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.