Wall Street Journal - May 3, 2004
Marilyn Chase, Staff Reporter of The Wall Street Journal

NEW DELHI - The beat of a dhola, a Punjabi drum, drew a crowd to a white tent set up on the G.B. Road, this city's red-light district. A theater troupe belted out a Hindi movie theme song. A magician in red hair and blue eyeliner opened his bag of tricks.

AIDS prevention programs often put the focus on prostitutes. On a Sunday in late March, however, doctors put the customers first.

It was "Health Camp" day, run by the AIDS Awareness Group, a non-governmental organization in this city. Two female physicians were going nose-to-nose with a gritty bunch of migrant workers, rickshaw drivers, and potential clients of crimson-lipped women hovering from staircases and balconies nearby.

The Bill and Melinda Gates Foundation brought Indian AIDS to the attention of Western media. ( See Wall Street Journal related article.) But a host of smaller NGO's like this one also have been struggling with more modest resources to hold the virus at bay.

There is Michael's Care, a 35-bed AIDS clinic run by the Sahara House, in New Delhi. There, former heroin user Loon Gangte runs programs on grants, tithes from his staff's salary, and handicraft sales. Although he takes antiviral drugs, his program can't afford them for patients like Anil John. Mr. John, age 30, said he gets by on "love and care."

Another is the Healthy Highways Project, a group fighting roadside AIDS. Its director Rajesh Kumar says there is a huge resources gap, adding, "We cannot compete with Gates Foundation. They are very big."

This Sunday street festival is a project of the AIDS Awareness Group, a small NGO addressing AIDS in prisons, and in sexual combat zones. Indu Jaggi, and Duggan Shella, two female physicians, are in charge of the open-air health camp. The Gates program gets high marks for being run by Indian people, who are "pretty clued in," says Dr. Jaggi approvingly. But Gates's mega-project doesn't operate in New Delhi's red light district.

This is Dr. Shella and Jaggi's turf. The G.B. Road is a strip of ramshackle storefronts on the ground floor, with brothels on the upper stories. The doctors minister to the brothel workers as well. But on this day, they held a sort of revival meeting for johns.

Free condoms supplied by the government of India get a mixed reception inside Dehli brothels, despite a smiling prophylactic poster captioned, "Hey mister, use me." So the doctors regularly redirect their pitch from the point of service to the potential consumers in the street.

Under the white tent deflecting the blistering midday sun, workers hung cartoons depicting HIV transmission. Simple line drawings offer a graphic primer of risk -- all the kinds of intimate contact that can spread the virus. One cartoon tackles the concept of HIV as a chronic infection that hides inside healthy-looking people, using the analogy of sturdy oak eroded from within by termites.

The doctors set up a low table with prescription pads. They invite the men to engage in a curbside consultation on whatever ails them. And they come armed with boxes full of miscellaneous medicines -- from antibiotics to antifungal drugs -- remedies for any random complaint the men may have.

Then they set out the centerpiece: three big boxes, each holding 2,000 Nirodh Deluxe condoms made by Hindustan Latex Co., supplied by the government of India. The products inspire occasional hecklers.

"One obnoxious guy was saying these condoms only last two or three minutes. (He) can go for hours and hours," recalls Dr. Jaggi, a veteran of Indian Army who reached the rank of major. "He was a Punjabi farmer, a sturdy Sikh who said he works hard in the field and hard in bed. So I said to him, 'Blow it up! You can fill it to your heart's content and it won't burst.' "

Dr. Jaggi's 18-year-old son, Kunal, a college student in a Nirvana t-shirt and black baseball cap, blushed at the graphic discussion. It was the first time he watched his mother run the G.B. Road health camp.

"Among people my age, even though there's sex education, people aren't as aware as they should be," he says. Soon he is drawn into debate with the road's crusty denizens.

Bicycle rickshaw driver Abu Mohammed says he is 45 years old. Toothless and weathered, he looks 60. But like many men from Bihar state, he migrated to the capital to find work. Leaving a wife and four children home in Bihar, he peddles through the stifling smog for a living. Although rickshaw drivers are believed by some to direct clients to certain brothels, Mr. Mohammed professed no contact with the sex trade.

Mr. Mohammed said he patronized a brothel 20 years ago, but denied going since then. He feels fit, he says in a mix of Hindi and Bihari dialect, but says he came to the health camp because he had a rash on his crotch.

The rickshaw driver says he suspects HIV infected a nephew, who was taken to a village quack and later died. Mr. Jaggi, translating and counseling by turns, then pointed Mr. Mohammed toward the open box of free condoms.

"I'm shy," the driver protests. Then he adds, "I know I need to use these."

A teenage construction worker on New Delhi's metro subway system then stopped by to ask if he could contract AIDS by eating with his roommates. Mr. Jaggi reassured him that casual contact poses no risk.

A police constable hovered nearby. Police raids in red-light districts often scare off the prostitutes and their clients, frustrating AIDS prevention workers. But on this day, the officer approved the gathering. So the men kept coming.

The crowd of men surged forward at the appearance of a well-known local figure. A vivid figure in a green sari and pink lipstick, Rehana (who by tradition goes by her first-name only) is introduced by the doctors as a local "sub-madam," but says she is there only to assist the doctors. As Dr. Shella translated, Ms. Rehana says she insists on condoms: "There are different customers every day. Some opt for it. The others, we send back."

When the Drishtantar (Illusion) Theater Group sounded the musical overture for its play, the crowd swelled to about 240. The conjurer spreads out his magic tricks. More men, who were sleeping under awnings, bathing, and washing clothes on the sidewalk, dodged oxcarts and rickshaw traffic to cross the road to see the show.

The street theater featured a melodrama about a drug addict with HIV who wanted to pawn his wife's stove for drug money. "Don't you care about your husband? Do you want me to die?" the actor shouted. "Better today than tomorrow," his stage wife cried. "You'll kill us all." Another character, a wandering guru, urged the addict to give up drugs and change his life. The addict became an activist. It was a happy ending, but not the end of the day's entertainment. Next the magician prepared his signature trick, "magic sticks," which he said carried an AIDS message.

Stethoscope draped around her neck, Dr. Jaggi nodded approvingly at the swelling crowd. She continued interviewing patients, thumping on one man's chest to listen for sounds of lung congestion. Pneumonia, colds, stomach upsets are rampant. She wrote scores of prescriptions, and dispensed drugs for routine ailments as the show wound down.

"It was a good day," she says. "We gave away three boxes of condoms." In the calculus of cases prevented, she adds, "That's 6,000 exposures."

Write to Marilyn Chase at marilyn.chase@wsj.com

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