Health Worker Mobilizes Indian Community to Seek Treatment and Support

JANUARY 2007 — When Bhadri Jandra discovered in January 2003 that she was HIV-positive, she counted on the support of her husband, a truck cleaner, and her in-laws who lived with them in Ongole in Andhra Pradesh. Instead, they shunned the 21-year-old Indian woman when they learned her status. Frightened and lonely, Jandra returned to her parents' home in a distant village close to Vijayawada in Krishna District.

Jandra's fortunes brightened when an outreach worker with the Safe Journey project contacted her in January 2004 at the suggestion of her neighbors. The program, funded by the U.S. Agency for International Development (USAID) and managed by Family Health International (FHI), sought to prevent the spread of HIV and mitigate its impact on the transport sector through advocacy activities and prevention, care and support services to truckers and their families.

Initiated in September 2002, Safe Journey was jointly undertaken by All India Motor Transport Congress Society (AIMTCS), Krishna District Lorry Owners Association (KDLOA) and the Center for Advocacy and Research. The project focused on Vijayawada because it was a hub for transport-related activities. FHI provided grant management and technical assistance to AIMTCS and KDLOA to implement services in Vijayawada and inform lorry owner associations throughout India about issues concerning mobility and HIV/AIDS.
 
Project Instilled Positive Outlook

Safe Journey provided treatment and psychosocial services to Jandra, and helped her develop a more positive outlook. She soon became a project volunteer in her parents' village—where people living with HIV/AIDS (PLHA) were confronting discrimination—and motivated other HIV-positive women to seek treatment and support. 

"Before joining the project, I had no future. I was always depressed, but since joining it I have hope," she said. "My self-esteem has also gone up. I have realized my responsibility as an Indian citizen. I now want to extend the same support to other PLHA."

Moved Back to Care for Husband

After her husband learned in 2003 that he too was HIV-positive, Jandra moved back to Ongole to care for him in the final stage of his illness from December 2004 until his death in January 2005. During that time, Jandra's in-laws developed a better understanding of HIV/AIDS and changed their view of her. They asked Jandra to stay with them after her husband died, but the young woman decided to move back with her parents.

In September 2005 Jandra became a community health worker for Safe Journey, helping to organize sexually transmitted infection (STI) clinics in the community, provide HIV/AIDS information and distribute condoms to women in the trucking community. She has referred approximately 10 PLHA and more than 50 women with STIs to the project.     

"Now I do not face any stigma and discrimination from my people in this community. I am glad that I, too, can hope for someone else," Jandra said.

Remained Volunteer after Project Ended

The woman, now 25, has remained a volunteer in her parents' village since the project ended Sept. 30, 2006. She has referred other HIV-positive women to the government voluntary counseling and testing center and the antiretroviral therapy center in her community, and addressed large audiences on HIV/AIDS issues.

In addition, KDLOA recently gave her funding to establish a clothing business in Vijayawada, which is expected to open in February 2007.                   

"I do not want to depend on my family for financial support, so I am starting my new business," Jandra said. "I am confident that I will succeed. As a community health worker, I have a very good name in the community."

Established a Sustainable Model for Serving Mobile Populations  

Safe Journey provided services to more than 86,000 migrant truckers, cleaners, workers in gas stations and roadside restaurants, and mechanics and their families. It demonstrated how strong local capacity building and program ownership can help establish a sustainable model for providing HIV prevention, care and support services to a mobile group and its family members, program officials asserted.

Since Safe Journey ended, KDLOA managers have been supporting project activities with corporate funds. The association has also submitted a proposal to the Andhra Pradesh State AIDS Control Society for funding. 

Overall, FHI has managed and assisted eight USAID-funded projects providing comprehensive HIV prevention, care and support services to more than 390,000 migrants, truckers and their families in India. FHI has provided grant management and technical assistance, and built the capacity of local NGOs (including lorry owners associations) to initiate and sustain HIV prevention and care activities in their respective communities, according to FHI/India Country Director Kathleen Kay.

For example, FHI provided grant management and technical assistance to South Asian Research and Development Initiative and its partners for an HIV prevention, care and support project. The program included strategic behavior communication messages, materials on risk reduction, peer education services, STI services, linkages to voluntary counseling and testing centers, information on available services, and a support group for returning migrants.

PHOTO: Bhadri Jandra, a community health worker with the Safe Journey project, issues medicines to clients at an STI clinic in March 2006. She helps organize STI clinics in the community, provide HIV/AIDS information and distribute condoms to women in the trucking community. The project has provided comprehensive HIV prevention and care services to more than 85,000 migrant truckers, their spouses and families, cleaners and allied workers since September 2002. (Photo by Anita Khemka)

— Alan Goodman