30 nov 2012
Aizawl: Maruti 800 taxis are ubiquitous in Aizawl city, the capital of Mizoram. And during peak hours, the roads are jammed with taxis.
As dusk approaches, government offices close early, 4 pm in winter and 5 pm in summer. Shops down their shutters at the same time and the streets are quickly deserted.
Following the Mizoram Liquor Total Prohibition Act of 1996, the entire state is dry. Unlike other cities, there are no pubs, discotheques, malls, theatres or cinema halls that are hangouts for young people.
The only thing to do is to prepare to go to the evening Church service.
It's a world away for Mimi and her friend, who are sex workers and a part of the city's dark underbelly.
They are at the taxi stand. They know some of the taxi drivers who they hire regularly to take them to hotels, to rooms on the city's outskirts.
Like them, many remain hidden as there are no brothels, no designated red light areas in Mizoram.
Sex workers and injecting drug users are high risk groups for HIV infection. Government programmes are focusing on reaching out to them with HIV prevention campaigns.
But this is proving to be difficult for there is fear of being identified as a sex worker in the state.
Women sex workers have been known to be humiliated in public, their hair shaved off by members of youth groups. Along with the church, these groups exercise an unusual degree of social and moral control.
"They rounded up ten of us and took us to the YMA hall. There they shaved off our hair. I had very long hair but they cut it off, said Reby (Name changed).
Mimi tells us she ran away from her home in a distant village to escape ill treatment. She was just 14. In Aizawl, her vulnerability was exploited and she became victim of rape.
"I was raped by a stranger. But I had no way of escape. I relive the trauma when I recall that night. I have not been able to tell anyone about it before. Sometimes they have slapped us and even beaten us up", she said.
Another sex worker tells us about her feeling of rejection when she was abandoned as a child.
There is a common thread in the stories of sex workers. Of neglect by parents and society. Most of them belong to broken families and are school dropouts. Worse, they have faced abuse by someone within the family or someone known to them.
We are at the Volcomh refuge centre, a drop in centre that was started 10 years ago to intervene directly with this highly stigmatised group.
For street-based sex workers, this has become their home. Every morning they wait for the doors of the centre to open before they crash out on the beds. They pool in to buy vegetables so that they can cook a meal in the kitchen. They have also used their money to buy cupboards to keep their clothes and makeup. And this is where they get ready before they venture out for the night. All of them are below 30 years of age.
"If there is no drop-in centre, where will we go? Many of us do not have a place to call home, a place to sleep," said Esther (name changed).
It's a safe space for those rejected by society. It is this non-judgmental approach that allows health workers to reach out to sex workers and help prevent HIV infection. The centre provides free condoms and conducts regular check-ups for sexually transmitted infections. Equally important, is the opportunity created to share and learn from each other's experiences. Especially on how to cope with the threat of violence when they are unable to negotiate condom use by their clients. About 365 sex workers, including trans genders, are registered with the centre. Of these, 57 have been found to be HIV positive. And over half the sex workers who are infected are those who are injecting drug users. Sex workers who are injecting drug users have been found to be more vulnerable to the infection. The detection of new cases is decreasing. However, it has been an uphill battle as residents object to the opening of drop in centres in their localities. But the State AIDS Control Society is appealing to all for a change in attitudes.
"We cannot look upon them as enemies or nuisance to the society. I gave one example of one church worker who had gone to Guwahati for HIV AIDS training, there she was asked one question and the question was that as a worker who is concerned with HIV AIDS problem in our state, how many friends did she have among people living with HIV. And the church worker said she was very ashamed because she couldn't name a single person living with HIV that she had come across, leave aside making friends with them. So she made a resolve to make friends with people living with HIV and that is what she did. My main message to the youth in Mizoram is that we have to make friends with the people who are living with HIV AIDS, we have to really understand high risk groups, especially female sex workers, work with them and see how we help them getting into the main stream, so that this HIV AIDS can be contained," said Dr Eric Zomawia, Project Director, Mizoram State AIDS Control Society.
23-year-old Mimi has been fortunate. She has a new friend, a new family. It all began with a chance encounter with K at a hospital. Both were there for treatment and K felt protective towards Mimi, a total stranger.
