India-Kenya learning together

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Comment by Avnish on December 13, 2009 at 1:30am

Dear Associates,

Following issue is important to review in light of Transporters and HIV/AIDS:

HIV tests compulsory for Punjab transport workers
http://www.tribuneindia.com/2008/20081026/main2.htm
Chitleen K Sethi. Tribune News Service

Chandigarh, October 25, 2008

The Punjab government has asked truck and taxi owners in the state to
ensure that their drivers and other employees undergo tests for HIV at
least once a year.

Amending the Punjab Motor Transport Workers Rules, 1963, the
government has added a clause making it compulsory for all transport
workers to undergo the tests at civil hospitals. The new rules also
state that in case a worker is found to be HIV positive, the employer
would ensure his free treatment.

Issuing a notification in this regard, the department of labour,
Punjab, said it had invited objections to the amendment before
finalising it. "We have not received any objection to the rules and
these would come into force from the date of the notification," said
Raminder Singh, state's labour commissioner.

Though the amendment is timely with the National AIDS Control
Programme-III focusing on reducing the risk of HIV among truckers, the
State AIDS Control Society is likely to raise objections to it. The
society follows the guidelines of the National AIDS Policy which do
not allow compulsory testing.

"No one can be tested compulsorily for AIDS except those falling in
certain pre-listed categories and truckers do not fall in those
categories," said Dr N.M Sharma, additional project director, Punjab
State AIDS Control Society. Truck unions would object to the state
government's move, he added.

The labour commissioner, however, pointed out that the Maharashtra
government had already amended its rules to include the clause. "We
have been keeping track of what other states have been doing in this
regard and this amendment is urgently needed in Punjab," he said. The
draft rules were made public in September and a period of six weeks
was given, but no objections were received.

Punjab has a flourishing transport business and truck unions run
almost a parallel economy. According to the National AIDS Control
Programme-III, nearly 36 per cent of the truckers visit sex workers.
"Truckers represent a key sub-segment of the total male client
population. Because long-distance truckers move throughout the
country, those who are at a higher risk of HIV can form transmission
bridges from the higher to the lower prevalence areas," states the
programme.

In order to ensure compliance, the labour department will depute a
special inspector to ensure that the truck and taxi owners have got
their workers tested for HIV. "The employer will have to produce a
certificate by December 31 every year clarifying the status.We have
added a penalty clause in the rules which will come into force in case
there is non-compliance," said Raminder Singh.

Comment by Onesmus Mutuku on December 12, 2009 at 9:12pm

Dear Friends,

I will be away the Whole of next week. Will be attending pathways to Reconciliation summit in Amman, Jordan.

See link; http://www.global-cities.info/amman09


Carol, as soon as we hear from Rituu, Rafique and TCIF on their meeting outcomes today then we proceed.

I quite agree we have a good number of key topics so far.

Prabakar, i will kindly respond to your question below in the mid of next week.

Thanks you all.

Onesmus

Comment by Dr. E. Mohamed Rafique on December 5, 2009 at 12:49am

Dear All,

The appended article appeared in Indian Express on the eve of this years' World AIDS Day,

Best regards,

Rafique

Driving to safety: Utsav for truckers raises HIV awareness
http://www.indianexpress.com/news/driving-to-safety-utsav-for-truckers-raises-hiv-awareness/547869/

The Transport Corporation of India Foundation (TCIF), the social arm of the Transport Corporation of India, organised the fifth nationwide ‘Truckers’ Utsav’ ahead of World Aids Day at 15 locations across the country on Sunday.

The event was aimed at creating awareness among truckers on the prevention of HIV/AIDS through concerts, street plays, song and dance performances and quizzes.

“The event is an annual feature that provides a platform to bring thousands of truck drivers together to create awareness on the prevention of HIV/AIDS and sexually transmitted diseases in an interesting and entertaining manner. Owing to the nature of their job, truck drivers have to travel long distances and stay away from their families for long durations, and are found to be the group most vulnerable to sexually transmitted diseases,” Shekhar Setu, project director for TCIF, said. “The initiative is targeted at taking care of both their physical and mental health.”

The Utsav had various multi-speciality health camps and parallel competitive events like arm-wrestling, bucket-lifting and singing contests, apart from the best maintained truck contest.

India has around five million truck drivers, with around 2 million of them travelling on long haul routes. Being sexually active, the community is found to be a very high-risk group, and also suffers from low self-esteem and social stigma.

The overall prevalence of HIV/AIDS among long-distance truckers is reported to be 4.6 percent, as compared to 0.36 percent among the general population, the organisers said.

The initiative, funded by the Bill and Melinda Gates Foundation, aims to implement a comprehensive integrated package on treatment for sexually transmitted infections, behaviour change communications, condom promotion and counselling among truck drivers through strategically located interventions at major halt points in nine states along national highways across the country.

