HIV/AIDS in Darjeeling, Northern India

Map downloaded from WikiMedia

Little information exists on the exact numbers of people living with HIV/AIDS (PLHIV) in the Darjeeling region of India because of its remote location and general lack of awareness about the disease; however, a recent epidemiological study revealed 11.8% HIV seropositivity among a group of intravenous drug users in this hilly district in northern West Bengal ^{( 1 )}.  

The following information is from an online blog publication by the Shanker Foundation Darjeeling Network of Positive People, which addresses the concerns of PLHIV in the region ^{( 2 )}.  

The backwardness of the area, prevalence of migration, intravenous drug use, growing sex worker population and focused awareness on HIV/AIDS in urban rather than rural areas have likely attributed to the vulnerability of this area with regards to HIV/AIDS.  In April 2002, one Voluntary Confidential Counseling and Testing Centre (VCCTC) was established in Darjeeling.  To date, 2480 persons have undergone testing, of which 116 were found to be HIV positive (31st May, 2007, VCCTC report); however, experts believe the number of PLWHA in the entire hills region to be far higher for a variety of reasons:

• Few people get tested due to lack of awareness and fear of stigma
• Awareness programs cater to the urban population and have not made strong connections to the rural population of Darjeeling
• VCCTC is located in the urban areas and has limited access to the rural population
• The poor economy and massive unemployment in the region have given rise to large migrant labourer and sex trade worker populations
• High risk groups have limited access to HIV/AIDS awareness programs
• Most institutions do not impart sex, let alone HIV/AIDS awareness education, to pupils.

Immediate educational and medical support is needed in the remote Darjeeling region as the level of awareness and testing for HIV/AIDS is so desperately lacking.   An increasing number of women and children with HIV are adding to the challenges of the area and unfortunately, this group is further marginalized by their positive HIV status in a society that already marginalizes women and children^{( 2 )}. 

Darjeeling Project 

In 2007, Dr. Louie made connections with Father Abraham, a Jesuit priest from Canada who has worked with the poor in northern India for over 50 years.  He introduced her to several organizations in the Darjeeling region that provide services to PLHIV and they expressed an interest in the Foundation’s programs.

The majority of the people in the remote Darjeeling region of India are refugees or migrant workers from Tibet, Nepal, Bhutan and the impoverished province of Bihar.  The HIV program in the region has only existed since 2002 and the issues of stigma, discrimination and gender inequality are enormous.  As an example, women are getting tested because of fears that the community will discriminate against them as well as their families if the results show them to be (HIV) positive.

The Foundation is poised to continue its not-for-profit initiatives by establishing locally run, sustainable programs in Darjeeling. Principals are planning to launch an extensive, proactive, medical and educational program similar to the Mae On Project in Thailand; however, the Darjeeling project will have a more regional focus on essential sustainability.  The Darjeeling Project initiatives include:

• Using acupuncture techniques to address substance abuse, improve the symptoms of chronic HIV infection, and reduce the side effects of ART;
• Offering nutritional counseling to patients;
• Providing a culturally sensitive educational component including workshops and counseling to help people better understand HIV and its stigma, along with gender equality issues.

The Darjeeling project will also include the creation of energy efficient stoves and improved housing. The Foundation’s intention is to train local staff to run the Darjeeling Project programs so that eventually their involvement will be minimal or altogether unnecessary, achieving their goal of sustainability.

REFERENCES

1. Mullick, Sengupta, Sarkar, Saha and Chakrabarti, 2006
   Phylogenetic Analysis of eng, gag and tat Genes of HIV Type 1 Detected among the Injecting Drug Users in West Bengal, India published in AIDS Research and Human Retroviruses, Volume 22, Number 12, 2006, pp.1293-1299
2. Roshan Rai, May 2008
   Shanker Foundation Darjeeling – May 2008 Update,
   Shankerfoundation.blogspot.com, posting for Saturday May 10, 2008