.

A CROWD has gathered at Vijay Char Rasta, one of Ahmedabad's busiest intersections. Neither for a film shooting nor an accident, and neither is it a dispute. A street school, run by Ahmedabad-based NGO Indicorps, is in progress. In a land that is home to the largest number of illiterate people, it is unfortunate that the school stands as an exception in its urban setting.

Speaking of the school, an Indicorps volunteer admits, "Many of these children attend school only for the free breakfast, yet it is important that they come, as it is the closest many will ever come to a school in their lifetime."

Though the non-traditional setting is unique, what distinguishes this from other informal schools is that the teachers — despite their traditional attire and language skills — are in fact young NRIs. They have joined Indicorps, as the website states, "to leave their comfort zones, place others' interests before their own... and explore their relationship with India."

Inspiration

Young Indians can gain inspiration from the example set by Indicorps. Though the volunteers aim to kindle an interest in learning among underprivileged children, they are aware that the school also makes a powerful statement to the people around them.

By choosing action over apathy, they are sending the message that young people need to take change into their hands if India is to become a better place for its citizens.

For a country that is one of the youngest in the world — nearly 33 per cent of Indians are below the age of 15 — the apathetic attitude of many youngsters towards community service is tragic.

Indicorps co-founder, 28-year-old Anand Shah says, "One needs to awaken the spirit of young people. There has to be the attitude that change is our responsibility and not that of the corporation, the Government, the Gram Panchayat or the next door neighbour." Anand began developing Indicorps 10 years ago from his Texas hometown along with his sisters Sonal and Roopal.

The street school is just one of Indicorps' numerous initiatives in India. Its primary programme is a yearlong fellowship in which NRI youth, aged 21-35, work on pre-selected development projects across the country.

Fellows hail from the U.S., Canada and the U.K., though applications from NRIs from other nations are welcome. Now in its fourth year, Indicorps has supervised over 35 fellows who have led projects as diverse as building entrepreneurs in Kanpur's slums and promoting health insurance among rural Maharashtrian women. So that the fellows adapt quickly to their project settings, they not only live at the project site, but also they take on the lifestyle of the area's inhabitants.

Needless to say, living with basic amenities in often-remote settings and on a stipend of Rs. 1500 a month is a far cry from the lifestyle of even many resident Indians.

Does Indicorps have a difficult time convincing fellows to stick with the programme initially?

"The challenge," says co-founder Sonal Shah, who was awarded India Abroad Person of the Year in 2003, "is not in getting people to stay, it is in getting people to return from India because just as they are beginning to realise what they can do, they have to leave."

But what tempts these youngsters to leave the security of home and lucrative jobs for an austere lifestyle of development work in India? Time spent in development activities is not just about promoting change within a community, Anand explains, it is also a unique exercise in personal development. "A year with Indicorps is an investment in our abilities. One builds problem-solving capacity, communication skills, and one learns how to take a vision and turn it into something successful." In short, Indicorps is not only building a cadre of more sensitised and aware youth, but it is also building leaders who will carry these lessons into their future careers. Current Indicorps fellow Shivana Naidoo, a medical school aspirant who has spent the last year working on a musical programme to encourage Hindu-Muslim communal harmony in Ahmedabad, describes a powerful lesson the year has taught her: "It is the working children of India — the rag pickers, boot polishers, child labourers — who have shown me the meaning of selfless service."

Indicorps brands itself as a leadership programme, and firmly believes that the reflection and personal growth that accompany the experience in development will help in building better, more effective leaders who can handle the challenges of tomorrow — and today.

For the Indians

Building leaders who can better represent India in their respective nations is at the crux of the Shah trio's goal. However, they hope to get people from India involved in their programmes — and perhaps also begin an Indicorps for resident Indians. "It is not good only for NRIs to come to India and give their time to the nation. Even people from India should be joining us," notes Anand.

Currently, Indians can get involved through Volunteer Ahmedabad (VA), an initiative to involve Ahmedabadis in local community projects. In its yearlong existence, VA information stalls have been set up at many campuses in the university-city. The message that Indicorps is spreading to youngsters in India is a simple one: you don't have to give a lifetime, a year, or even a day. Give what you have of your time and skills and you can help make this country a better place.

For many Indicorps fellows, simply living in India is an once-in-a-lifetime experience that often proves to be deeply enriching. Though they do admit to feeling the pangs of homesickness at times, most come to cherish the year for the invaluable lessons they have learned.

Rupal Soni, an Indicorps fellow working in the desert regions of Kutch to preserve traditional women's handicrafts, puts it eloquently: "Before living here, I never knew how many stars actually called the sky home. The desert sat me down for a quick lesson. `Rupal, you fool,' he said, `there's a lot of the world that you have left to see. You have to leave behind what you think you know in order to see it.'"

Treating Women's Health

Treating women's health (The Hindu, Oct 23rd 2005)

SMITA JAIN

Without formal education and facing great odds, Parmaben has succeeded in her mission to bring healthcare to Kutchi women.

Pioneering work: Parmaben's activities have impacted the lives of women in her community. Photo: Gauri Gill

HER earlobes hang almost touching her neck. Thick, white bangles cover her forearms; her richly woven kanjaria and audni speak of her desert-home. She has never had any formal education, and has only recently learned to write her name.

