Lack of awareness, proximity to the Golden Triangle are also contributing to the birth of the HIV/AIDS epidemic in one of India’s most politically troubled regions.
New Delhi: Northeast India generally brings to mind two diametrically opposite images — the first, a picturesque region abundant in forest and rivers, and the second, a terrain bludgeoned by bullets, bombs and bloodshed.
Geographically knitted to the mainland by a slender land chain called the Chicken’s Neck, the northeast has always remained a politically isolated mass. Inhabited by heterogeneous tribes and sub-tribes of Aryan and Mongoloid origins, the region has been rocked for decades by insurgency, with several terrorist groups either demanding sovereignty or separate statehood.
Unabated violence has exacerbated under-development in the region and has fostered socio-economic problems such as unemployment, rising crime rates and drug addiction. The last of the three has, in turn, fostered another alarming situation that the northeast is now being forced to deal with — a rapidly increasing HIV-infected/AIDS population.
How serious is the problem?
The first case of an intravenous drug user (IDU) being infected by the HIV virus was detected in Manipur in 1990.
The state shares its international borders with Myanmar, a country that falls in the dreaded Golden Triangle. With a 350,000-sq-km area thriving on illicit drug trafficking along the Myanmar, Laos, Vietnam, and Thailand route, the vulnerabilities of Manipuri youth, given the porous borders, have been intensified.
The neighbouring state of Nagaland shares a similar fate. According to the National AIDS Control Organization (NACO), which is a division of the Ministry of Health and Family Welfare that provides leadership to HIV/AIDS control programme in India, both Manipur and Nagaland are highly prevalent states with high infection and vulnerability. Assam is also highly vulnerable but in the low prevalence category, as are Arunachal Pradesh, Mizoram, Meghalaya, Tripura and Sikkim.
The lack of proper awareness and education about HIV has seen infected persons transfer the virus to their sexual partner and unborn baby. The malady has, in the past few years, shifted to the rural areas where stigma and discrimination invariably render the infected person a social outcast.
Red Ribbon Express in NE
It’s a train with a mission. Its passengers, traveling across the country on a year-long journey to create awareness about HIV/AIDS in the interiors, found that people in the north east were still highly ignorant about HIV transmission.
Bijano, counsellor at the Dimapur Civil Hospital, admits that despite aggressive campaigns and information dissemination across different media, including radio and television, awareness levels continue to be abysmal.
“Many people do not know the difference between HIV and AIDS. For them both are synonymous. It is tough explaining it is not contagious and that lack of knowledge could lead to cruelty, humiliation and ostracization of those whose positive status is known,” says Bijano.
Remoteness, non-industrialization and lack of infrastructure make it difficult for NGOs and health providers to be consistent in their service delivery. Also, the law and order problem, compounded by rising unemployment, has made the youth more susceptible to substance abuse and risky behaviour such as indulging in unsafe sex and sharing needles while shooting addictive drugs.
Voices from the region
Father Joe Ngamkhuchung, chief functionary of the Dimapur-based NGO, North Eastern Drugs HIV Training Centre drew attention to the situation in Nagaland, saying, “Transmission through the sexual route is as much as 60% and unless sex education is made mandatory, ignorance will most certainly not be bliss.”
Father Joe Ngamkhuchung
Efforts have been made by agencies to attract people from blocks, sub-divisions, panchayats and zilla parishads and make them participate in the country’s battle against HIV/AIDS. Self-help groups and mahila mandals have been mobilized to create awareness among women, so as to minimize the ‘feminization of the epidemic’.
J.S. Rao, project director, Assam State AIDS Control Society said there are an estimated 10,700 HIV/AIDS cases in the state. Extensive training programmes have been held with medical personnel to ensure there is no bias and discrimination. Focus has also been on busting myths and misconceptions relating to the infection spreading through touch, sharing vessels or using the same bathroom.
Outlining plans for Assam in the next financial year, Rao said, “We will identify places with high migrant population, IDUs and commercial sex workers along with NACO. The attempt would be to mainstream and integrate people with HIV/AIDS into society and to step up our intervention with the high risk groups like truckers, for whom Guwahati is the entry point to the entire Northeast.”
Jahnabi Goswami, general secretary of Indian Network for People living with HIV/AIDS (INP+) and treasurer, Assam Network of Positive People (ANP+), felt that the states in the northeast are more cut-off than other parts of India. Even local NGOs find it difficult to work for long stretches because of factors like inaccessible terrain, low funding and lack of infrastructure.
“NACO’s programmes revolve largely around spreading awareness in order to reduce HIV infection. Not enough emphasis is being laid on issues of basic care and support like rehabilitation and nutrition,” said Father Joe Ngamkhuchung.
Non-existence of programmes post-antiretroviral therapy (ART) is another area that requires urgent attention. “Patients who feel better after visiting the ART centres often ask for some kind of employment to sustain themselves. Unfortunately, such programmes ran either by the central or state government. Training in small-scale industry programmes such as piggery, duckery and fishery should be conducted to help people earn their livelihood,” he added.
Currently there are 35,000 unemployed youth in Nagaland. Post-ART people should have the option to pick up work that is aligned with their medical condition. Employers need to be sensitized to ensure that the person is not victimized or robbed of his livelihood. “Lack of mid-way homes where those on ART treatment can stay, receive counseling and engage themselves gainfully are the need of the hour,” Ngamkhuchung said.