Mapping truckers' route to the health centre

New maps pin-pointing the exact location of “wellness centres” in sub-Saharan Africa are improving truck drivers' access to treatment and care for HIV and other sexually transmitted infections (STIs).



Oil giant Shell, with risk specialist Maplecroft and the North Star Alliance, which builds roadside clinics at truck stops, have developed and printed 20,000 maps for distribution to truck drivers in Kenya, South Africa, Cote d'Ivoire, Burkina Faso, Togo, Tanzania, Uganda, Botswana, Guinea, Mali and Namibia. The maps show the locations of more than 160 clinics.



"Many of us want treatment but at times you might not know where to get it when you are on the road but these maps can help us now," Eliud Musili told IRIN/PlusNews at Mlolongo, a truck stop in the Kenyan capital, Nairobi. "Now you can even advise other drivers where to get [health services]."



In East and Central Africa, the maps are being distributed to truckers at North Star Alliance-supported “SafeTStops” where wellness centres provide a range of services, including screening of STIs, HIV testing and counselling and tuberculosis screening, for truck drivers and communities with whom they interact.



"The wellness centres have been put up in areas where these high-risk groups converge to provide information about HIV and other STIs, prevention methods like condoms, diagnosis of STIs and testing and counselling," says Dorothy Muroki, project director for the Regional Outreach Addressing AIDS through Development Strategies II, a project of  the NGO, Family Health International (FHI). "For high-risk groups, information is critical."



FHI runs sites in Uganda, Tanzania and Rwanda in partnership with North Star Alliance, the Solidarity Centre and local transport unions; so far, the map distribution has not been rolled out at these sites.
























Read more:
 Cross-continent truckers risk more than HIV
 A life-changing highway
 Sex by the side of the road
 "I sleep with my wife and my girlfriend, that's all"

Living dangerously




For more than six years now, Julius Mwapele*, 35, a father of five, has worked as a loader at Dar es Salaam port; three months ago, he visited a clinic to treat a persistent rash on his penis.



"At first I wanted to [ignore] it but when it continued, I decided to go to a clinic here at the port," he told IRIN/PlusNews. "At the clinic, they told me I had gonorrhoea; I was afraid but they told me it can be treated."



While his job is not particularly well paid, compared with many of the residents around the port, Mwapele is well-to-do. He suspects that he contracted the STI from a local woman.



"I have three mistresses here - I buy food from them," he said. "I get into sexual relationships with them so that at times I can get free food when I don't have money but when I get money, it is my turn to give them a treat."



Sex stops



Sex work is widespread at truck stops along sub-Saharan Africa’s transport corridors; a 2006 University of Manitoba study found an estimated 8,000 female sex workers on the trans-Africa highway from Kenya's coastal city of Mombasa to the Ugandan capital, Kampala. It also reported that truckers and their assistants had high rates of reported STIs and many exhibited high-risk sexual behaviour.



The SafeTStops aim to provide truck drivers and sex workers with information and other services in a non-judgmental way. "Women do not get into commercial sex work for fun but due to economic needs, just like truck drivers seek sexual services from commercial sex workers because they are rarely with their spouses," said FHI's Muroki.









''We have a joke that after five bottles of beer, every woman is beautiful''

The centres are also a source of entertainment. "We provide facilities like pool and offer reading material and TV so when one walks in, nobody knows for sure what has brought them except the clinic personnel," said Victoria Jonathan, head of the wellness centre in the port of Dar es Salaam. "This gives a sense of privacy; the uptake of the services is very impressive.



Alcohol a factor



"The centres are alcohol-free to send the message that alcohol abuse is one of the key drivers for risky sexual behaviour," she added.



Ben Manyala, an HIV-positive trucker in Dar es Salaam, agreed that alcohol was an important factor in HIV transmission among truck drivers.



"Alcohol is contributing [to the spread of HIV]; we have a joke that after five bottles of beer, every woman is beautiful," he said.



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* Not his real name