DE-MYSTIFYING HIV/AIDS VIA THE WIRES: MOIRA ENGINEER FITS INTO A NEW ROLE... ---------------------------------------------------------------------------
Karl de Souza <[EMAIL PROTECTED]> lives in a quiet part of Moira village, but does an unusual job along the North Goa beach belt. This computer engineer turned management consultant for global major PriceWaterhouseCoopers, leads a hot-line that takes the average resident of Goa beyond the myths about HIV/AIDS. Says he: "I grew up in Bombay and, over the last eight years, worked mostly abroad in about ten different countries, including the UK, US and Singapore." Why did he opt to settle in Moira with his Singaporean wife, child and mother? Says this young man in his early thirties: "Both my wife and myself decided that we need to do something more worthwhile in life, giving more that we receive, and making God the centre of our life. So we came back (to Goa) and got involved. AIDS is an issue which deals with all segments of society and life. I met Sofia Caldeira of Rishta, was taken up by their work and joined." So, today, to find out information about that much-feared ailment called HIV/AIDS, in Goa you just ring a four-digit number, 1097. The phone takes you directly to a help-line run by the non-governmental organisation called Rishta. Like others of its kind, this help-line phone service provides total anonymity and confidentiality, thus promising you with a means to find out literally "anything you wanted to know but were afraid to ask on HIV/AIDS." 1097 was commissioned in India in 1997. It came to Goa only last December. Their counsellors work out of the beach village of Calangute. 1097 is a toll-free number. From mobiles you can also dial in on 0832-2282636. Youngsters are sometimes worried whether the counselor will lecture them or tell their parents they're into sex. But this help-line promises: "In fact counseling is not about giving advice, but having a professional friendly conversation. We don't make decisions for you. We just tell you the pros and cons and leave the decision up to you. We never judge people. Youngsters phone many times asking common questions and we answer them seriously." India with 3.97 million cases ranks second -- in absolute numbers -- only to South Africa in this global epidemic. Goa which is surrounded by States with high HIV prevalence itself has an estimated 12,000 people living with HIV. Young people call in for varied reasons: What does someone planning to get married need to know? Is weight-loss necessarily indicate HIV/AIDS? Or does getting sick very easily indicate being HIV positive? Can one get HIV/AIDS by kissing? What exactly is the much talked of 'safe sex'? Can one make out if someone has HIV/AIDS just by the way the person looks? And a lot more. FREDERICK NORONHA talks to Karl about his work and dreams: -------------------------------------------------------------------------- How has the experience been so far? What is the response like? -------------------------------------------------------------------------- In fact quite good very positive. Initially, after the first month's spike, the number of (incoming phone) calls got really reduced. For example, on some days, we had no calls at all. We used to wait for each call and used to get so excited even if one call came. Continuous waiting was also quite stressful; just imagine waiting and waiting never knowing when the phone will ring. But we used the time well for training and retraining. After some time, we got used to waiting and it is now second nature. Now it is picking up. We get calls regularly, in fact many times referrals by friends or previous clients besides the doctors or institutions we have networked with. Which is great. It means people are talking about this service, and have heard positive reports. We still have a long way to go. We are working hard to be as established as, for example, Childline (the 1098 phone-in service that helps children in distress). It is a new concept. Specially telephone counselling, since there is no other service like this which really deals with tough issues like stigma, support, betrayal, hurt, fear and guilt. AIDS is just the tip. Or a manifestation of the different things which have been hidden in society like adultery, casual sex, homosexuality etc. -------------------------------------------------------------------------- >From the calls coming in, what would you identify as the major concerns in Goa currently, related to HIV/AIDS? -------------------------------------------------------------------------- I think there is a lot of experimenting by guys before marriage and, so, with it, comes guilt and fear. Then, there is the whole issue of someone to talk to, someone who understands i.e. psychosocial support. Usual misconceptions -- for instance, can you get AIDS through touching, kissing, mosquitoes, etc. There are calls on information on sexual health, sexuality and basic sex education Safe sex of course is an important concern. There are people who want to know more about testing and especially the window period. -------------------------------------------------------------------------- What are the type of people calling in? Are they reluctant? Shy? Afraid? -------------------------------------------------------------------------- I guess the people who are really shy are afraid to call. Which is why many times we get blank or silent calls. This is from people seem to be working up the courage to talk. There is this whole aspect of confidentiality. Questions on, is the phone call recorded, will we report AIDS cases to the authorities, etc. Then there is the whole culture and tradition issue. As I said earlier, AIDS is just the surface of underlying problems. Since the predominant mode of transmission is sexual, many times you end up talking about intimate aspects. People are somewhat hesitant or shy about discussing personal aspects of their life with a total stranger and that too on a telephone. Which is why setting up the rapport in the opening greeting is important. Once trust is established, especially with repeat callers, then they really open up and are grateful of the anonymity the line provides. -------------------------------------------------------------------------- How, in your view, does Goa compare with other places on this front -- both the HIV/AIDS problem and also the response? -------------------------------------------------------------------------- There is no doubt Goa is a low-prevalence state when compared to states like Maharashtra, Karnataka etc. But the point is that these states are Goa's neighbours, and, whether we like it