"She was sitting in front of me. Other people at the hospital were talking ill of her. I felt a rush of affection towards her. When I was discharged from the hospital, I invited her home", said K.
K's husband is dead and she lives with her three children and aging father in a small hut. She lives on the wages she gets as an agricultural labour. She says she was ashamed to tell anyone in her community how difficult it was for her to make ends meet, to pay for the children's school. Mimi moved in with them and extended financial support.
"Things have improved for us after she has started living here. She pays for the children's expenses. She loves the children a lot. She gets them food and clothes. When we run out of gas, she arranges for that too," said K.
For Mimi, K's family is now her own. She has made plans for the children's education so that they do not share her fate. The children, on their part, return Mimi's love, even refusing to eat their dinner unless she is present.
"I treat her like my own child. She is not an outsider to me," said K's father.
Except for K, no one else in the family knows Mimi is a sex worker. The neighbour gossip, but she is not bothered by it. K says she wishes the best for her friend's future.
29-year-old Lalawmpuia grew up in a poor family. As a teenager he felt like a social misfit and this made him stop attending church. He was 18 when he started using drugs like his friends who come from a similar background.
"The YMA and JAC would catch us and beat us up. Even possessing a syringe could lead to our being beaten up, "said Lalawmpuia, who has a poultry business.
Nearly every Mizo above the age of 14 is a member of the YMA, a non-government organisation that emerged out of the concept of looking out for each other. Of the total population of nine lakh in the state, four lakh are members. The YMA helps to conduct funerals and to rebuild during times of natural disaster.
"We try to source from where they get those stuff from. If a parent can't control his kid at home, YMA acts as a parent for them. Since this is a total prohibition state, like alcohol is banned in the state. YMA tries its best to, in its locality it is free of drugs," said Joe R Z Thanga, Secretary, Mission Veng Young Mizo Association.
The YMA's antidrug squad was feared. It declared 2005 as Anti-Drugs year and the campaign carried on for some years. The crackdown was backed by the moral authority of the Church, which looked at drug addicts as sinners. With over 94 per cent of the Mizo people being Christians, the Church plays an important role in the people's lives.
Mizoram is flanked by Bangladesh in the west and Myanmar in the east. It has a 722 kilometre international border, a border that is porous. Its geographical location makes it a conduit for drug trafficking across the Indo Myanmar border.
The heroin seized in the state has been found to come from Myanmar. The easy supply led to a number of young people being devastated by the twin epidemic of drug addiction and HIV AIDS.
HIV transmission was largely drug driven in the state, through sharing of infected syringes and needles.
Those who could not afford heroin began to inject cheaper pharmaceutical drugs like Spasmo Proxyvon and Parvon Spas. These drugs, which are not meant to be injected, crystallise in the veins. It leads to abscesses, tissue necrosis and subsequent amputation of limbs.
Like the case of Rinsanga, a truck driver, who is unable to drive because of his condition.
"A good number of valuable lives have expired due to overdoses or adverse effects of drugs. The problem of drugs abuse is of such magnitude which required concerted efforts to protect the society," said Lalbiakmawia Khiangte, Commissioner, Excise and Narcotics.
The emphasis of the Commissioner of Excise and Narcotics is on supply reduction. According to him, the YMA was fulfilling the duty of citizens and were helping bring down the number of drug related deaths.
"The powers of search and seizure is not vested with them. But it is okay so long as they are illegal possessors and illegal traffickers," said Khiangte.
However, addressing the supply side is clearly not enough. What's worrying is that the HIV epidemic in Mizoram has moved from high risk groups to the general population. There's also the realisation that drug addiction has to be tackled as a disease and not as a crime. Drug users who are treated as criminals, go into hiding and are unable to access help or treatment.
The National AIDS Control Organisation, along with UN agencies and the Australian Government, has worked towards sensitising the Church and the YMA leaders. Take the case of the Grace Inn drop-in centre, run by the Church and the Government. The centre provides counselling, needle exchange and abscess management. It also provides harm reduction services through oral substitution therapy or OST. Drug users are administered buprenorphine which minimises drug withdrawals and can lead to complete cure.