“The programme has made us conscious of the disease and preventive care that needs to be taken. There are practical problems and challenges in our job — this initiative realistically addresses those issues,” said Om Prakash, a truck driver who attended the event at Sanjay Gandhi Transport Nagar.

Organisers of the event told Newsline that considering the increased use of condoms and detection of cases, it can be hoped that not only have awareness levels gone up, but the spread of the disease is also being checked.

Comment by Rituu B. Nanda on December 3, 2009 at 9:48pm

Dear All,

Warm greetings from cold Delhi!

The Kenya team is ready to go ahead with the SALT visit in preparation of the video conference. Onesmus and Marlou proposed a few items to focus for learning during the SALT visit they thought would be interesting for the Kenya team to explore further and then share with the India team. The Kenya team is interested to know from 'India' if these topics would be of interest for the friends in India as well. The topics suggested are:
1. Could we explore the added value of starting from strengths as opposed to starting with naming the problems during Community conversations?
2. Self worth (Esteem)
3. Risk and vulnerability
4. The way SALT team is set up and functions around the Wellness Centers

I was delighted to read Ash’s posting on Magnet theatre performance by MSM who were trained by truckers. The issue of MSM activity among truckers has come up again and again during the discussions on Ning. Ernest and Ash have shared their experiences in India. Oluoch Madiang from Kenya forwarded several intense and emotional discussions on MSM among Kenyans on Facebook.I will quote Madiang, “The issue of homosexuality is currently hot in Kenya after the recent gay wedding of Kenyans in the UK… the issue of MSM in Kenya is causing confusion and a lot of people are still in denial”. Would the Kenya team like to delve deeper into this subject?

I look forward to your comments and suggestions.

Thanks!!

Rituu

Comment by Ash Pachauri on December 2, 2009 at 8:39am

Dear All,

CHP has had a wonderful week of cross-community learning and sharing! CHP and the Delhi STRC have been working on a project called "Meri Awaaz/My Voice -- A Celebration of Voices from the Ground". As part of this initiative, a training workshop on Magnet Theatre (MT) with MSM was conducted from 25 Nov, 2009-30 Nov, 2009. We have trained MSM in MT before. What was interesting and unique about this training was that it was conducted by truck drivers! It has been a week of a brilliant cross-community exchange!

The MSM troupe scripted and performed a play on HIV risks and vulnerabilities and police/goon harrassment. They were invited to perform at NACO's Red Ribbon Express launch on Dec 1, 2009. A number of communities, non-community professionals and general population audiences were present. The performance was a huge success!

There are 3 key observations/learnings I wanted to share:
1) The cross-community bonding was powerful;
2) The understanding of issues across communities was evident from discussions and from the performances and acting (this became stronger by the end of the training);
3) While the MSM performance focused on HIV vulnerability issues related to harrassment by clients (e.g. being forced to have sex without a condom by goons); in an MT script developed earlier by truck drivers (which the truck drivers performed on the spot yesterday) a parallel situation was presented where the truck driver gets drunk and harrasses an MSM. He forces him to have sex without a condom.

Both the MSM and truck driver troupes will be performing again in Delhi sometime in the next week or so (either at IHC or at Dilli Haat). I'll keep you posted on the date/venue! Please join!

With kind regards,
Ash

Comment by M.L. Prabakar on November 30, 2009 at 6:52pm

Dear Onesmus and team members,

A BIG "Hi" to everybody in the group.

The SALT visit plan sounds exicting. I like the points of concern especially the one on self worth and esteem. This has always been my concern when i worked with truckers. The respect they gain in their and family is very low. Though they earn well they are not respected and are lesser preferred than their brothers by families who want to give their daughters in marriage. This really affects their mind sets. Their ability to deal with life inspite of these odds is remarkable. Regarding the aspect of risk and vunerability I would suggest that you discuss with them regarding their ability to face risk in driving, Taking responsibility of a huge and the commodities they transport the reason behind this is that i have seen Truckers transporting perishable goods (like vegetables) skipping their meals and driving non stop. These strengths can be of great use to handle other risk factors related to STIs and HIV. When I saw the explanation of the Turn Boys I understood that they are very similar to the cleaners or conductors among the truckers in India. Changing flat tyres had been their most difficult tasks. Onesmus I would like to ask you about the connection between Alchol and other substance abuse among truckers Kenya. Is that an issue and does it have an influence on HIV prevention. Among the truckers in southern parts of india this is an issue the truckers say under the influence of alcohol their possibilities to use condoms is very less. Some also use substance that can help them to prolong their ejaculation this leads to dry sex. Are there similar issues there.
Have a great community conversation.

