Skip the loo, my darling

Things are looking up says a beaming Usha Chaumar, 33, formerly a manual scavenger. "We make pickles, vermicelli and 'papad' (spicy savouries) at home, too, which gets us an additional income of around Rs 2,000 per month." Renu Rakesh has more.

- Alwar, Rajasthan (WFS) - Sunita Nanda, 33, from Alwar, Rajasthan, is just back from the Big Apple. She had a terrific time there. While in New York, Nanda sashayed down the ramp with leading supermodels and also attended a series of events held at the United Nations headquarters, marking the International Year of Sanitation.

Her children are delighted as they listen to their mother describe the interiors of the plush UN Millennium Plaza Hotel - where heads of states and leading diplomats and, more recently, Nanda stayed.

But that's where the similitude between world leaders and Nanda, as well as the 36 other women from Alwar, who were invited by the Prince of Orange of the Netherlands, ends.

Five years ago, Nanda earned a living cleaning dry latrines and disposing off night soil by carrying it in containers balanced on her head. She had married into a family of manual scavengers and was quickly initiated into the 'family business' by her mother-in-law. She abhorred the work but since it was the only source of income, acquiesced to it. Between the two women, the family earned a paltry monthly income of Rs.400.

But all that changed in 2003 when Dr Bindeshwar Pathak of the Sulabh International Social Service Organisation met up with the women manual scavengers of Alwar district and resolved to liberate and mainstream them.

Through his NGO, Pathak set up a centre called Nai Dishayein (New Directions) where women are trained in vocations such as food processing, tailoring, embroidery and beauty treatments. The first batch in 2003 saw 28 women eagerly learning the new skills. The next batch saw the numbers double.

The women work at the centre from 10.30 am to 4 pm and earn a monthly stipend of Rs.2,000. Their food products, candles and other items are purchased by hotels and restaurants in Delhi and in the national capital region (NCR). "For a year, we couldn't sell anything that we produced because people said they were made by the 'untouchable' scavengers," says Santosh Singh, who manages the centre.

"For a year, we couldn't sell anything that we produced because people said they were made by the 'untouchable' scavengers," says Santosh Singh, who manages the centre.

But things are looking up says a beaming Usha Chaumar, 33, who explains, "We make pickles, vermicelli and 'papad' (spicy savouries) at home, too, which gets us an additional income of around Rs 2,000 per month."

"Initially, we didn't believe Dr Pathak. We couldn't believe anyone could liberate us from this age-old practice. But a few months after his Alwar visit, he invited us to Delhi for the World Toilet Summit and put us up at the five-star Maurya Sheraton hotel. The organisation also gave us Rs 200 as travelling allowance. When we returned to Alwar, we were sure our life was going to change forever," recalls Nanda.

Shakuntala, 35, another former scavenger, says, "Most of us are now literate. Some of us can even speak a few words of English. We now send our children to English medium schools. Earlier, we didn't have any say in such affairs. The family decided where our children would go for their schooling. The centre has given us dreams and we want to realise them."

Besides rehabilitation, the NGO works towards helping then gain social acceptance, too. The recent trip to New York is the result of such efforts. Earlier in the year, the women had participated in a fashion show organised by the NGO at the India Habitat Centre in New Delhi. They had walked down the ramp with leading Indian models like Marc Robinson, Indrani Dasgupta and Tapur Chatterjee, in apparel designed by them under the six-month-long guidance of designer Abdul Haldar.

The show was attended by the Prince of Orange of the Netherlands, who then invited them to the UN this year. The trip was sponsored by Sulabh International in association with the Irene Network, a UN voluntary organisation and the UN Department of Economic and Social Affairs (DESA).

"We could never ever dream that such a thing could happen to us. What happened in New York was much beyond our dreams," says Chaumar, who addressed the international community from the podium of the United Nations. There she spoke about her days as a manual scavenger, about how Sulabh International helped her do away with the humiliating job, and of her being the sole breadwinner of her family. Among her audience were leading diplomats and top UN officials. Later, Chaumar was unofficially crowned as princess of sanitation workers.

