InterPress News Service (IPS); Monday, 6 January 1997
Suman Pradhan

Birganj, 120-kms from the capital city Kathmandu, is landlocked Nepal's busiest border checkpost: a steady stream of trucks carrying goods from Indian ports and manufacturers enter this Himalayan country here.

And as they wait for clearance from customs officials, the truck drivers and their assistants relax at wayside eating places, frequenting the brothels that have sprung up clandestinely on both sides of the border.

Experts worry that truckers could be among the largest carriers of the human immunodeficiency virus (HIV) that often leads to the fatal AIDS disease.

Harendra Kumar, 31, is one of the hundreds of Indian truck drivers who regularly haul goods-laden trucks to this trading outpost. He says he can't remember how many trips he has made to Birganj since he started driving on this route between Calcutta port and the Birganj Customs Office, two years ago.

Neither can he remember how many trysts he has had with commercial sex workers (CSW) on the roadside. Kumar has heard about AIDS, but does not know enough to want to practice safe sex. He seldom uses condoms, he said.

His Nepali counterparts are none the wiser either. A 1995 survey conducted on the major trucking routes from Nepal's capital city to Birganj and Janakpur, two major border towns, found that most of the drivers and their helpers frequently visit CSWs, often without taking adequate precautions.

Such ignorance on both sides of the border, say experts, could make border towns with large transport networks into major centers for the spread of the virus that causes AIDS. They say truckers may be passing on the HIV virus to uninfected areas as routinely as they now ferry goods.

"The high mobility of transport workers and their ignorant attitudes towards AIDS represent a core group of potential transmitters of HIV to other areas," says a report funded by the AIDS Control and Prevention Project (AIDSCAP), a U.S-based agency.

The urgency to check the spread of HIV is all the more in border areas where truckers from all over India and Nepal converge.

The situation, according to Dr. Kalyan Raj Pandey, director-general of Nepal's Health Services, is alarming. "The disease is epidemiologically believed to be in an early stage of transmission in Nepal," he said, while pointing out that in India the virus has spread rapidly in recent years.

Since it was first isolated in the southern city of Chennai (previously Madras) nearly a decade ago, the number of HIV cases in India has jumped to an estimated three million. The World Health Organization (WHO) expects the numbers to swell to over five million by the turn of the century.

Nepal with its long and porous borders cannot expect to be isolated by the epidemic in neighboring India. Already, the country is estimated to have around 10,000 HIV positive cases.

"Nepal's long open borders and its close ties with India creates higher risks of cross border transmission of HIV," says Joy Pollock of AIDSCAP. "Past research has shown that Nepal needs to target its anti-AIDS intervention activities towards major transport routes leading to the border," she adds.

Pollock cites an Indonesian study which demonstrated the catalytic effect an expanding but ignorant transport industry can have on the spread of HIV. She said the report showed clear links between the transport industry and commercial sex activity, which in turn leads to increased risks of HIV transmission.

Much of these characteristics have already begun to appear in Birganj and the neighboring border town of Raxaul in India. The two towns are the principal trading outposts, accounting for nearly 90 percent of the overland trade between the two countries. Both have expanding transport networks and concealed but thriving brothels.

"Couple these with the ignorant attitudes of the trucking communities and their high mobility," says a health worker in Birganj, "and we have a situation which could one day lead to explosion of HIV cases in other parts of the country."

Such fears have already galvanized NGOs on both sides of the border to join hands in a "unique partnership" to combat the spread of AIDS in the trucking community.

For the last 16 months, the Bhoruka Public Welfare Trust, a Calcutta-based NGO, and the General Welfare Pratisthan of Nepal have been pooling their resources to educate the trucking community at Birganj and Raxaul of the increased risks of transmission of HIV and other sexually transmitted diseases.

"The goal is to attempt to halt AIDS on the highways," says Dr. Asha Rao who thought up the project. She thinks the time has now come to replicate the effort at other entry points on the Nepal-India border, and also along India's north-eastern border with Bangladesh.

"We are looking for a Bangladeshi NGO to work with us in the same way we have been working here with a Nepali NGO," Dr. Rao said.

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