AIDS in India

Sex and the poor

http://www.economist.com/books/displaystory.cfm?story_id=12459721
Oct 23rd 2008
>From The Economist print edition

ONE of India's leading AIDS doctors, Alka Deshpande, did not choose her
specialisation. Working as a hospital doctor in Bombay (now called Mumbai)
in the late 1980s when AIDS was discovered in the city, she merely decided
that she was prepared to touch the infected. Her colleagues would not do
so—and perhaps still will not. According to a recent UN study, over half of
Indian health-care workers thought AIDS was transmitted by touch.

In a mostly-Hindu society, which for thousands of years considered one-fifth
of its members "untouchable", discrimination and ignorance of this kind have
a particularly unpleasant significance. Indeed, the ways in which AIDS and
India's traditions interact are a striking feature of these essays about the
disease in India, commissioned by the Gates Foundation. On a tour through
the south-eastern state of Andhra Pradesh, which has a fifth of India's
estimated 2.5m HIV cases, Kiran Desai meets women of several hereditary
prostitute castes, including relatively affluent beauties who are apparently
not unhappy with their lot, as well as wretched sex slaves, pimped by their
neighbours. AIDS haunts them all.


In Karnataka, a hilly southern state, William Dalrymple—the only non-Indian
contributor to the collection—meets the inheritors of the now illegal
tradition of temple prostitution. In ancient times, its practitioners
included the daughters of royalty, dedicated in childhood to service the
devotees of the goddess Yellamma. The modern lot almost all belong to a
single caste of illiterate dalits. They are distinguishable from
run-of-the-mill village prostitutes only by their early entry into the
career and therefore a higher probability that they will contract HIV.
Nearly 40% of Karnataka's devadasis—literally, slaves of god—are believed to
be infected with the virus.

India's regulations against sodomy and soliciting are another ugly local
feature. By criminalising gay sex and prostitution, these laws have blocked
many sincere efforts to quell the virus. Among Bangalore's gay men, as
described by Mukul Kesevan, one in five has HIV. They come in three
categories: kothis, who specialise in being penetrated; panthis, who
penetrate; and "double-deckers", who do both. The kothis, alas, seem a
particularly woeful bunch. Many are rent-boys, perpetually terrorised and
periodically raped by the police. Some are hijras, members of India's
semi-ostracised "third sex". By contrast, panthis, the transmitters of the
AIDS virus, often lead regular family lives.

Almost all these essays are about sex and poor people. There are two
exceptions. One is an interesting story by Siddharth Dhanvant Shanghvi about
the death of a gay film-maker in Mumbai from AIDS. The other, by Vikram
Seth, is about his own awakening to the virus in California in the 1980s.
Accompanying it is a poem that he wrote at the time, a dying man's
meditation on death, which ends: "Love me when I am dead/And do not let me
die." It is a moving plea.


More typically, these well-to-do writers seem to struggle for empathy with
their wretched subjects. Sunil Gangopadhyay, a Bengali poet, succeeds better
than most, with an engaging memoir of wanderings in Sonagachhi, the main
red-light district of Kolkata (previously Calcutta). Ms Desai's essay is
also finely observed: for example, a passage on the miseries of open-air
prostitution, along a lonely coast-road, where a woman's price falls during
the monsoon. Yet an awkward effort to write her father's terminal cancer
into this narrative of suffering suggests her feelings of alienation from
it. Sensibly, perhaps, Sir Salman Rushdie keeps his rather short dispatch
from among the hijras of Mumbai more impersonal. Yet his contribution, which
includes a description of a stiff, ex-army father's begrudging, but
complete, acceptance of his hijra son, is one of the best.


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