Band aid policy

27 08 2009

My next froth and fury will be about the band aid policy on abortion in sri lanka….await!

Bliss . Cellphones . Independence Square

24 08 2009











shiny new and slightly faded
scrolling streaming surfing screaming
fingers blur.

bhangradiscotweeting birds
shrill and chiming
always interrupting
something else.

full of secrets
untold stories, dates broken
calls unanswered.

sms sadist, cli anguish.
smaller faster smaller smaller
goodnews badnews nonews gossip
pictures pop up smiling
friendly camera clicks.


Independence Square

The lions are sitting in rows,
on Independence Square.
Their stone eyes are fixed and sad.
They’re watching the people
who pass them at dawn
and at sunset,
wearing their oldest clothes –
no one can tell how
clever or happy they are.

The relentless constitutional,
around, around, around.
The girls in search of the boys
in search of the girls.
The middle-aged parents
In pursuit of their
once waistlines.
Fleeing from the coronary
That follows close behind.

The lions are sitting in rows,
In Independence Square.
They’re all exactly sixty years old.
They sit and they sit,
and they listen to the rich old men
in faded tennis shoes,
discuss the economy,
in low voices before they
start touching their toes.

The Urge

23 08 2009

Belly up

Back curved

Body curled

Feet up

Deep into the night


Far into the morning


On too-warm sheets

In the afternoon

With round inky shapes

Long neverending stretches

In the middle of journeys

Waiting in bus-stops

Quickly quickly between classes

And again again and again

And then.

It’s over.

And now again.

The crisp pages

Of a

Many-leaved book.

The Wisdom of Whores

14 08 2009

(Book Review)

The Wisdom of Whores, bureaucrats, brothels and the business of AIDS, by Elizabeth Pisani, 2008

No two words can capture a reader’s attention as effectively as the words free and sex. I think the word whores should be added to the list. The title of Elisabeth Pisani’s book is more focused on grabbing a reader’s attention than in it about the wisdom of whores, bureaucrats, brothels or the business of AIDS. But once you do start to read it: the book is an interesting and easy study, albeit a little repetitive.

Based on her experiences working as an epidemiologist and consultant to FHI and UNAIDS among others, her book encourages policy makers and programmers to take a closer look at what works and what does not, in the fight against AIDS and to base interventions on scientific research and evidence. She encourages leadership within governments and in UN to take on the tough issues, the unpopular issues, even though they won’t get them the votes.  Experience has shown that a few key actions have been successful in preventing the spread of HIV in the region and these should be the priority for action.

For those working in the field, her messages are nothing new: harm reduction works, particularly in prison settings, abstinence programmes are a waste of money, preventing HIV transmission among sex workers and their clients is the best way of preventing the spread of the virus to the general population and that Asia will not face a generalized epidemic like the one in Africa.

However she does touch upon a few interesting issues such as the effectiveness of peer based education and outreach programmes; they don’t always work, especially among groups of sex workers who are actually in competition with one another rather than part of a community. Peer based outreach works best among communities who consider themselves part of a collective, like the gay (and lesbian) brotherhood. Her description of and interaction with the waria community in Indonesia is also interesting and strikingly similar to the Hijra community in India. Waria, a term for transgender people is derived from the words wanita (woman) and pria (man). Many waria sell sex for a living, mainly because of the high stigma against them and the limited job options open to transgendered people. As long as society looks down on such persons, they will have limited livelihood options, and they will continue to sell sex to survive. One cannot address HIV without looking at this aspect of society as well.

However, The book is contentious on some counts: Firstly, the author believes that women are not trafficked into sex work. While I believe this to be true to some extent, one cannot ignore the fact that in south Asia, many minor girls are trafficked into sex work. In fact globally, an estimated 800,000 people are trafficked each year, of which women account for 80%. Of this 80 % over one fourth are minor girls. Majority of women and girls are trafficked for sex making them increasingly vulnerable to HIV; and the younger they are the more vulnerable. Those who continue to stay in sex work by choice when adults, is a different issue, but the number of young girls being trafficked into sex work is real.  Further studies such as one by J Silverman[1], on HIV Prevalence and Predictors Among Rescued Sex-Trafficked Women and Girls in Mumbai, India, it was found that the mean age of girls trafficked into sex work from Nepal to India had fallen from 14-16 years old in 1986 to 10-14 years old in 1997. Of these, the younger they are, the more vulnerable they are to HIV with 60% prevalenace amoung rescued sex trafficked Nepalese girls and women aged 7-14years compared with 31% prevalence amoung the 18-32 age group.

Secondly, Yes HIV is a health issue, but it is also a development issue and it is fuelled by poverty and inequality. Unless these foundations change, unless the way men and women relate to one another change, HIV is not likely to disappear. By introducing HIV and sex education into school curriculums, this change in gender norms and the foundations of the relationship between men and women is being challenged. It may not help prevent new HIV infections in the short term, but it is a long term investment in society and particularly in women: so what if it is using HIV money. After all, there is money in HIV unlike in women’s health, maternal mortality or women’s sexuality.

Yes there is big money in HIV and we are constantly reminded of this in the book. The money may be a little less than there was a few years ago, but still there is money. Along with money comes the corruption, the under hand deals and kick backs. But this is true of any sector, not just HIV.

