THE PROTAGONIST

How the truck driver is the quintessential element of the logistics system and the issues that matter to him, to us.

The truck driver is the quintessential element in this vast system of logistics and trucking industry in India. Ultimately it all boils down to him having to drive the truck across hundreds of kilometres and deliver the goods safely at the required destination. In a country where most of its goods transportation are handled by trucks, and does a valuable contribution to the GDP; it would seem that the driver would be in a better position. However the reality is far from that. Truck-drivers in India are not of particular interest to the general public though they play a vital role in keeping the supply lines of food and sundry things, going to the remotest corners of the far-flung country. They are probably one of the most stigmatised and harassed profession based community in the country.

Although there are no accurate figures for truck drivers and their crew, there are over 5 million trucks plying on the roads of India today.

Many truck drivers are surprised and even angry to learn that they are now labelled as having high-risk behaviour, especially when they see themselves as hard-working, god-fearing people who provide a vital service.

The truck driver’s life is riddled with problems from being typified as a rash, rude individual, high incidence of HIV and STDs in the community, besides being the constant target of officials to extort.

A report, “Corruption in Trucking operations in India” published by Transparency International made startling revelations about the current situation of industry. According to the study. trucks plying on roads pay anywhere between Rs.211 and Rs.266 as bribe money per day depending upon the route. Based on this estimate Rs.79,920 is paid as bribe by a commercial truck during a year. With around 5 million trucks operational in the country, bribe money floating around in the trucking operation is about Rs.22,000 crore a year! A

nother problem faced by the driver is excessive stoppage times,

increasing transit times. En-route stoppages including those at check points and entry points take up to 11 hrs in a day. About 60 % of these (forced) stoppages on road by authorities like RTO, Police, forest, sales and excise, octroi, weighing and measuring departments are for extorting money. Number of trips could increase by 40% if forced delays are avoided. Cost to national economy is about Rs.1130.47 crore per year due to forced stoppages.

RTO and Police, the two key enforcement agencies’ share in bribe money works out to be around 43% and 45% respectively, accounting for almost 90% 1 of total bribes involved in trucking operations

India has one of the largest road networks in the world and around 5 million truck drivers ply on these routes. With buoyant demand for products, there has been an increase in the demand for truck drivers by various transport companies. In the quest of a good job, these drivers take up the assignments in different parts of the country and stay away from their respective families for long stretches. Therefore, due to the nomadic lives they lead, the high pressures of job and long absence from their families make them vulnerable and easy prey for commercial sex workers

The truckers are a high risk community as far as AIDS is concerned. As a community, truckers have 12 times 2 more than the national average of AIDS occurrence in the country. Among India’s 5–6 million truckers, nearly half work on long-distance routes across the country. Approximately 300,000 long-distance truckers in India are living with HIV. HIV and AIDS interventions for truckers in India have been under state government programs, which lack oversight by a national program. Moreover, most government HIV and AIDS interventions have lacked strategic locations and adequate health services for this high-risk population. Truckers play an important role in the Indian HIV epidemic. Data indicate that truckers are three times more likely to have non-regular partner sex than other

men in the general population in India. One third of truckers report commercial sex and truckers are an estimated 10-12 percent of clients of sex workers.HIV prevalence among long-distance truckers ranges from three to seven percent, and one to seven percent have at least one STI. Truckers, therefore, constitute an easily identifiable and programmatically addressable sub-segment of men at risk.

However, truckers are not a homogenous population. Not all of India’s five million truckers are clients of sex workers, and therefore are not at equal risk of acquiring HIV. Studies indicate that length of time away from home and age correlate with levels of risk behaviour among truckers in India. Accordingly long-distance truckers are potentially at high risk of acquiring HIV and STIs, because of the amount of time they spend away from home and their relatively young age. Anecdotal information suggests that long-distance truckers may be driving 8,000 to 10,000 kilometres in a given month, which often translates into absences from home ranging from weeks to several months at a stretch. Long-distance truckers’ enhanced potential risk of acquiring HIV is to some extent validated by risk behaviour and biological data. A study in north India found that HIV prevalence in long-distance truckers is 3.5 times higher than the prevalence for inner-city truckers (seven percent among truckers travelling on the national highway as compared to two percent among inner-city truckers).