"We heard and read the lifestyles of Hollywood stars and rock stars and we wanted to copy them. So we thought that it was really hip and cool to do drugs. What we do here is basically to get this medicine, it is called oral substitution therapy. What happens is that the medicine takes care of the craving in the withdrawal. They slowly taper down our dosages. We hang around with guys like us because there are no discriminations here. It is the first step towards leading a normal life, towards re-integration back to the society. We share our problems and our aspiration. We motivate each other and comfort each other because a lot of the non addicts and the alcoholics, they do not understand the problem faced by the addicts," said David Vanlalvena, former injecting drug user.
Drug de-addiction centres like this one are unable to cope with the demand. Intravenous drug users need intensive counselling. But because of shortage of funds they are unable to get an adequate number of counsellors. The relapse rate is quite high. And to manage this relapse, counsellors are needed.
Things have come a long way. Some churches have set up panels and are holding their own awareness programs. Others are setting up special camps to bring back drug users into the fold.
"They are wrong activities, but the person who are addicted to drugs or are involved in social sex are not outcast. They are guided to come to the main stream so that addiction as well as the practice of social sex are given up very soon with the grace of God," said Upa Lalthangliana Varte, Church Elder, Mission Veng Church.
"Spiritually, mentally and physically they could be cured because of the mercies of Jesus found in the Bible, so I was convinced that this should be a part of the gospel so I am interested in it," said Rothuami, Deacon, Baptist Church of Mizoram, Central Church, Upper Republic.
"I think we need a framework to work for that are infected by HIV AIDS. We still need more awareness because when we see and when we interact with some people who are infected by HIV AIDS we develop some sort of sympathy. But we have not reached the level of empathy so there are many people who still believe that HIV is like a punishment given by God to those who are sexually immoral. So in order to improve our ministry to people living with HIV, I think we need more awareness," said Reverend VL Hruaia Khiangte, Baptist Church of Mizoram, Shalom Baptist Church.
On World AIDS Day today, it is clear that increased attention on the North East, including Mizoram, by the National AIDS Control Organisation is showing results. But a lot more needs to be done.
Apart from treatment and care issues, there is need for focus on prevention strategies with young people. To extend programs to rural areas.
And everywhere we visited, the important question of livelihood programme came up - a programme that is so vital for the complete rehabilitation of sex workers, injecting drug users and people living with HIV.
In Mizoram, sex workers are many, protection little
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| Dr Sanjay Kumar Cardiac Cardiothoracic Heart Surgeon India |
As dusk approaches, government offices close early, 4 pm in winter and 5 pm in summer. Shops down their shutters at the same time and the streets are quickly deserted.
Following the Mizoram Liquor Total Prohibition Act of 1996, the entire state is dry. Unlike other cities, there are no pubs, discotheques, malls, theatres or cinema halls that are hangouts for young people.
It's a world away for Mimi and her friend, who are sex workers and a part of the city's dark underbelly.
They are at the taxi stand. They know some of the taxi drivers who they hire regularly to take them to hotels, to rooms on the city's outskirts.
Like them, many remain hidden as there are no brothels, no designated red light areas in Mizoram.
Sex workers and injecting drug users are high risk groups for HIV infection. Government programmes are focusing on reaching out to them with HIV prevention campaigns.
But this is proving to be difficult for there is fear of being identified as a sex worker in the state.
Women sex workers have been known to be humiliated in public, their hair shaved off by members of youth groups. Along with the church, these groups exercise an unusual degree of social and moral control.
"They rounded up ten of us and took us to the YMA hall. There they shaved off our hair. I had very long hair but they cut it off, said Reby (Name changed).
Mimi tells us she ran away from her home in a distant village to escape ill treatment. She was just 14. In Aizawl, her vulnerability was exploited and she became victim of rape.
"I was raped by a stranger. But I had no way of escape. I relive the trauma when I recall that night. I have not been able to tell anyone about it before. Sometimes they have slapped us and even beaten us up", she said.
Another sex worker tells us about her feeling of rejection when she was abandoned as a child.
There is a common thread in the stories of sex workers. Of neglect by parents and society. Most of them belong to broken families and are school dropouts. Worse, they have faced abuse by someone within the family or someone known to them.
We are at the Volcomh refuge centre, a drop in centre that was started 10 years ago to intervene directly with this highly stigmatised group.
