TARGETED INTERVENTION FOR MIGRANT
LABORERS IN COORG DISTRICT, KARNATAKA, SOUTH INDIA
the Vineeta Rastogi Foundation carried out consultancy work to support the
Karnataka State AIDS cell in its HIV/AIDS prevention activities.
Karnataka has the third highest rate of HIV
among India’s states. It is therefore urgent to
carry out prevention work through target groups and the general population.
No effort is directed towards the plantation labourers of Coorg district.
The designed intervention seeks to promote HIV/AIDS awareness, prevention,
and treatment with a direct focus on the migrant laborers of Coorg district,
Karnataka. The project also addresses the broader community’s health needs,
thereby creating a more receptive environment in which to address HIV/AIDS
This targeted intervention fits the
objectives of the Karnataka State AIDS Prevention Society (KSAPS) of mapping
the state of Karnataka in terms of the prevalence of the disease and work
with vulnerable sections of the population. There is, at present, no NGO is
working in AIDS in Coorg District.
HIV/AIDS has to be treated within the
cultural context of India and must address global issues such as poverty and
gender bias. Empowering people, by restoring confidence in their own
capabilities, is cornerstone of sustainable development
Unfortunately, information pertaining to
low-risk populations, such as villagers, is virtually unknown. But these
groups are bound to become the disease’s next victims. Despite the lack of
solid data the dynamics are worrisome. Migrant labourers live and work away
from their family, peers, and elders. Away from this natural community
value and reward system, they are lonely, unguided and unjudged. This
combination can make them seek unsafe sexual practices and drug use because
there is no guidance from peer pressure and no fear of peer punishment.
Migrant labour is also, by its very nature, mobile and, therefore, offers a
dangerous vector for disease within the migrant labour population and even
back in their home villages.
A WHO study group reported the management of
patients with sexually transmitted diseases lacks trained personnel,
laboratory facilities and funds. Diagnostic facilities at the primary
health care level are either very limited or nonexistent.
In light of this, a large proportion of STD
patients are condemned to resort to self-treatment, traditional healers,
drug vendors or pharmacists. Sadly, most health professionals are reluctant
to treat HIV/AIDS infected patients. Private physicians seldom provide
partner counselling or management and rarely report STD cases, which hampers
estimates of accurate prevalence rates and condemns many to death.
Migration is a considerable factor in
Karnataka’s economic profile. The group is sizable. Very often, migration
is addressed from an international perspective and can be neglected at the
local level. Migration in the state is dictated by poverty and the need to
earn income. Migrant laborers find work as coolies, work on construction
sites, in coffee and tea plantations. The laborers are either from
Karnataka itself or from neighboring states such as Tamil Nadu and Kerala.
Prevention work for this high-risk group can
prove difficult due to its inherent mobility. Opportunities for follow-up
are rare. Again, the mere distribution of condoms can prove a hopeless
In Coorg district, Karnataka’s famous coffee
plantation area, migration takes two forms: the laborers migrate to the
district (some with their families) to find work part of the year or during
the entire year. They originate from northern Karnataka and from the
adjacent states. The local upper class is also mobile and travels
frequently outside the district. These two patterns of migration need
special focus in terms of prevention work.
An assessment of HIV/AIDS cases conducted by
the Vineeta Rastogi Foundation in March 2000 revealed that there were at
least 20 such cases in the district, when official figures generated by
surveillance for the State AIDS Cell, report a steady number of 8 cases.
Eighteen cases were males, all local Coorgis, most of whom had traveled
outside the district. At the time of the assessment, one adolescent girl
had just married a Coorgi who immediately took her to Bombay’s infamous red
light area to earn extra income. She is now infected with HIV. Her story
is one of the many tragedies taken place in India.