WOMEN, INJECTING DRUG USE AND ASSOCIATED HARMS

Presented by Dr. Salam Irene, Manipur, India

Introduction

The question of harm minimisation cannot be tackled as an isolated phenomenon. If it is to be effective, we need to analyse the reasons why lesser amount of women practise harm minimisation. And the answer is intrinsically woven into the complex political, social, cultural and religious scenario in Manipur. Politically, there is accelerating instability, economically it is extremely difficult for a women to earn a decent wage or pursue a livelihood that enables her to live a comfortable existence. Young village girls educated in the metropolis and towns are unwilling to return home to the traditional occupations of weaving and agriculture. Socially and culturally, the state is in transition - on the one hand even as ethnicity is being strongly asserted, some age-old values, traditions, religious beliefs are being questioned. The youth are in a state of confusion, not certain of anything in a disturbed, changing state. In such circumstances, young women are especially vulnerable to falling prey to drug abuse, and prostitution as a means to find a more viable means of livelihood. Perhaps, clean life-styles and perspectives imposed on indigenous communities, de-legitimises the cultural uniqueness and historicity of these people, and ultimately destroys them!

To minimise harm, we need to acknowledge and recognise that women have the right of the highest attainable standard of physical and mental health, and the major barriers to its achievement is inequality between men and women, especially with reference to female drug users and sex workers. Such women also need to be provided with some basic technical skill, which enables them to earn a decent livelihood, and they need assistance in marketing their products. They need to realise their worth as women and take pride in themselves. Prostitution, it is often asserted, causes great physical, emotional and moral harm, and often leaves them incapable of returning to moral lives. Regular counselling services should be provided at home, besides that in organised rehabilitation centres and a drop-in crisis intervention centres could be set up to provide them with a support service. Sex education at a high school level is a must, as also open and honest dialogue and communication within the family. This is an essential prerequisite for harm minimisation. Single parent households, headed by a women also need to be acknowledge and accepted, and children of women and drug users and sex workers, need to have access to counselling and support services. Last but not least, to make any programme of harm minimisation truly effective, we need to incorporate the spiritual dimension which deals with human relations and spiritual values, and which often develops in an inconspicuous way, beginning with the daily relationship between people. Each one reaches her final goal by fidelity to her own vocation - this goal provides meaning and direction for the earthly labour of man and women alike.

Present Scenario

Estimated 1 million Indians are believed to be infected with HIV. At present rate of transmission 5 million will be infected by the year 2000 A.D. 75% of infection through sexual contact. Women have little or no access to affordable health services. Poverty makes them socially vulnerable to HIV. Women can seldom negotiate condom usage or other risk reducing strategies. Lack of access to information is linked directly to women's lack of participation in decision affecting their lives. Lack of primary education increases women's vulnerability to HIV AIDS (inadequate information too). Cultural constraints add to women's vulnerability. Topic of sexuality, taboo, sex education are non-existent in many cultures. Women's inferior general health and poor genital health in particular.

Patterns of economic dependency.

The epidemic places increased burden on women as primary care givers. All the above highlights the inequalities between men and women.

Strategies

· Need for special consideration to women in the developing countries (Third World Countries). As they struggle to cope up with the consequences of this epidemic.

· Engage the men to take responsibility for having safer sexual practices.

· Present and future support and care of children of HIV/AIDS infected women.

· Women's responsibility must include discussion and decision about engaging into sex relationships.

· Improve conditions of women.

· Delay initiation of sexual activities in girls.

· Promote women's rights to own and inherit land and property.

· Postpone or delay age of first pregnancy.

· Gender specific research on HIV AIDS in women.

· Timely diagnosis and treatment of lower tract infections.

· Care for reproductive tract infections should be an essential component in family planning programmes.

· Stop over emphasis on preventing women from transmitting HIV when inadequate priority in policy and programmes to preventing women from getting HIV. Most women get their infection from men.

· Despite awareness most people have not translated information into personal, community and public action.

· Prevention of anaemia, pregnancy related morbidity and provision of safe abortion should be the primary focus of prevention efforts centred on women.