Cheers,

Prabakar

Comment by bobby ramakant on November 24, 2009 at 12:32pm

Dear Onesmus,
thanks for your comment below. Very thought provoking indeed and reminds me of my SALT experience in December 2007. May be it is a different way of looking at the same situation - may be two different perspectives of a similar situation. If communities talk about the problems they face - it also helps us see (possibly) the inherent strengths in the communities - and - underline the local responses which also reinforces the strengths and local wisdom, I guess.

all the best, bobby

Comment by Onesmus Mutuku on November 23, 2009 at 2:21pm

Dear all,

I am adding a few thoughts linked to the below concern raised by both Marlou and the Team in the discussions below ,

1. Could we explore something on added values on
Starting from strengths as opposed to starting with naming the problems during Community conversations?

2. Self worth(Esteem),

3. Risk and vulnerability.

Any others?

Regards,

Onesmus

Comment by Marlou on November 19, 2009 at 7:35pm

Dear all,

I am very excited by the exchanges happening! We are learning so much already from Trucker responses in Kenya and Inda.

A concrete question from me now: The team in Kenya plans to carry out the SALT visit by the end of November. Can we make concrete suggestions of where the visit will focus on, so that the team going to Mlolongo can learn and capture the lessons that are most useful to the friends in India.
I personally believe that the way the SALT team is set up and functioning around the Wellness Centers in Kenya is an absolute asset in the Kenyan response. Will this be an element of interest for the video-exchange?

Looking forward to hearing your thoughts,

Marlou

Comment by Onesmus Mutuku on November 17, 2009 at 10:39pm

Dear Riruu,
Here is the response to the questions you posted:

What do you mean by rest of the team and neighbourhood community?

Our Team in Mlolongo is composed of People from Network of PLHAs and Truck drivers. Part of the PLHAs members are from the Support groups in the neighborhood of the truck stop. During the SALT visits, which happens in the truck stop or neighborhood community where every one is invited to participate including the Sex workers.People voluntarily join the discussion and later show interest in wanting to become part of the Facilitation team. The members then takes the responsibility of mentoring the new team mates into the process including its Facilitation even beyond the truck stop. Ideally into their Networks.
The facilitators self assessment is a key tool to bring out what strengths exist within the team and areas to improve on for competence down the line. Basically their emerges accountability pairs (People team up to learn from each other)

' I am happy to join the team any time to support our friends in the transport corridor to truly understand how to fight the disease, Chair Lady- Shauri Moyo Baptist support Group.

o What are wellness centres? Who has set them up?

These are refurbished containers, strategically located in the truck stop where truckers and people from the neighborhood can pop in and access information on HIV/AIDs, health and other Life issues. They also connect as people to share and learn from each other. Normally the conversations are moderated by a facilitator to enhance Knowledge exchange. It also links truckers to other Services like ART, Counselling and testing.
In our context we have had recreational centers along the corridor but they do not have the AIDs competence function.
The centres are integrated to the community through ACP supported by the SALT team. Ideally making the centre NOT to look like an expertise plat form which just offers services alone.

Several players have put their hands in their set up. They include; Great lakes Initiative against AIDs through Constellation, World food program through North Star foundation, Mombasa Port and our National AIDs Council.


o Who are turn boys?

Generally in Kenya, they are men at the youthful age who are hired to assist the Truck drivers in their journey. Their task normally is to Change flat tires, greasing, guard the truck in the night etc

o Who were your partners in this initiative?

GLIA /World Food Program/ North star Foundation/National Aids Control Council/Liverpool VCT/ Ministry Of Health

o Please elaborate on joint working of PLHIV and truckers.

When we first did the 1st SALT Visit in Mlolongo, it was noted that the Network of PLHas had a lot to share with the Network of Truckers. These ranged from Access to treatment, positive living(Life beyond hiv), overcoming self stigma, acknowledging the issue and testing etc We truly saw the synergy and how the two Networks complement each other.
Drivers were encouraged and they were motivated to test and know their status.
Todate, they ask to be referred to ART clinics along the Transport corridor for treatment and they have formed a truckers support Group. Initially this was not there.

o Mainstreaming ACP within PLHIV network?

' i see the value of using the ACP in my Network of PLHas, it helps people see their strengths and as an organizations you dont need a lot of money to initiate it. I have come from Mbeya to meet groups and i used the approach and more people have joined the Umbrella network,' Joan Chamungu Tanzania reflection during the GLIA training in Chalinze 2008.

The National coordiantor NEPHAK - Kenya see the need for transferring the ACP to the groups under the Umbrella and they have committed in their plans, resources to transfer the approach to the affiliate Groups.

Hope this answers your queries Rituu,

Onesmus

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