Breaking the silence

The Red Ribbon Express spreads the message of HIV awareness, prevention, countering stigma and life after HIV around the countryside.

The train is painted a cheerful sunshine yellow with a hint of blue and red. The tagline says “Uniting India Against AIDS. Zindagi Zindabad”.

From The Hindu.

‘Celebrate Life’ is an appropriate tagline for the train that communicates the compl exity of HIV: Everyone is vulnerable, yet it is preventable. HIV is not about morality; countering stigma against people living with HIV is integral to HIV prevention.

It is day 42 since the Red Ribbon Express was flagged off from New Delhi Railway Station on December 1, 2007. It has just entered Lucknow where it will halt for two days. It receives a jubilant welcome. Local NGOs have set up a small exhibition space around the platform. It is mid-morning and the queues are getting longer. Young men are in majority. The train is attractive, looks interesting, and curious crowds are growing.

The energy is youthful. Those in the driver’s seat — quite literally — are young people themselves. Mohan Singh Rana, CEO of the Red Ribbon Express who will be on board through its journey, is all of 27. Nehru Yuva Kendra’s volunteers play a critical role in outreach and mobilisation, as they travel in the train and at every halt go cycling into nearby villages spreading HIV awareness through nukkad nataks and skits.

One year, 22 States, 70,000 km: The sheer scale of the project is overwhelming. During the course of its journey, the train will criss-cross the length and breadth of the country making 180 halts (in 180 districts), language changing 11 times over, before it returns to New Delhi on December 1, 2008.

Like a messenger of peace and goodwill, the train brings HIV information wherever it goes. From touch-screen to bicycle, it uses a synergy of technology and interpersonal communication to reach out. It has daunting challenges to meet. For one, HIV is a complex issue with many links — science, women’s vulnerability, reproductive health, sexuality, migration… The country is diverse with dialects changing every few 100 miles. The audience is varied — men, women, urban, rural, literates, neo-literates. And yet, there is something about the sheer spirit and energy that seems to bring everything together. According to CEO Rana, an average of 3,000-4,000 people visit the train each day. The response has been overwhelming.

The first three coaches containing the exhibition use a communication style that is highly interactive packaged as infotainment. The touch-screen games, audiovisuals, interactive models make the exhibit extremely attractive to a young audience. There are music videos and PSAs (public service advertisements) featuring youth icons, actors and cricketers.

There is basic information: What is HIV, how it spreads, how to protect oneself. A map shows HIV prevalence across States and districts and national response to the epidemic. There is information on the National Rural Health Mission; HIV and reproductive health, why pregnant women should test for HIV.

UNICEF and ad agency JWT have ensured that communication is simple without being simplistic; no small challenge when it comes to an issue as complex as HIV. K. Beena, UNICEF, Lucknow, explains that as the train travels across the country, the visuals will remain the same while the language changes 11 times over. “That is why we ensured the visuals have faces representing different parts of the country,” she says.

There is no reference to high-risk groups, perhaps to consciously emphasise that everyone is vulnerable and not only certain population groups.

A coach designed as a 60-seater auditorium is meant for in-depth training for cohesive groups such as healthcare providers and elected representatives. Male/female doctors and counsellors are also on board. The live training sessions are designed for a cohesive group — doctors, district officials, teachers… The intention is that, as leaders, these people become more aware and can further ignite HIV awareness among the communities they work with. The live nature of the training helps dispel doubts.

Easily the most powerful part of the training is an experience shared by an HIV positive speaker who represents the State network of people living with HIV. In Lucknow, a confident 30-year-old Radha, President of the Faizabad Network, spoke of losing her son and husband to HIV, being thrown out of in-laws’ home and how the Network supported her. The survivor of many battles says she is committed towards HIV awareness and prevention, and dispelling fears in people’s minds because “I don’t want anyone else to go through what I had to go through.”

Radha’s share reminds me of Ashok Pillai, one of the pioneers among positive leadership in India, when he pointed out years ago “Unless people meet those with HIV how will they believe the problem is real?”

Young people show an enthusiastic response; the tech-savvy nature of the exhibits is clearly working well. A group of young college girls said they were inspired and moved by Radha’s experience and sharing. As NSS volunteers, they have been part of HIV awareness programmes themselves.

There were students and researchers interested in the issue: A young man pursuing a diploma on HIV; another doing a research on opportunistic infections. A young woman from Dimapur working with an NGO in Gorakhpur was glad to know the language will change when the train reaches the North-east.

Women were remarkably few and far between. One woman said she came with a male member of the family. She’s fascinated and excited; this was all new to her. And yes, she says, women don’t come on their own; they hesitate.

Meanwhile, a train stops on the next track and young men, barely 20, en route to Rae Bareilly cross the platform and wander in. Clearly, the audience is diverse — from those working on the issue and associated with it, to college students, to the wanderer. There’s something for all.
Spreading the word

The train is an interesting partnership between various ministries and departments such as National AIDS Control Organisation, the Railways, Youth Affairs. Various colleges, women’s groups and departments have been mobilised to encourage people to attend the exhibition.

While the train is stationed on the platform, a range of activities happen across the district. At every halt, NYK volunteers cycle to neighbouring villages in teams of 6-8, each team covering four villages a day doing nukkad nataks and skits. Where the train halts for more than a day, cyclists spend the night in the village. More than 43,000 villages will be covered through the year. In addition, there are two buses with a mobile exhibition covering the district’s periphery.

Rana says managing crowds at the platform sometimes becomes a challenge. The coaches have a limited capacity, viewing exhibits require time and attention. At some places such as Pratapgarh in Uttar Pradesh the response was so good he extended closing time from 5.30 pm to 8 pm. “But I cannot do it at every halt — we have to run 366 days,” he says. Perhaps platform activities need to be such that learning begins even as people begin to queue.

At Lucknow, there were very few women visitors. Most came as part of a group from a college; while some came accompanied by male relatives. The train may need to examine if the majority male crowd discourages women from coming by themselves. Perhaps a reserved viewing time for women may be required at some halts.

The train is presently travelling across the Hindi belt. Crossing Rajasthan, Madhya Pradesh, parts of Maharashtra and Chattisgarh, it is presently in Uttar Pradesh. From here, it heads to Uttaranchal, Jharkhand, and Bihar before reaching Guwahati on March 8, when the language will change for the first time to Assamese.

Twenty-two years into the epidemic in India, and people across quarters are finally talking about HIV. The silence is broken. It’s a big step.



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