Migration And Aids Menace In Orissa
Two years ago, dreaming of a better future Bula had left for Mumbai. Son of a daily labour, the twenty seven year old Bula of Padmavati village under Purushottampur block in Orissa’s Ganjam district hadn’t had the luxury of education. Soon after his arrival, Bula could get to work as a daily labour. “I felt I was lucky. I was very happy,” Bula says.
However, his happiness didn’t last long as ill fate struck him a bad blow. Back in home since over six months, Bula is fighting for life and against social stigma as he has been detected with HIV positive.
Bula’s is not an isolated case. Hundreds like him from Ganjam district are unsure about their life. Their dreams have turned into nightmares. And they have forced their near and dear ones to undergo the tragedy.
Like forty year old Umari Sahu of Beguniapada block in Ganjam district. Her husband is no more. He died after suffering for a couple of years. Yet, even today Umari, holds him responsible for her ill fate. She states that her husband had migrated to Surat, where he was infected with HIV. However, before detection of the virus he had already passed on the virus to Umari. Now she is being treated and under care. Umari’s only consolation: her children 2 sons and 2 daughters are out of danger.
Aauli Sethi,35, of Kalyanpur village of Digapahandi block has a similar story to tell. Aauli claims that she got infected through her husband who died after suffering for two years. Her husband was a migrated labourer worked at Surat too. Her two children; one half year old son and two year old daughter had also succumbed to susceptible fever few years ago.
In rural Ganjam stories like this are not difficult to find. “It’s a sad story. The situation is grim. Unless care is taken, it will go out of hand,” said a health department official.
According to Dr. E P Rao who has been working at the SATHI Centre under Tata Steel Rural Development Society (TSRDS) the major cause of AIDS in Ganjam is the unsafe sexual behavior of the migrant labourers. The most vulnerable population is the adolescent group who indulge in unsafe sex, despite much awareness campaigns and information provided at railway stations and other such places. “Another dangerous development is that the AIDS affected people multiple the infection rates as they enjoy sex with their wife without her knowledge that her husband is AIDS affected,” Dr. Rao says. “Thus families in the rural areas of Ganjam from where the labourers migrate should go for test and after confirming the status, should go for marriage, added Dr Rao.
Official records says, in Orissa, where this killer virus has been spreading its tentacles through the last decade, reported as many as 500 AIDS related deaths. The number could be more considering the unreported deaths and un-detected cases. Sadly, Ganjam district tops the list in Orissa.
The reason for it being so high in Ganjam is that thousands from this district migrate, like Bula to industrial cities, primarily, Surat in Gujarat and Mumbai in Maharashtra for work.
Most ileterate or semi literate, the youths from rural Ganja migrate with eyeful of dreams. However many of them return to only to count the days of their life after being infected with the deadly virus.
In a startling revelation, Indian Journal of Medical Research has reported that this killer virus is on the rise in Orissa, recording as many as 459 AIDS-related deaths over the past three years, while there has been a marginal decline of the incidence of AIDS in the country.
The report suggests an increasing epidemic trend has been noticed in seven of the low-prevalence States such as Pudduchery, Jammu and Kashmir, Jharkhand, Bihar, Orissa, Rajasthan and West Bengal. The assessment showed that HIV prevalence among the adults was 0.36 per cent while the rate in high prevalence states stood at an alarming 0.8 per cent. In the low and moderate epidemic states like Orissa, the rate of infection stood at 0.2 per cent. As per the data, Orissa’s adult HIV prevalence rate has seen a rise from the 0.06 per cent level in 2002 to 0.22 per cent in 2006. This also explains why the number of people living with HIV/AIDS (PLHA) has increased over the same time-from 9,717 to 48,248; at a 400 per cent growth. It is also reported that Tamil Nadu is one among the high-prevalence States to have recorded a
decline in the rate, while it remained stable in Andhra Pradesh and Karnataka.
However, this low-prevalent state Orissa has been witnessing an alarming situation due to the unsafe sex practice of migrated labourers who unmindful of the fact that sexual route is the major cause of HIV/AIDS, prefer to sexual escapades in the slum areas of Surat known for its red light areas rendering few minutes pleasure. Particularly, the unemployed youths of Ganjam, the home district of Orissa Chief Minister Naveen Patnaik, migrate in lakhs (6 lakh as per rough estimation) to Surat (Gujarat) and Mumbai. The maximum migration is reported from Hinjili, Purushottampur, Aska, Digapahandi, and Beguniapada blocks of Ganjam district. People migrate with the hope of employment. Of course city life is also an attraction to them.
For the migrant labors, job opportunities galore in the Textile Mills, the diamond cutting industries in Surat & shipyards of Alang. For the illiterate youth, who is untouchable everywhere as far as getting a job is considered, such places are heavens. Few care about sanitation and healthcare. As per a rough estimation, around ten lakh Oriya people including floating (migration 6 lakh) live in Surat alone.
