India: Mobility hampers HIV treatment follow-up among migrant labourers in Kerala

HIV cases in Perumbavoor guest workers
Kochi: After a rise in drug-related issues sparked tensions between locals and migrant labourers in Perumbavoor, there is now concern about health department's difficulty in tracking guest workers, who tested positive for HIV in the last few months, and provide them with treatment. Wrong mobile numbers and addresses and frequent movement within the state due to the nature of work pose hurdles in tracking them.
Health department decided to conduct a field visit to Perumbavoor and Kerala State Aids Control Society (KSACS) will convene a meeting with govt departments such as police, excise, labour and local bodies to chalk out a plan to address the issue.
Data with health department shows that about 26% of those who tested HIV-positive in Perumbavoor area in the past few months were guest workers. The random testing was conducted through Perumbavoor taluk hospital.
Although the department is reluctant to share the total number of people tested and how many turned positive, officials said their real concern was migrant labour. The percentage may not appear alarming, as migrant labour testing HIV-positive is only 1/4th the total number of people who tested positive in Perumbavoor. However, the real worry is different: the migrant population is floating, and health officials are concerned because they are unable to trace many HIV-positive guest workers. Hence, timely intervention has become difficult.
Health officials realised that in most cases, the addresses provided are fake, making it difficult to track them in their home state too. "We are compiling data regarding all HIV cases in the area, including the latest test results," said a KSACS official.
"By the time we get detailed test results, we fear the infected guest worker would leave here. Attempts to trace them using the phone numbers or address given by them often reach a dead end. We learned that some of them even possess multiple Aadhaar cards," he added.
Even if addresses are genuine, tracking them isn't easy. "Their mobility makes it difficult to trace them. Due to the nature of their work, they move from one place to another within days. In some cases, they leave the state. In such cases, we have to seek the support of National Aids Control Organization (NACO)," said another KSACS official.
Although state govt instructed labour and home departments to prepare a registry of guest workers more than four years ago, the work remains incomplete. Labour department was supposed to issue digital ID cards through Athithi portal, but the process is still halfway. Local bodies and health departments are supposed to conduct inspections at the accommodation facilities of guest workers, but they rarely do it.
Health department plans to seek district administration's support for coordination with various govt departments in the district. The plan is to assign specific targets for each department.