or not, the health of the people there will have an impact on us. Which is what we are seeing.... But what is worrying is the trend due to changing lifestyles especially due to the exposure to media and urbanisation. High-risk people can no longer be classified as commercial sex workers or migrant labourers. Anyone who is not tested could be at high risk since we have no idea about his or her personal history. Talking about the help-lines, in places like Mumbai, Bangalore or other metros or cities of course the number of calls is much higher. But I don't think we lack anything. In fact my focus is to make our help-line the model if not the best. We are in fact the first AIDS help-line to go online. You can check out http://www.aidshelpline.org or http://www.aidshelpline.com. We are still testing and improving the site. But it has some great information, specially for youth. -------------------------------------------------------------------------- What have been the constraints in your work? -------------------------------------------------------------------------- There are three main areas of constraints -- administration, finance, staff. Firstly, in terms of administration, we are strictly governed by NACO (National AIDS Control Organisation) guidelines which are done on an all-India national level and are many times not relevant to many states or outdated. All our educational (IEC) material etc has to be vetted, which can be delaying. Secondly although as such the line exists as a government subsidized help-line, it is run by a non-governmental organisation. So there are the usual constraints. A clear demarcation needs to be done between the two, especially on the points of responsibility and accountability. So many times we have to walk the tight-rope being careful not to upset one or the other and cause friction or misunderstandings. On the finances front, such a new concept requires lots of advertisement etc. But personally we have a miniscule budget on advertising. There, logistics too. Given the complexity of manning the help-line, we need quality counsellors who have good experience in all types of counselling and especially HIV/AIDS counselling. In fact telephone counselling makes the job more complex, especially since you don't have control (the client can cut the call anytime) and further we don't get to watch the body language of the client. Also the counsellor needs to understand the local health structure and languages. Given the recommended salary constraints, it is next to impossible to get such staff. At present we are lucky but there is no bond in the contract and they can leave anytime. -------------------------------------------------------------------------- If you could start things again, what would you have done differently? -------------------------------------------------------------------------- Nothing really. The line has succeeded beyond my expectations. Only maybe we could specify the demarcation between accountability and responsibility of the GSACS (Goa State AIDS Control Society) and the non-governmental organisation more clearly. Maybe also more media buzz, more awareness through advertisements and promotional material and of course better salaries for the counsellors. In fact we were lucky to have the previous Health Secretary Ms Rina Ray as project director who was very understanding and supportive and had a great vision. So we could ride out most teething problems. So also the NGO advisor, Dr. Mariette Correa, who has taught us and guided us a lot. -------------------------------------------------------------------------- Could you describe the amount of time, man-hours spent on this work by the project? -------------------------------------------------------------------------- Well the project working time is from 9 am-7 pm. Time is spent in counselling, lots of training, discussing cases, administration and lots of networking. -------------------------------------------------------------------------- What results do you'll expect? What results have you already seen come in? -------------------------------------------------------------------------- We expect quite clearly to make this the best telephone counselling in the country and are serious about it. We expect naturally more people to learn about it and call us immediately to clear a doubt or get psychosocial support. We expect the callers to inquire about other aspects of safe sex, including abstinence and how to negotiate and say 'no' and handle peer-pressure. Also parents who are arranging their children's marriage need to know so much about testing and the risk they face. About results, it is perhaps too early to say or make out an analysis. All one can say is by seeing the trend of friends referring friends is an encouraging sign. It means there is trust and also people are discussing AIDS which is a big step in behaviour change. -------------------------------------------------------------------------- Do you think the time, energy invested is worth it? -------------------------------------------------------------------------- Definitely no question about it. -------------------------------------------------------------------------- What are the other types of help-lines that Goa needs? -------------------------------------------------------------------------- Probably one for women in distress. Definitely crisis counselling like the Good Samaritans, and ones for suicides. Then, for sexual health too. This and sexuality problems could be made officially part of the 1097 service, and promoted like TARSHI in Delhi. Goa though is too small to warrant a separate line for that. (ENDS) -- ------------------------------------------------------------------------- Frederick Noronha (FN) | http://www.fredericknoronha.net Freelance Journalist | http://www.bytesforall.org http://goalinks.pitas.com | http://joingoanet.shorturl.com http://linuxinindia.pitas.com | http://www.livejournal.com/users/goalinks ------------------------------------------------------------------------- T: 0091.832.2409490 or 2409783 M: 0 9822 122436 ------------------------------------------------------------------------- Goa's first Usenet newsgroup: http://soccultureindiangoa.shorturl.com ########################################################################## # Send submissions for Goanet to [EMAIL PROTECTED] # # PLEASE remember to stay on-topic (related to Goa), and avoid top-posts # # More details on Goanet at http://joingoanet.shorturl.com/ # # Please keep your discussion/tone polite, to reflect respect to others # ##########################################################################