Long-distance truckers are also nationally mobile and so have the potential to expand the geographic spread of HIV by linking the epidemic from relatively higher-prevalence areas in southern India to lower-prevalence areas in the north. For these reasons, long-distance truckers are an important bridge group to work with to slow the spread of HIV into the general population. To further substantiate, truckers, as a group, have higher rates of HIV and STIs (11% and 23% respectively according to one survey in South India) than the average male.

In 2003, the Bill & Melinda Gates Foundation created the India

AIDS Initiative, later called Avahan, to curtail the spread of HIV in India.1 To achieve this, Avahan works with high-risk populations—those who are at greatest risk of acquiring and transmitting HIV. These populations include female sex workers, high-risk men who have sex with men,* and injecting drug users, as well as bridge populations (e.g., clients of sex workers) who can act as links between the general population and high-risk populations.

The foundation has three primary goals for this initiative:

1. Build an HIV prevention model at scale in India.

2. Catalyze others to take over and replicate the model.

3. Foster and disseminate learnings within India and worldwide.

As an important component of the Avahan initiative, the foundation allocated funding of US$12 million to prevent the spread of HIV/AIDS and sexually transmitted infections (STIs) among drivers and their helpers. The project aimed to increase safe sexual behaviours and to reduce sexually transmitted infections and new HIV infections among truckers through innovative approaches to

prevention programming. In the first 18 months of operation of the project, data from behavioural tracking surveys and the Avahan’s routine monitoring system revealed that only seven percent of long-distance truckers were accessing program services. Further, the routine monitoring system indicated that only 40-50 percent of the population accessing services were actually long-distance truckers.

Transport Corporation of India (TCI), as a major cargo transport company, recognized the importance of truckers in its business and launched a project specifically targeted to this population. This five-year HIV prevention project, Project Kavach (a Hindi word meaning protection or shield), is being implemented by TCI’s social arm, the TCI Foundation, and by the Avahan India AIDS Initiative.TCI initially set up intervention sites named “Khushi” clinics at 36 locations along major national highways. Within two years, however, program data indicated that despite a national presence, critical program gaps remained. A behaviour tracking survey in mid-2005 revealed that program awareness among the target population was only 12 percent and service uptake was only

7 percent. Other data revealed that approximately 40-50 percent of services were inadvertently directed at individuals other than longdistance truckers (such as short-distance truckers and other people working at the transshipment locations).

In response the program decided to:

1. Focus interventions on the largest impact locations, thereby halving the number of locations to 17

2. Within a location maximize coverage of long-distance truckers by intelligent placement of services

3. Ensure a standardized interface across locations in order to increase brand recall

4. Enhance exposure to program services by increasing the number of service touch points in a site

5. Make truckers the face of the program by engaging them as peer outreach workers

These changes resulted in doubling of monthly communication reach and monthly clinic uptake as well as a 50 percent increase in monthly condom sales. Moreover, focusing services in and around natural traffic areas resulted in 85-90 percent of services reaching long-distance truckers of the population accessing services were actually long-distance truckers.

The TCI Foundation is exploring several plans and ideas for making Project Kavach more effective:

• Strengthening links with testing and treatment facilities around

each clinic so as to develop a strong referral network.

• Enabling each Khushi clinic to undertake HIV testing.

• Building a mechanism to track truckers’ movements. The project

now has no way of ensuring that truckers needing further treatment

would return to a clinic (and truckers often lose their Khushi

passports).

• Documenting the lessons and achievements of the program to

help in developing a future strategy.

Truck drivers do not have the most secure of jobs either. Erratic payments coupled with the loans that most of them take to buy their truck make it all the

harder on them. Most of the truck drivers are not a part of any union for fear that their employers would fire them. It seems to be in the best selfish interest of the owners that they prevent the drivers from joining any union which would obviously demand higher pays and other amenities.