Population Council Research that makes a difference

Subhash Prajapati

Subhash Prajapati

Dr. Subhash Prajapati stands in front of his clinic in the Mankhurd slums of Mumbai. He has been trained as part of the RISHTA project (Research and Intervention in Sexual Health: Theory to Action; an acronym meaning ''relationship''in Hindi and Urdu) to manage STIs by diagnosing, treating, and counseling patients. Photo: RISHTA.

I work in a one-room clinic in a crowded settlement of single-story houses and narrow slums. It is a typical Mumbai slum. The residents are primarily migrants. Usually there is a long queue of patients.

Many of the migrants live without their wives for nearly three-quarters of the year, a situation that is known to lead to men visiting sex workers. Even married men who live with their wives visit sex workers.

I often find that men who complain about an irritation in the bladder have been going out (having sex outside marriages). I treat the problem, educate them about STIs, and tell them to use condoms during treatment and to stop going out.

Not all men admit to having extramarital relationships. But I nevertheless dispense advice. I use a chart with illustrations, and patients can relate their symptoms to the illustrations.

Before RISHTA, people were hardly aware of STIs and that these infections could be a step toward getting infected by HIV. After training, I've learned not only to treat infections but also to counsel patients. And I've seen a decline in STIs—gonorrhea, in particular.

RISHTA also introduced street theater and discussions with individuals and groups of people. All of this influences the thinking of individuals, changing lifestyles and communities.