Yet Parmaben Sava has been nominated for the Nobel Peace Prize for her pioneering work in bringing health care to Kutchi women through the collective Kutch Mahila Vikas Sangathan (KMVS).

A Dalit by birth, Parmaben married into a family in the Kutchi village of Jam Kunuriya (near Bhuj). Following the tradition of her grandmother and mother, she served the community as a dai ben (a midwife) and was well known for her skill and care.

First encounters

She first encountered KMVS when the founders — Lata Sachde, Alka Jani and Sushma Iyengar — came to her village in 1988. She was intrigued by these women from the city who were camping outside their homes under the harsh desert sun, and speaking to women about forming a collective that would work for their well being. They identified Parmaben's unique talent in health care, and encouraged her to join the collective. Parmaben sought her husband's permission to attend the meetings, but met with severe resistance from the community. Despite this, she persevered.

Today, she is one of the pillars from which KMVS derives its strength. She has been successful in training a network of over 2,000 skilled midwives and conducts regular camps on reproductive rights, health and family planning across villages in western Kutch. She has delivered over 1,000 babies, and was instrumental in beginning the first clinic for women in Khavda.

She has inspired people around her; over 40 of her own relations hold positions of leadership in KMVS. Her grandson, a coordinator with KMVS, says, "Our family has learnt how to work from my grandmother. We realise that by following our heart and working according to our principles, only good will come — good for society and good for us. But we realise that she has struggled a lot to reach this point."

Parmaben smiles wryly thinking back to those years. "I had to fight many battles, and faced many struggles. My husband would always ask why I thought I could go out alone. It was a struggle to make him understand. I also had to bear the insults of society, but I tried to pay no heed to it and thought of them as barking dogs with no bite."

What kept her going, despite the negativity around her? "I had a deep understanding of the health problems of women from my community and wanted to uplift them. I realised that it was my duty to do it, even if I had to struggle. To gain something, you also have to lose something."

Before KMVS brought in its health initiatives, Parmaben says, the condition of women in the villages of western Kutch was deplorable. The social mores of Muslims and Harijans — two communities that dominate this region — dictated restricted roles and positions for women. Healthcare for women was almost entirely neglected and not believed to be important. Women's health-related problems were treated in a crude manner or left untreated. "If a serious health complication arose, the woman would be taken by foot to the nearby town (Khavda). It was not uncommon for the woman or the baby — or both — to die during the journey."

In Khavda, there was a general government hospital, but it was always poorly equipped and under-staffed. Besides, the doctors were always male. "Women, especially from our communities, feel embarrassed to speak about gynaecological problems with the doctor. Also, the men did not even understand the conditions we faced." In those early days, a clinic only for women seemed like a far-flung hope.

Yet in early 2005, after many battles with the Government, KMVS opened a women's health clinic in Khavda. "I had always dreamed of a health clinic for women," says Parmaben, "and now I am so happy that it is a reality."

Due to the efforts of leaders such as Parmaben in educating rural women about reproductive rights and training women in health care, thousands of women avail of KMVS resources in their villages and at the clinic.

Success

She has noticed that nearly all women from the region come to the clinic for their deliveries. Women have also been showing a greater degree of awareness and confidence in voicing their right to health care. Women across the villages look up to Parmaben as their doctor; indeed, due to her wealth of experience, she has often proved to be more effective than a doctor.

The previous week, Parmaben says, a woman in the final stages of her 10th pregnancy arrived at the clinic. Her baby was lodged dangerously in the side of her stomach.

She had approached the doctor at the government hospital, but he had refused to treat her on the grounds that the situation was too complicated and had directed her to the hospital in Bhuj. The woman could neither afford the trip nor bear the long journey.

She had heard about the new women's clinic and arrived there. That day, the clinic doctor was out of town, and Parma was the only one to receive the patient. Though she has had no formal training in handling anatomical emergencies, she began the treatment based on her experience. She began administering small doses of glucose, and slowly massaged the woman's stomach to ease the baby out. After a few hours of painstaking treatment, the baby was delivered successfully.

Parmaben believes that her inspiration comes from within, and from the good family values she has learnt. Women should be allowed to develop a sense of self-respect and self-esteem, she says. She laughs as she talks of her forthcoming trip to Canada. "For many years of my life, I lived behind my long ghunghat. It was difficult to even leave my house. This seems almost unreal."

Parmaben's nomination comes as a part of a project known as "1,000 Women for Nobel Peace Prize 2005". Since its inception in 1901, the Nobel Peace Prize has been awarded to 80 men, 20 organisations and only 12 women. The award is often given to statesmen who have been instrumental in negotiating formal peace agreements between countries. Yet the role of women in promoting peace within families, communities and societies is often taken for granted, and their tireless efforts in pursuit of the well being of people around them are not considered to be peace promoting. Recognising this "1,000 Women for Nobel Peace Prize" was begun in 2003 as an effort to identify and make visible the efforts of women across the globe who have had a substantial impact on their communities due to their courageous efforts in combating violence, injustice, discrimination and violence. Among the 1,000 women who have been chosen from across the world, 91 are from India, and 157 are from South Asia. Their work ranges from working towards communal peace, social leadership training to combating gender-based violence.

E-mail the writer at smitajain2@gmail.com