I can’t help thinking that the book is a westerner’s perspective of an issue meant for western readers, and any persons referred to as experts are also of that genre; with the expertise of the region edited out. As a South Asian working on HIV in the region, I have seen my fair share of western experts, most overrated and over paid, fly in for a few days, do their “magic” and write up reports that have no relevance to the complex reality of the region. The other big mistake is to generalize one Asian country’s experience to apply for the rest. Her main perspective of Asia comes from Indonesia and I would be cautious in generalizing the Indonesian experience to apply to the sub continent.

Although the wisdom of whores isn’t really their wisdom, but rather an interpretation of the lessons the author has learnt from travels in the region and interaction with marginalized communities, for someone who has not worked in HIV, the book comes across as an eye-opener and is worth a read. Full of politically incorrect words such as whores and drug addicts, the books is written in a popular anecdotal style with easy to understand language that a non development professional can easily relate to, pick up and enjoy.

If you work in HIV however, be warned – it may irritate you.  Not only could it have said exactly the same thing in less than half the length, but you may also land up feeling like me: a little patronized.

[1] HIV Prevalence and Predictors Among Rescued Sex-Trafficked Women and Girls in Mumbai, India, Jay G. Silverman, PhD,* Michele R. Decker, MPH,* Jhumka Gupta, MPH,* Ayonija Maheshwari, MD, MPH,† Vipul Patel,‡ and Anita Raj, PhD§

What does it mean to be a man?

11 08 2009

There are some dominant characteristics that constitute being a man in south Asia. Being physically strong and attractive, being the protector, the leader, the chief decision maker, being sexually successful and being heterosexual are just some of them. These definitions are commonly referred to as Masculinities. The plural form “masculinities” conveys that there are many definitions for being a man and that these can change over time and from place to place.

These dominant forms of masculinities are instilled in men from birth onwards and perpetuated by men and women, mothers and fathers, in schools and on the streets, throughout a mans life. Once instilled, men are required to constantly prove their manliness. Men are taught from an early age that to be a successful leader you must be ready to put up a fight. Adolescent boys for example think they are proving their manliness by engaging in risky behavior, like driving too fast and too rash, or drinking and driving, or proving them selves to their friends by going through with certain dares. Ragging in universities is a good example of this in Sri Lanka. Some men consider beating their wives an expression of their manliness. Many young men are initiated into sex by their friends. Some are forced to visit sex workers whether they like it or not and rarely refuse for fear they will be considered less of a man.

These aspects of masculinity are encouraged to prevail for a man to be a “real man” and are endorsed by key institutions, such as in business, politics, the military and in sports. Such institutions are structured and designed around these masculine roles making it extremely difficult for women to play a leadership role. We see this from the few number of women in parliament in Sri Lanka for example.

However, these behaviors have a cost to society. Ragging for example has lead to countless closures of our Universities and even to the death of some students, most notably S. Varapragash in 1997. Drunk driving and the resultant injuries and deaths from road related accidents amount to millions of rupees in losses. These are costs that can be easily avoided, lives that can be saved.

What if a man were to develop and take on characteristics that are not those of the dominant man, if he were to become for instance a secretary, or a kinder garden teacher, or a nurse, would that make him less of a man? At least as women we are given the choice today to either wear pants or skirts, to work and pursue a career or to stay home and bear children or both. A young girl can be a tomboy and get away with it, but a boy who is sissy is called a “sothiya” a “ponnaya”, laughed at and taunted. A man who is not naturally aggressive or competitive is forced to pretend to be or face scorn. In fact, “feminized men” are at the bottom of the hierarchy. Studies in our neighboring countries India and Bangladesh show that feminized men are more likely to be abused as adolescents, most often by members of their own family. They are also more likely to harm themselves and commit suicide than their peers. It seems like the worst insult one man can hurl at another is the accusation that a man is like a woman.

One reason for this is that women are less valued than men in our society. We know from the rates of female infanticide across the region that this is true. The girl child is seen more as a burden and liability to the family. When compared to boys, girls are less valued hence less educated, less fed, given less opportunities, confined and treated as less than human in many instances. Our culture and the rituals associated with it celebrate the male child, while a daughter’s arrival is not half as jubilant.

Certain jobs associated with caring and rearing, are considered too demeaning for men to do, almost unclean and dirty.

But no man can possibly live up to the dominant characteristics of being a man all the time and still be human. As a society we expect too much from men. We expect them to be super human; men are looked down upon if they show emotion or if they cry, men are expected to do tough physical jobs, they must succeed at all costs, they are expected to be assertive, to know all about sex and how to perform in bed (in reality young boys get even less sex education that young girls[1])  We place too much pressure on men. And if men cant live up to the pressures we place on them, they turn to other ways to vent their frustrations like drinking, violence, abuse and the like.

As a society we need to redefine what it means to be a man. This will not only allow men to develop deep and rich connections with others, including women and children but also with other men. These connections are what make life full and rewarding, but they require vulnerability. We need to allow men to explore their softer side without being ridiculed and tormented instead of narrowing their emotional range and depth. This will be good, not just for men, but for women too. By redefining what it means to be a man, there will be less violence against women and more harmony between the sexes.

[1] In a recent review of the Millennium Development Goal indicators for young people from 9 countries in Asia, no country reported more than 50percent level of sexual knowledge among boys with some countries reporting as low as 3percent. Redefining AIDS in Asia, 2008