The situation is particularly bad in Orissa, which has recorded as many as 459 AIDS-related deaths over the past three years. Out of 24,676 blood samples screened during the period between January, 2002 and September, 2005, 2,506 HIV positive cases were detected in the State. Furthermore, 641 persons were found to be full-blown AIDS cases ( 459 deaths were reported during the same period). Of all the districts, Ganjam has been found to be the worst-affected district and is closely followed by Kendrapara, Puri, Cuttack and Koraput.
Until December 2007, Ganjam district accounted for 35 per cent of the total AIDS deaths and 37.8 per cent of a total of 8,200 HIV-positive cases in Orissa, according to Orissa State AIDS Control Society (OSACS). As per official records, 10, 862 persons were by HIV infected in Orissa till September 2008. Among them, 1,020 were AIDS patients. Ganjam district happened to be the major hub of this killer virus. There
over 4,296 HIV-positive cases in the district while 363 of them were AIDS patients. Till now, Ganjam has recorded 293 deaths due to AIDS, which is the highest in the State. At the Anti-Retroviral Testing (ART) Centre in the district town of Berhampur, out of a total of 37,386 persons tested from 2002 till February 2008, 3,491 were HIV-positive. ART treatment has been started on 1,015 cases.
Sadly though, the emerging face of the HIV epidemic is increasingly turning younger, rural and feminine. Prevailing gender stereotypes and early marriage ensure that women remain ignorant and unable to protect themselves, making them especially vulnerable to infection from husbands. According to National Aids Control Organization (NACO) report 3006, of the total HIV-infected population in India, 38.4 per cent are women and 57 per cent rural. One of the most debilitating impacts of this epidemic is the stigma and discrimination resulting from disclosure of status. And AIDS widows, in particular, bear the brunt of inhuman social ostracism. Their situation exacerbates due to loss of the earlier social support system and source of earnings, dependent children and denial of healthcare.
Another disturbing trend is that HIV is fast spreading in rural areas. Despite targeted efforts, HIV prevalence among female sex workers has not fallen below 52% since 2000, according to the National AIDS Control Organization (NACO). In States like Haryana, fewer than half of all sex workers, brothel or street-based, knew that condoms prevented the spread of HIV/AIDS. Over 30% of street sex workers still do not know that condoms prevent HIV infection and many in India still decide a ‘client’ has AIDS or not based on his physical appearance. Ostracism, humiliation and mistreatment at the hands of family members, community and the medical fraternity are increasing in Orissa. But there is not a single organization offering care and support to people living with AIDS (PLWHAs) in the State.
The statistics; numbers and figures may vary and may present a serious picture if the unreported and undetected cases of HIV/AIDS in the state as the official figures too vary that was presented by this prestigious national journal and the figures shown in the information sheets of the ART Center located inside the MKCG Medical, Berhampur in Ganjam district of Orissa. As per the ART center of the MKCG Medical, as many as 361 cumulative death cases have been recorded during last three years. In the year 2006, only one case of death had been reported while the death cases rose to 19 in 2007 and the number of deaths rose alarmingly in 2008 when 211 cases of AIDS related deaths have been recorded. And up to 31 October 2009, the numbers of deaths are 361 as per the records of ART center of MKCG Medical, while the journal reports only 293 death cases in Ganjam district. So, if the unreported and undetected cases are to be taken into account, then it may not astonish the people having knowledge on AIDS/HIV menace in Ganjam district of Orissa.
Considering the above-mentioned issues a Memorandum of understanding has been signed between Gujarat State Aids Control Society (SACS) and its counterpart in Orissa for a period of five years i.e. from January, 2007 to January 2011. UNDP has set up 14 ICT Kiosks in various high migration blocks in Ganjam and also near the Berhampur railway station. UNDP has also agreed to set up similar kiosks in Surat and Alang. In collaboration with UNDP; ICT Kiosks (Help-Desks) has also been established at Berhampur and Balugaon Railway stations where, the pre-departure information as well as counseling on HIV/AIDS and distribution of IEC Materials to be provided to the out migrants. Apart from the facilities available at the state run medical colleges, non government organizations are also committed to fight the killer AIDS in their centers.
One such centers is the SATHI community care center of TATA steel as part of its Tata Steel Rural Development Society project. Located at Bahadurpeta on the outskirts of Berhampur city, it caters to the need of the HIV/AIDS infected people where opportunistic infections are being taken care of and the people with such infections are being counseled.
However, a lot has to be done. According to an activist, there are a lot of works to do on awareness as prevention is considered to be the best and only way to control the AIDS. Various progarmmes and awareness campaigns are being under taken by OSCAS and various NGOs, Institutions and Organizations, but in most of the cases facilities are available in it happen in the urban areas,instead of rural areas where majority of the vulnerable population live. Ironically, huge part of the budget meant for the AIDS control, is being spent on salaries of the staffs at centers located at various places in the state.
(Names of the patients have been changed)
By Santanu Barad from Berhampur