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26 May 2011
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In-depth: SUDAN: Conflict and conservatism
SUDAN: Prevention efforts target truckers and tea-sellers
Photo: Kristy Siegfried/PlusNews
Truck drivers at a truck station outside Port Sudan
Port Sudan, 8 January 2008 (PlusNews) - It takes 36 hours to drive a heavily laden truck from Port Sudan, a major transportation hub on Sudan's eastern Red Sea coast, to the capital city of Khartoum. Ramshackle truck stations have sprung up along the dusty, rubbish-strewn route where drivers can catch a few hours sleep and buy food and tea from local shack dwellers.
That drivers often buy more than tea from the female vendors was well-known but rarely talked about, until recently. "For sure, they often have 'friends' at the truck stations," said Manal Mahgoub, HIV/AIDS officer with ACORD, an international humanitarian organisation with an office in Port Sudan. "The majority of sex workers are tea-sellers."
The potential for long-distance truck drivers and sex workers to spread HIV has been well-documented in other countries, but AIDS-awareness is so new in Sudan that none of the trucking companies has a policy of educating their drivers about the risks of HIV infection. That task has fallen to non-governmental organisations like ACORD, with coordination by the Sudanese National AIDS Control Programme (SNAP), a government body.
ACORD runs regular awareness-raising sessions, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, at the truck stations. Many of the truck drivers are illiterate, so the organisation has also recorded and distributed 12,000 cassettes about HIV/AIDS that the drivers can play in their cabs. Meanwhile, the staff at three health centres in the vicinity of Port Sudan's truck stations have been trained to provide voluntary counselling and HIV testing (VCT).
Safiedinn Ahmed, 40, from Southern Kordofan State in south-central Sudan, is one of 24 men working in the industry that ACORD has recruited to talk to their peers about HIV. Although not a driver himself, he often talks informally to the drivers at his company while they share a meal.
"They're frank about having a 'friend' in this place and another 'friend' in that place," he told IRIN/PlusNews. "I talk to them about Islamic culture, but if they're going to do it anyway, I tell them they should protect themselves."
Many of them do the tea selling to hide their real business.
Ahmed himself is not at liberty to offer that protection; only SNAP officials and clinics providing family planning services and treatment of sexually transmitted infections (STI) are allowed to dispense free condoms.
Relaxing in his cab at a truck station outside Port Sudan recently, Mohammed Ibrahim, who has been driving trucks for 27 years, said embarrassment would prevent most men from going to an STI clinic to ask for condoms. "There should be a private area, like in the men's toilets, where drivers can get condoms," he said.
None of the other drivers who gathered around as Ibrahim talked had attended any of ACORD's awareness-raising sessions. They said they knew about condoms but had never used them.
"One of the problems with doing training with truck drivers is the nature of their work," Ahmed commented. "There are new truckers all the time and they're never here longer than one or two days."
If working with truck drivers is difficult, targeting sex workers is even more so. Some of the women are refugees from Ethiopia and Eritrea, where HIV prevalence is thought to be two or three times higher than Sudan's 1.6 percent; others have moved to Port Sudan from various parts of the country after divorcing their husbands, being widowed or disowned by their families for becoming pregnant outside of marriage.
Without the support of a husband or parents, and few jobs open to them, some turn to sex work. "Many of them do the tea selling to hide their real business," explained Atif Mohammed Al Hassan, who used to work for an HIV programme targeting sex workers in Port Sudan, run by Ockenden International, a non-governmental organisation that focuses on displaced and refugee communities. Ockenden has since pulled out of eastern Sudan and the programme is now run by the Sudanese Family Planning Association.
To determine which of the women were genuine tea-sellers and which were sex workers, Ockenden began its programme by recruiting women like Zainab Osman, who had moved to Port Sudan with her two children 15 years ago after leaving her husband in Northern Kordofan State in central Sudan.
She started out as a tea seller, but later sold clothes and perfume door-to-door, and came to know many other women in similar circumstances. "I knew which of them were just selling tea and which were also sex workers," she told IRIN/PlusNews. "I heard a lot of information from Ockenden so I passed it on and when I told Ockenden about these women, they asked if I could bring some of them for training."
Some of them were shy in the past to buy them, but nowadays, many sex workers, their bags are full of condoms.
One of those she recruited was Amira Habib, who had also come to Port Sudan after leaving her husband. Although a qualified nurse, she could not find work that paid enough to support her three children and eventually began selling tea, and sex, at a truck station.
At first, business was good - she earned 30 to 50 Sudan Pounds a day (US$15 to $24). But after a long period of sickness, she lost most of her regular customers and could no longer afford to keep her daughter in school.
Admitting that her initial motivation for attending the training was to collect the incentive money, Habib said she was "shocked and afraid" by what she learned. Despite her nursing background, she had not known how HIV was transmitted. "They told us how to protect ourselves and how to give information to our colleagues," she said.
Initially, Ockenden gave the women condoms, but were later informed that only SNAP officials could do so. According to Osman, women who have been through the training now buy condoms from pharmacies. "Some of them were shy in the past to buy them," she said, "but nowadays, many sex workers, their bags are full of condoms."
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SUDAN: Conflict and conservatism
February 2008
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Features
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HIV status a closely guarded secret for most
HIV rate is mostly guesswork
PMTCT programmes still in their infancy
Awareness-raising takes a softly-softly approach
Prevention efforts target truckers and tea-sellers
Fadia Awad: "Three years ago, this house was full of women...they don't come anymore"
HIV, sexual violence messages struggle to get across
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Links and References
•
UNAIDS
•
WHO Fact Sheet
•
Sudan Household Health Survey - 2006
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