Talking about their visit to the Big Apple, the women say they loved the big-city experience - they were most impressed with the skyscrapers and enjoyed their trip to the Statue of Liberty on Liberty Island in the New York Harbour and the Battery Park in lower Manhattan. And what were their observations of the women of the metropolis? Though they were inspired by the working women in the city, the former scavengers were not too impressed with their clothes. "Less clothes and more exposed bodies. Our men would never let us wear such clothes and step out to work," says Shakuntala.

Of course, Nanda, Chaumar and the other foreign-returned women are the fortunate few in a state, which has the second highest number of female manual scavengers, after Delhi. This, despite the fact that Rajasthan had adopted the Employment of Manual Scavengers and Construction of Dry Latrines (Prohibition) Act, 1993. According to Pathak, the reason for the prevalence of the practice is the failure of the state to appoint an executive authority to prosecute violators of the Act. According to central government estimates, there are 342,000 persons engaged in manual scavenging in India. Voluntary organisations believe the actual numbers are at least four times this figure.

In Alwar alone, there are about 100 female scavengers, while Bharatpur tops the list with 600 as per figures sourced by the NGO from the state government. However, impressed by the results of the Nai Dishayein initiative, the Rajasthan government is now ready to provide financial assistance to Sulabh International to replicate the Alwar model in Tonk, another district of the state, where out of 225 scavengers, 190 are women. (Women's Feature Service)

 

Surviving a battle they fight every day

In India's business capital, the NGO Sanmitra is helping HIV positive women re-enter the mainstream workforce, thereby ensuring them a life of independence and dignity. Sumita Thapar has more.

the industrial metropolis and the proverbial melting pot – ensures everyone learns the art of ‘surviving’ Mumbai; people living with HIV being no different. India’s migration capital has perhaps the longest history when it comes to an effective HIV response. Even as early as 2000, Mumbai had projects and homes looking at children affected (orphaned) and infected with HIV, and the community and civil society had already begun playing their role.

One important link in this chain of effective response is Sanmitra, an NGO registered in December 2002 and located in Siddharth Hospital, Goregaon. Sanmitra focuses its efforts on helping HIV positive women re-enter the mainstream workforce. Along with that, it has also been working among street-based sex workers and bar girls. The thrust is on HIV prevention, care and support. This includes treating sexually transmitted diseases; making women aware of services such as testing for HIV; for those who test positive testing of CD4 count; where CD4 count is below 200, helping them access free antiretroviral treatment (ART) from public hospitals. At present, Sanmitra’s projects reach out to about 1,000 street-based sex workers, 2,000 bar girls and 500 of their male partners.

According to Prabha Desai, who heads Sanmitra, the biggest challenge for people living with HIV today is stabilising health and getting re-enty into the mainstream labour force. “We cannot create artificial jobs in NGOs. Factories and offices are reluctant to recruit HIV infected people,” she says. Desai says employers hesitate as they are not sure if HIV positive people will be as punctual and efficient as the rest; if co-workers will accept their presence. “Employers are telling us, for now, we will recruit affected people but not those infected.”

She elaborates on the difference between infected and affected people: infected are those living with HIV themselves. Affected are family members, spouse, children, parents, etc. – those not infected themselves, but bearing the brunt of HIV, including psychological and financial effects. Desai observes that the employers are reluctant to take in the infected, but if there are any affected people, employers are willing to give them employment.

Desai’s solution to this situation has been simple: set up an enterprise for doing industrial assembling and packaging jobs, get work outsourced from factories and train and employ affected and infected people to do these jobs. In another initiative, Sanmitra trains affected and infected people, most of them young widows, to become HIV counsellors and para-health workers. Desai strongly believes earning livelihood is critical to one’s well-being. “How long can positive people go begging from one church to another? Is that the solution? We have to set systems in place so people can live well,” she emphasises.

Sanmitra’s income generation programme called the Swayambhu Uddhyam Kendra has found support from factories producing electrical goods. The Maharashtra Industrial Development Corporation (MIDC) has been supportive, as have large companies such as Larsen & Toubro. At Swayambhu, a 20-year-old AIDS widow with two children shows us how she assembles switches. Hands deftly hammering she says, “If I work fast and concentrate I can do about a 100 pieces a day.” At any given point of time, there are about 10 women like her who spend seven-eight hours here each day. They earn wages on a per piece rate. This adds upto a minimum of Rs 70 per day, some earn upto Rs 120. Over a month, they earn about Rs 2,000. The NGO gives them a bus and train pass, along with some basic nutrition in the form of a daily snack.

