Tsunami and Its Aftermath on Vulnerability to HIV in Coastal India

http://www.swasti.org/main/media/Effect_of_Tsunami_on_HIV_Vu lnerability.pdf

Apart from the devastation and havoc that a natural calamity causes, it has far reaching effects on the lives of the people affected by it. Vulnerability to HIV is one such reality that cannot be ignored. Swasti, Health Resource Center, with the support of Oxfam International conducted a unique study that focused on understanding the vulnerabilities of Tsunami affected communities in India, to HIV. Covering thirty locations across five states, the study found that vulnerability existed in almost all locations and was heightened in two-thirds of the locations. Moreover, physical proximity of displaced populations was established as the primary factor contributing to a chain of events that led to increased vulnerability. Additionally, increased unprotected sex with non-regular partners was recognized as the key risk factor. Also, coastal communities in the tsunami-hit areas were vulnerable to HIV even before the Tsunami. Thus, the effects of humanitarian crises and aid measures influenced the behaviour and practices of the affected, significantly heightening their vulnerability. Consequently, there is a need to mainstream HIV, reproductive and sexual health service components in humanitarian aid, as well as, include communities from disaster-prone areas into national HIV and sexual health interventions.

The massive tsunami of Dec. 26, 2004, caused devastation in 14 countries bordering the Indian Ocean—especially in India, Indonesia, the Maldives, Sri Lanka, and Thailand. About 227,000 people lost their lives and 1.7 million were displaced.

In India, more than 2,000 kilometers of coastline along the southern Indian states of Tamil Nadu, Andhra Pradesh, Kerala, and the Union Territories of Puducherry (formerly Pondicherry) and the Andaman and Nicobar Islands were affected.There were tremendous successes in the humanitarian response to the tsunami, such as the prevention of outbreaks of deadly waterborne disease among those who were displaced from their homes. However, the urgent needs identified by communities and aid providers—to supply food, water, shelter, medical care, psychosocial support, and eventually the means to make a living—tended to overshadow the need to provide information and services that could prevent the spread of HIV.

Yet, even when aid providers prioritize AIDS prevention activities, there is a dearth of information to help them understand what conditions trigger increased risk of infection or how communities and aid providers can best address those conditions.

The research undertaken by Swasti is aimed at discovering ways in which the tsunami and its aftermath affected the risk of contracting HIV. Its purpose was not to measure how many tsunami-affected people are now HIV positive. Instead, the study aimed to identify changes in behavior that occurred after the tsunami that placed community members at greater (or lesser) risk—changes that may have been triggered by trauma and and losses, disrupted communities, and by the aid effort itself.

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