For street-based sex workers, this has become their home. Every morning they wait for the doors of the centre to open before they crash out on the beds. They pool in to buy vegetables so that they can cook a meal in the kitchen. They have also used their money to buy cupboards to keep their clothes and makeup. And this is where they get ready before they venture out for the night. All of them are below 30 years of age.
"If there is no drop-in centre, where will we go? Many of us do not have a place to call home, a place to sleep," said Esther (name changed).
It's a safe space for those rejected by society. It is this non-judgmental approach that allows health workers to reach out to sex workers and help prevent HIV infection. The centre provides free condoms and conducts regular check-ups for sexually transmitted infections. Equally important, is the opportunity created to share and learn from each other's experiences. Especially on how to cope with the threat of violence when they are unable to negotiate condom use by their clients. About 365 sex workers, including trans genders, are registered with the centre. Of these, 57 have been found to be HIV positive. And over half the sex workers who are infected are those who are injecting drug users. Sex workers who are injecting drug users have been found to be more vulnerable to the infection. The detection of new cases is decreasing. However, it has been an uphill battle as residents object to the opening of drop in centres in their localities. But the State AIDS Control Society is appealing to all for a change in attitudes.
"We cannot look upon them as enemies or nuisance to the society. I gave one example of one church worker who had gone to Guwahati for HIV AIDS training, there she was asked one question and the question was that as a worker who is concerned with HIV AIDS problem in our state, how many friends did she have among people living with HIV. And the church worker said she was very ashamed because she couldn't name a single person living with HIV that she had come across, leave aside making friends with them. So she made a resolve to make friends with people living with HIV and that is what she did. My main message to the youth in Mizoram is that we have to make friends with the people who are living with HIV AIDS, we have to really understand high risk groups, especially female sex workers, work with them and see how we help them getting into the main stream, so that this HIV AIDS can be contained," said Dr Eric Zomawia, Project Director, Mizoram State AIDS Control Society.
23-year-old Mimi has been fortunate. She has a new friend, a new family. It all began with a chance encounter with K at a hospital. Both were there for treatment and K felt protective towards Mimi, a total stranger.
"She was sitting in front of me. Other people at the hospital were talking ill of her. I felt a rush of affection towards her. When I was discharged from the hospital, I invited her home", said K.
K's husband is dead and she lives with her three children and aging father in a small hut. She lives on the wages she gets as an agricultural labour. She says she was ashamed to tell anyone in her community how difficult it was for her to make ends meet, to pay for the children's school. Mimi moved in with them and extended financial support.
"Things have improved for us after she has started living here. She pays for the children's expenses. She loves the children a lot. She gets them food and clothes. When we run out of gas, she arranges for that too," said K.
For Mimi, K's family is now her own. She has made plans for the children's education so that they do not share her fate. The children, on their part, return Mimi's love, even refusing to eat their dinner unless she is present.
"I treat her like my own child. She is not an outsider to me," said K's father.
Except for K, no one else in the family knows Mimi is a sex worker. The neighbour gossip, but she is not bothered by it. K says she wishes the best for her friend's future.
29-year-old Lalawmpuia grew up in a poor family. As a teenager he felt like a social misfit and this made him stop attending church. He was 18 when he started using drugs like his friends who come from a similar background.
"The YMA and JAC would catch us and beat us up. Even possessing a syringe could lead to our being beaten up, "said Lalawmpuia, who has a poultry business.
Nearly every Mizo above the age of 14 is a member of the YMA, a non-government organisation that emerged out of the concept of looking out for each other. Of the total population of nine lakh in the state, four lakh are members. The YMA helps to conduct funerals and to rebuild during times of natural disaster.
"We try to source from where they get those stuff from. If a parent can't control his kid at home, YMA acts as a parent for them. Since this is a total prohibition state, like alcohol is banned in the state. YMA tries its best to, in its locality it is free of drugs," said Joe R Z Thanga, Secretary, Mission Veng Young Mizo Association.
The YMA's antidrug squad was feared. It declared 2005 as Anti-Drugs year and the campaign carried on for some years. The crackdown was backed by the moral authority of the Church, which looked at drug addicts as sinners. With over 94 per cent of the Mizo people being Christians, the Church plays an important role in the people's lives.