A 20-year-old AIDS widow with two children shows us how she assembles switches. Hands deftly hammering she says, “If I work fast and concentrate I can do about a 100 pieces a day.” As much as livelihood for its sake is critical, work also acts as therapy helping women heal.

Working with other HIV positive people in a safe and nurturing environment helps women reach out to each other. Being employed and taking home a salary gives them a newfound confidence. They work for a few months gaining foothold, and move on to other jobs. Some train to be outreach workers in health programmes or lab technicians, others take up sales jobs. People are encouraged to move on, so they can enter the mainstream again.

As much as livelihood for its sake is critical, work also acts as therapy helping women heal. Sanmitra believes in the power of peer counseling – people who have been through the experience themselves reach out to others. Its Ayush training academy runs three-month courses for infected and affected people, training them to be para-health workers and counsellors. Most trainees are young widows. The course runs over weekends and is offered free of charge. Of the 50 people trained over the last two years, presently, 10 are employed with Sanmitra and the rest with other NGOs.

Trained outreach workers and counsellors work as part of the community initiative under the government-run programmes for prevention of HIV and offering services to infected people. These include the PPTCT (Prevention of Parent to Child Transmission) programme and the ART (Antiretroviral Therapy) programme offered at public hospitals. Under PPTCT, pregnant women are counselled on HIV and encouraged to test. Women who test positive require constant follow-up, ensuring they return to the hospital for delivery. Under the ART programme, outreach workers act like a bridge between the programme and its users to ensure treatment adherence.

One woman counsellor says when she tested positive some years ago all she had heard about HIV was that “it is a death sentence”. Meeting Madhu (name changed), a peer counsellor at JJ Hospital, gave her a lot of courage, she says pointing to a woman sitting next to her. “I realised – we can live.” Another woman recounts the experience when she met Madhu, 33, who talked about her HIV status and her HIV positive daughter. “First, I thought she was lying. Then I thought – maybe I can live too. Before that, I had even thought of suicide.”

Over the last two years, Sanmitra’s outreach staff of 25 including 10 counsellors has reached out to over 1,000 infected people, mostly women. Trained women counsellors counsel pregnant women, outreach workers do home visits. In resource starved public health settings, these footsoldiers are doing remarkable work. Add to that the benefit of peer counselling. The power of peer counselling in enormous, say the positive women. They should know – they have been on the other side of the table.

Many HIV positive women face a double stigma – of HIV and also of widowhood. The trajectory of experience is similar in most cases: husband’s HIV status gets known, he dies some years later, leaving the woman emotionally exhausted and physically drained out. There is little or no family support. There are little children to be looked after. As HIV depletes family resources, there is emotional and psychosocial stress along with the economic. There are constant health issues – trying to ward off opportunistic infections, ensuring proper nutrition, especially those on antiretroviral therapy (ART). Bouts of sickness make it difficult for them to keep a regular job in a scenario where stigma persists and employers cannot be taken into confidence. Children’s education and nutrition remain their biggest concerns.

Thirty of Sanmitra’s staff of over a 100 are HIV positive – that’s one in three. They are motivated to match the mainstream in terms of skill and efficiency. “Everyone lives and works together. Positive people are sheltered – we don’t give them jobs that might put them at risk in any way. Some flexibility in terms of working hours may be required,” says Desai. “Earlier, MDACS (Mumbai District AIDS Control Society) used to insist that counsellors have professional qualifications. Now, our counsellors have passed tests conducted by MDACS in Grade A. That battle has been won.”

Desai says when women first come to the centre, they are traumatised. A couple of months of work helps them start rebuilding their lives. “Just look at them now,” she says pointing to their smiling faces. The women look confident and cheerful – it’s difficult to believe they have survived a battle they must fight everyday. Having experienced firsthand the near-death-experience and then bouncing back after hitting rock bottom with suicidal thoughts and severe depression, these women are extremely generous when it comes to reaching out to others. As HIV positive women reach out to each other and those newly infected, they are saving lives, and in turn finding a new meaning for their own selves.