Narasimha, a 30-year-old HIV+ auto-rickshaw driver, wonders about his future

Narasimha, a 30-year-old rickshaw driver in Hyderabad, found out he was HIV+ five years ago when he contracted TB.

He admits that he visited commercial sex workers a number of times. His wife, who he says he did not infect, left him shortly after finding out what exactly he had contracted.

After starting anti-retroviral treatment two years ago, he has slowly regained his strength and is back at work.

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In a haunting twist, his male passengers often ask to be driven to prostitutes around Hyderabad’s parks and main train stations.

I asked him if he warns them about the possible consequences. He shook his head, explaining that upon returning to work after his recovery from TB, one of his first passengers asked to be taken to a commercial sex worker.

When Narasimha tried to warn the passenger of the risks he was taking, the man yelled at him: “What do you know? You have it?”

Alarmed by the prospect of his HIV+ status being exposed, and his livelihood threatened, Narasimha backed off. Since that experience, he quietly fulfills his passengers’ requests.

In this video clip, Narasimha explains how he copes, knowing his body will build up resistance to the ARV treatment and that the next level of treatment will remain out of his grasp.

Exposing an Indian middle class illusion

The illusion that the Indian middle class is largely untouched by the AIDS epidemic is beginning to crack as people from this socio-economic group find friends and relatives close to them suddenly struck down by disease.

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The common perception is that commercial sex workers, truck drivers, and “other uneducated people” are the ones who invite the illness by their wanton carelessness.

But doctors who cater to middle and upper class Indians increasingly have their hands full.

Dr. Uttara Murthy, a Bangalore-based psychiatrist, counsels private patients who have found out they are HIV+ and are struggling with that fact.

Dr. Murthy counseled her first middle class HIV+ patient eight years ago. Her practice keeps her busy.

Video blogging

Sorry for not having any updates for a few weeks. I have been stumped by some techical difficulties.

At this moment, I am in the workspace of 4 pioneering videobloggers who have kindly helped me solve the technical issues that have riddled the videoblogging portion of the project.

So thanks to the following people for getting the project back on track: Jay Dedman, Ryanne Hodson, Michael Verdi and Josh Kinberg.

And if you want to get into videoblogging and want to avoid the problems I had, check out their online videoblogging tutorial at Freevlog.

Look for a new video per day!

Back in the U.S.

Srinivas and I are heading back to the US at the moment (waiting to board our connection in London). We have collected over 15 hours of video and audio, and nearly 2000 photographs. Over the next month, we will continue to update our Voices blog with photos, audio and video. We hope to have the final flash presentation ready by the end of September.

Prevention versus Treatment

Indian government data pegs the number of people living with HIV/AIDS at 5 million.

Even if we assume the number is unrealistically low—the government’s methodology for data collection is roundly questioned—and triple it to 15 million as many NGOs do, the percentage is still less than two percent of its one billion plus population.

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The numbers have made prevention the priority in India rather than treatment of those already infected. But keep in mind that in absolute numbers, India has one of the world’s highest numbers of people infected with HIV behind South Africa.

Affordable and accessible treatment programs must also be an important part of the strategy to bring this epidemic under control.

Here is footage of one prevention program called ASHA (”Hope”) which provides education to young women who are considered at risk because they have little or no education and are likely to be married at a young age. Through the program, they learn about HIV/AIDS, safe sex and are provided vocational training.

The program stresses the need for peer counselors to visit people in their own communities rather than bringing them to an office.

These young women and peer counselors meet in a one-room community center in a village at the edge of Hyderabad. There are no fan and no lights–just the hot breeze and sunlight seeping in through two windows.

Navigating the teen years as an HIV+ orphan

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Here are some excerpts of an interview with Murgesh, a 16-year-old HIV+ orphan. He is keenly aware of how ARVs are helping him survive his teenage years.

Kids at play

Over the past week and a half, we have photographed and interviewed people with full-blown AIDS. Some of them couldn’t even lift their heads off their pillows.

We also spent time with people who were down to their last ounce of strength but had a dramatic turnaround once they begin taking generic (and government subsidized) anti-retro viral (ARVS) drugs.

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The most inspiring stories and images are of the HIV+ orphans at the Freedom Foundation. Despite great odds, these kids are full of life—in huge part to their daily regime of ARVs.

But their health is hanging by a thin thread: the constant search for funding for their supply of ARVs and the inevitable that they will develop resistance to these ARVs.

This video shows children playing after school at the Freedom Foundation in Bangalore.

Getting our bearings

After being stranded in Kuwait for a 6-hour delay, we landed safely in Mumbai by mid-morning on Saturday. The monsoons unleashed a torrential rain to greet us at the airport, flooding EVERYTHING.

There has been no time to feel jet lagged. For the first time ever, I (and Srinivas) managed to stay awake till midnight Mumbai time to place me firmly in this timezone. We stayed with a photo editor at the Times of India, who introduced us to several people working on HIV issues in some capacity. One person he told us about–who we have yet to meet–is a Fulbright scholar studying the impact of being HIV+ on the relationship between mothers and their children. We hope to meet her soon for an interview.

On Sunday morning, we left for Hyderabad where we have arranged to spend time at an HIV/AIDS clinic. We will be traveling with an organization to rural villages as where they are conducting some outreach programs. Back soon with some photos and audio.

The journey begins…

When we land in Bombay on June 23, we plan to stay with a friend of Srinivas’s (another photographer) who lives in a colony for journalists in Chembur (a section of Bombay). This trip is already shaping up to be so different than any previous trip to India for me when i would usually stay with relatives and attend weddings. I am looking forward to hearing Indian journalists’ perspective on the coverage of AIDS there and around the world.

Stereotypes

At the South Asian Journalists Association convention this past week, I had an opportunity to hear Ross Kauffman (2005 Oscar winner for “Born into Brothels“) and Roberto Romano (”Stolen Childhoods“) speak about the filming and editing process of their documentaries. I also heard Shahidul Alam, a leading Bangladeshi photojournalist, talk about his experience taking photographs of Muslims, and other South Asian people.

What struck me about the work of Kauffman and Alam work overall, is that they showed children in their own environment–doing what they do–and they let that do the talking about their conditions rather than any heavy-handed images of people suffering. Alam was especially sensitive about showing “Brown” people living their lives rather than showing them the way the Western media normally wants to see them: almost always in dramatic images of suffering.

Srinivas and I also hold that it is best to show the richness of people’s daily lives, the kind we see in the smallest interaction. The trick will be to balance that with the global implications that are winding their way into the issue…weaving it in so people can contrast the daily lives with the social and economic politicis in the background.