Positively
Neglected
By Preetu Nair
05 November, 2006
Countercurrents.org
Rehana has just resumed her night
job at Vasco, in Goa state, India, after a brief illness. If luck is
smiles she will earn anything between Rs 100 and 500, from what she
calls the only work she has.
And because she and her family
must survive, she fails to insist that the customer to use condom though
she is HIV positive and aware that using condom decreases the risk of
HIV transmission. "Most often we are not in a position to negotiate
safer sex" she said.
When Rehana (one of her many names) was 15, she caught a morning bus
to Goa from Karnataka, along with her lover. By evening she was sold
to a brothel keeper in the unofficial red light area of Baina for Rs
10,000. At the age of 23, she tested HIV positive.
Rehana, who till then wanted
to live a normal life and get rid of the world of drinks, diseases,
beatings and neglect in utter disbelief started drinking heavily."
I began drinking heavily because I knew I was dying. Besides, I drink
to reduce the pain I undergo while having sex with a customer".
She knows that she can still
live well and long, if she gives up her addiction to alcohol, gutka
and beedis coupled with a careless attitude to medication and failure
to adopt lifestyle changes. But what's killing her more than the virus
is the lack of hope, the absence of family and community support, tension
and their poor socio-economic condition.
"I am aware of the community
care services for HIV positive persons, but don't want to avail them
as of now I don't want to leave Baina, my home, where I am not stigmatized
and treated differently," she admitted.
Rehana is not alone. There
are many like her who want to leave commercial sex work (CSW) and live
a healthy life but are unable to as there is no alternative. However,
she added, "If these services are made available to me at home
along with economic rehabilitation then I would definitely leave CSW
and live a healthy and less painful life".
Living with HIV is not easy.
And for a HIV positive trafficked victim it is a bigger struggle. Despite
their suffering they are rarely able to express themselves. To survive,
majority of them hide their HIV status. What is really alarming is that
though there is awareness about risks, use of condoms is low, both with
non-paying and paying partners, thereby increasing the risk of transmitting
the virus. A Behavioural Surveillance Survey 2003-04 at Baina showed
that only 69 percent used condoms regularly.
Goa State AIDS Control Society
(GSACS) sentinel surveillance estimates that in 2003, around 30.14 percent
sex workers in the state were HIV positive. However, the real figure
would be probably much higher now.
The United Nations recently
reported that that India with 5.7 million infections has become the
HIV/AIDS capital of the world surpassing South Africa's 5.5 million.
Though there is dispute regarding the number of infections, no one denies
that despite various attempts the spread of the virus shows no sign
of slowing down.
Talking to GT/Weekender,
Dr Prakash Kanekar, Project Director, Goa State AIDS Control Society
(GSACS) admits that they can't afford to be complacent and need greater
commitment to reverse HIV/AIDS epidemic as the task has become more
difficult after Baina demolition. "It is now extremely difficult
to identify a commercial sex worker"
Even Arun Pandey from Arz,
an NGO working with trafficked victims in Goa, candidly admits that
HIV positive trafficked victims continue to be victimized due to lack
of community based services and failure of the state and even NGOs to
protect them. Instead of making them independent we make them dependent.
We not only put their life at risk but also fail to control the spread
of the virus." Arun added.
Interestingly, majority of targeted interventions undertaken by NGO's
through GSACS among CSWs are focused on free condom distribution and
creating awareness through peer educators. Besides, GSACS also funds
two community care centres with 10 beds each –Freedom Foundation
in the North and Aasro in the South – but they are short stay
home providing services required in between a home and hospital.
However, Ninoshka Norton,
Project Coordinator, Freedom Foundation, admitted that they have often
observed that HIV positive trafficked victims put on DOTS or ART don't
continue treatment once they leave the home. "Once out of the home,
they go back to their normal routine and start drinking and smoking.
This deteriorates their health further," she added.
No easy choices
Though it is difficult to
describe the predicaments and circumstances women in CSW face, GT/ Weekender
tries to comprehend a few of them to better understand their lives and
situations under which they live
ALL ROADS LEAD TO
…
The eldest daughter of the
family, Surekha was dedicated to Goddess Yellama as soon as she gained
puberty and brought to Baina by a brothel keeper for CSW. Three years
back she was tested HIV positive and was also found to be suffering
from TB. "I wanted to leave CSW but there was no alternative. Besides
there is no one to take care of me," she said.
Though her CD4 count is low,
doctors can't put her on ART, because she is taking treatment for TB.
However, her TB can't be cured because she doesn't regularly take medicines.
NO DATE WITH MEDICINES
Madhumita is just back from
a date in Mysore. Date means going out of the state for CSW. She is
fully educated about the pros and cons of HIV, yet hardly practices
what she has been preached.
Two years back when she tested
positive, she expected support from her mard (lover). He was at first
sympathetic but when he needed money, she was back on the streets. She
protested but he threatened. "I started to go on date, 15 days
after I was detected positive. I was feeling week but then got tired
of the abuses hurled at me by my mard. When I work, he is happy and
there is peace at home", she reveals. However, what she reveals
later after is much shocking, "whenever I go on a date, I stop
DOTS treatment," she admitted
HOME IS WHERE YOUR
HEART IS
In a police raid at Baina
recently, a HIV positive trafficked victim was rescued and sent to the
State Protective Home. At that time she was taking DOTS treatment, but
stopped it when sent to the home. Her condition deteriorated and she
started vomiting blood at the Protective Home. Thus forcing D.C. Kundalkar,
In - charge, Protective Home to write to the Mormugao Deputy Collector
Levinson Martins, "it is not possible to take care of her and medically
treat her in the Protective Home."
As the medical tests confirmed
that she was HIV positive and suffering from TB, Martins shifted her
to Assro and meanwhile tried to make arrangements to send her back to
her home in Karnataka. But she escaped from there within a few days
and returned to her home in Baina.
*(Names of HIV positive trafficked
victims have been changed in order to protect their identity)
(This article appeared on
GT Weekender, Panjim edition, October 29, 2006)
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