Mizoram is flanked by Bangladesh in the west and Myanmar in the east. It has a 722 kilometre international border, a border that is porous. Its geographical location makes it a conduit for drug trafficking across the Indo Myanmar border.
The heroin seized in the state has been found to come from Myanmar. The easy supply led to a number of young people being devastated by the twin epidemic of drug addiction and HIV AIDS.
HIV transmission was largely drug driven in the state, through sharing of infected syringes and needles.
Those who could not afford heroin began to inject cheaper pharmaceutical drugs like Spasmo Proxyvon and Parvon Spas. These drugs, which are not meant to be injected, crystallise in the veins. It leads to abscesses, tissue necrosis and subsequent amputation of limbs.
Like the case of Rinsanga, a truck driver, who is unable to drive because of his condition.
"A good number of valuable lives have expired due to overdoses or adverse effects of drugs. The problem of drugs abuse is of such magnitude which required concerted efforts to protect the society," said Lalbiakmawia Khiangte, Commissioner, Excise and Narcotics.
The emphasis of the Commissioner of Excise and Narcotics is on supply reduction. According to him, the YMA was fulfilling the duty of citizens and were helping bring down the number of drug related deaths.
"The powers of search and seizure is not vested with them. But it is okay so long as they are illegal possessors and illegal traffickers," said Khiangte.
However, addressing the supply side is clearly not enough. What's worrying is that the HIV epidemic in Mizoram has moved from high risk groups to the general population. There's also the realisation that drug addiction has to be tackled as a disease and not as a crime. Drug users who are treated as criminals, go into hiding and are unable to access help or treatment.
The National AIDS Control Organisation, along with UN agencies and the Australian Government, has worked towards sensitising the Church and the YMA leaders. Take the case of the Grace Inn drop-in centre, run by the Church and the Government. The centre provides counselling, needle exchange and abscess management. It also provides harm reduction services through oral substitution therapy or OST. Drug users are administered buprenorphine which minimises drug withdrawals and can lead to complete cure.
"We heard and read the lifestyles of Hollywood stars and rock stars and we wanted to copy them. So we thought that it was really hip and cool to do drugs. What we do here is basically to get this medicine, it is called oral substitution therapy. What happens is that the medicine takes care of the craving in the withdrawal. They slowly taper down our dosages. We hang around with guys like us because there are no discriminations here. It is the first step towards leading a normal life, towards re-integration back to the society. We share our problems and our aspiration. We motivate each other and comfort each other because a lot of the non addicts and the alcoholics, they do not understand the problem faced by the addicts," said David Vanlalvena, former injecting drug user.
Drug de-addiction centres like this one are unable to cope with the demand. Intravenous drug users need intensive counselling. But because of shortage of funds they are unable to get an adequate number of counsellors. The relapse rate is quite high. And to manage this relapse, counsellors are needed.
Things have come a long way. Some churches have set up panels and are holding their own awareness programs. Others are setting up special camps to bring back drug users into the fold.
"They are wrong activities, but the person who are addicted to drugs or are involved in social sex are not outcast. They are guided to come to the main stream so that addiction as well as the practice of social sex are given up very soon with the grace of God," said Upa Lalthangliana Varte, Church Elder, Mission Veng Church.
"Spiritually, mentally and physically they could be cured because of the mercies of Jesus found in the Bible, so I was convinced that this should be a part of the gospel so I am interested in it," said Rothuami, Deacon, Baptist Church of Mizoram, Central Church, Upper Republic.
"I think we need a framework to work for that are infected by HIV AIDS. We still need more awareness because when we see and when we interact with some people who are infected by HIV AIDS we develop some sort of sympathy. But we have not reached the level of empathy so there are many people who still believe that HIV is like a punishment given by God to those who are sexually immoral. So in order to improve our ministry to people living with HIV, I think we need more awareness," said Reverend VL Hruaia Khiangte, Baptist Church of Mizoram, Shalom Baptist Church.
On World AIDS Day today, it is clear that increased attention on the North East, including Mizoram, by the National AIDS Control Organisation is showing results. But a lot more needs to be done.
Apart from treatment and care issues, there is need for focus on prevention strategies with young people. To extend programs to rural areas.
And everywhere we visited, the important question of livelihood programme came up - a programme that is so vital for the complete rehabilitation of sex workers, injecting drug users and people living with HIV.
