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POPULATION: In Tamil Nadu, Women Lead the War Against HIV

Soma Basu

MADURAI, India, Oct 12 2005 (IPS) - When a group of HIV-positive women dared go public with their health status at a modest function in early October, it was a revolution for this conservative town, famed for its ancient granite pagodas that speak of development in another millennium.

True, there were just a half dozen of them, but these were women with the kind of extraordinary grit it takes to face up to what amounts to a death sentence and a socially pilloried existence before the end comes.

As the audience sat in spellbound silence, it was the inner voices of these women that resounded through the packed meeting hall – some expressing anger, others bewilderment and a couple of them she tears.

One woman said her husband died ”not because of the HIV but due to lack of counselling and sheer vexation.” For the sake of her children, she decided to battle on against the virus instead of ending it all by killing herself.

She was lucky, she said, because her parents and in-laws accepted her and kept her health status a secret. Today, she works as a community health worker in a social service society.

Her testimony was important because Madurai, among its many distinctions, is classified as one of southern Tamil Nadu state’s seven ”highly prevalent for HIV” districts. Perhaps there were anonymous sufferers out there who may now be encouraged to seek help.

By sheer coincidence, the public interaction, organised by the Family Planning Association of India (FPAI) echoed the theme of this year’s United Nations Population Fund (UNFPA) report, which delves into the issue of improving the lives of poor and needy people, not only financially, but emotionally and psychologically as well.

But the main objective of the public event was to help other PLWHAs (people living with HIV and AIDS) to learn to live with dignity, come out of dejection and also take turn at explaining to the public how it is possible to help to those afflicted with the virus.

A former construction labourer narrated how she turned to sex work because she needed to be making more money after discovering that she was sero-positive.

A widow with three children to support and little choice in the matter, she calmly turned herself into a ”skilled negotiator” in order to make the best of an impossibly bad situation and also not spread the virus further.

Many PLWHAs have taken up counselling and are in the forefront of the struggle to prevent HIV/AIDS in this state, which is now officially claiming to have ”reversed the epidemic in last two years”.

Ranging from negotiating safe sex practices to co-opting women’s self-help groups to involve housewives in the work of disseminating information about HIV, it is the so-called ”weaker sex” that is now in the forefront of the war against the virus.

Barriers are constantly being broken in this battle in which stigma and discrimination are the main enemies.

The results are visible in the shape of fewer instances of families breaking up, parents accepting their HIV-positive children instead of dumping them at orphanages, and uninfected people standing by their afflicted partners.

In some cases, entire villages are standing by their PLWHAs, determined that their communities and school-going children are not discriminated against.

”The change is slow but visible,” avers T. Raja of the Mother Saradadevi Social Service Society which is based in the nearby town of Dindigul.

Raja attributes the ”major shift in peoples’ attitude and behaviour” to the fact that more ”innocent” homemakers are falling prey to HIV and deserving of sympathy – unlike their husbands who are seen as wayward and perhaps guilty for bringing the virus home.

Strangely, says Raja, any resistance at all is coming from the medical fraternity. Last week, for example, one HIV-positive individual with a painful abscess in his underarm was turned away from hospital after hospital in Madurai because no doctor would attend to him.

”This is where we step in… by offering referral services and trying to help doctors, nurses, paramedical staff cope with the treatment of HIV patients instead of being scared and remaining shrouded in ignorance,” said Louis Paulraj of the FPAI.

”We cannot go on a war path with doctors because we constantly need their help. But definitely we find it easier to motivate simple rural people than the doctors,” Paulraj added.

But the new trend all over Tamil Nadu, the state where India’s first HIV case surfaced in 1986, is for people with HIV/AIDS to be accepted and allowed to lead a normal life.

In Tirunelveli, another outlying town, women PLHWAs, who are part of a self-help group, prepare special meals to be distributed to others like them throughout Tamil Nadu in a scheme which also happens to be income generating.

There are several PHWLAs who have preferred to continue with whatever they have always doing, like selling fruits and vegetables, rather pick up training for a new vocation from NGOs.

”We bought sewing machines for some women but they were unwilling to go for training courses far away from their villages or opt for any other vocation but their own,” said Jaya Karupai of the Madurai-based mercy trust. ”We realised that care and support programmes have to be need and area-specific.”

Tamil Nadu, which incidentally is ruled by a tough woman chief minister, Jayaraman Jayalalithaa, can rightfully claim to have done its bit in containing HIV and helping women help themselves.

”From the beginning there has been some kind of readiness in terms of providing ART (anti-retroviral therapy) or PPTCT (prevention of parent-to-child transmission) etc. Even the primary health care system of the government is good and the state machinery has proactively tried to deal with the issue,” observes Pichai Mani, president of Tamil Nadu Positive People’s Network.

That record compares well against the national situation in which the number of HIV cases doubled from two million in 1994 to four million in 2002. Presently the number of HIV infected people in India stands at 5.19 million.

In this doomsday scenario in India, which is widely feared heading to be the AIDS capital of Asia by 2010 with a whopping 25 million HIV positive people, Tamil Nadu’s performance stands out as a symbol of hope.

Home to 60 million people, the prevalence rate of HIV in the state came down from 0.75 percent in 2003 to 0.50 percent in 2004 as result of its aggressive anti-transmission policies.

Tamil Nadu was the first Indian state to introduce AIDS education in high schools, set up information hotlines, and launch awareness campaigns that specifically attacked ignorance and stigma associated with HIV.

Instead of targeting high-risk groups, Tamil Nadu went all-out by making it compulsory for cinema theatres to show AIDS awareness spots and introducing innovative and cost-effective programmes such as enrolling thousands of barbers as condom promoters and information disseminators.