HIV/ AIDS prevention at the grass root level at Sonagachi, Kolkata

On 10th February, 1998, S.B. Devi Charity Home and Calcutta Project Basel launched a programme with the title ‘Public Health in a Prostitution Area’ (PHPA). In this program, commercial sex workers (CSWs) are our main target group. Our mission is to raise their awareness about preventive measures and to treat them.

The project consists of health education and primary health care. This includes health and nutritional advice, basic and personal hygiene, an immunization programme, birth control, protection against sexually transmitted diseases (STD) and HIV/AIDS, communicable diseases, mental support and care for the CSWs’ children. We are working in two different ways. One is treating the patients with homeopathic medicine and the other is giving emphasis on health awareness by individual discussion, group discussion and adult learning.

At the individual discussion level, we take care to have friendly manner and a friendly body language with each and every patient in our PHPA clinic. We use an easy language in which patients can understand and talk about their personal problems which are related to their diseases as well as their mental state. During this individual discussion with CSWs, we promote the utilisation of condoms. The same is done in the group discussion which is held once per month in our clinic. Topics relate often to STD/HIV/AIDS. This discussion involves a wide range of skills from listening to their problems, giving them vital information and helping them to solve their problems. The group process helps our patients to make changes in their attitude and behaviour. Adult learning involves giving patients practical information about their disease. This helps them to understand how the diseases spread and why it is important to treat them. The other vital element of adult learning is how in future they can protect themselves, their partners and their children.

Our team consists of two field workers, two health workers and two physicians. In the last six months, we have also introduced drama sessions in our group discussions. More than 50 CSWs enjoyed the program every month. We are trying to give a brief picture of the sad reality of AIDS. The plot is as follows: A young sex worker is now a mental patient because very recently her ”babu” (lover) had passed away by AIDS but she didn’t know what AIDS is. To realize the condition of that sex worker, two other CSWs want to know about AIDS and they come in our PHPA clinic with the help of our field workers. We discuss with about HIV/AIDS and safe sex practice with the help of pictures. We also demonstrate the use of condoms with bananas through our peer workers. We show in our drama that a sex worker practiced sex without condoms before, but after our counselling she refuses a client who wants to have sex without a condom. In the drama, she appeals to the audience to refuse sex practice without condoms.

During the last 4 ½ years, we have gained a lot of knowledge about this neglected group of the society. We have succeeded to obtain their trust, faith, respect and friendship. This motivates us to continue to care for them.