Doctor Relies on an Ancient Text in Battle With a Modern Epidemic
On a recent visit to one of this city’s 20,000 prostitutes, the doctor offered a few pointers on escaping India’s raging AIDS epidemic, beginning with the boudoir’s most essential equipment.
For one, her bed stood six inches too high, he said. He sat against the edge of the mattress, feet flat on the floor, to demonstrate the optimum height. And the walls were the wrong shade of pink. Too hot.
He liked the placement of the TV, high in a corner overlooking the bed, and the radio on the windowsill, blaring Hindi film music.
“Audiovisual aids are helpful,” said Dr. Sachchidananda Sarkar, 49, who heads the government’s effort to control AIDS and other sexually transmitted diseases in India’s West Bengal state.
While most physicians would regard such details as matters of personal preference, Sarkar believes they may be key to preventing the spread of AIDS.
Sarkar takes his inspiration from ancient Indian texts, particularly the Kama Sutra, tweaking the guide to erotic pleasures according to his extensive fieldwork and research in Calcutta’s red-light districts.
For some 1,600 years, couples have turned to the Kama Sutra to make sex more fun. With 5 million Indians infected with HIV, Sarkar hopes the Sanskrit text holds the secret to making prostitution safer.
According to the doctor’s theory, prostitutes can make the most of foreplay with dancing, singing and yoga -- spiced up with gentle love bites and scratches -- and satisfy customers with less intercourse or, ideally, none at all. Sarkar thinks shorter sex reduces the risk of injuries to the skin that can spread the HIV virus.
A client seduced with traditional entertainment, herbal oil massages and perhaps a little poetry is at least less likely to resist when a sex worker tells him to put on a condom, Sarkar said.
“If the irritation is not there, and they are being satisfied by the other techniques, then they will do it,” he said. “That is my objective. How far I’ll be successful, I don’t know, but ultimately that is my idea.”
Sarkar and a team of assistants, including a model, a beautician, a social worker and a madam skilled in persuading prostitutes, began spreading the virtues of Kama Sutra sex in Calcutta in mid-August.
So far, about 20 prostitutes have joined Sarkar’s free six-month course, he said. They meet for two classes a week and receive instruction in the brothels, sometimes with the help of volunteer clients.
“This project makes us safe, and clients happy, so it has a dual purpose,” said Rakhi Biswas, 39, a prostitute and madam supervising a few other prostitutes. She is also helping Sarkar teach other sex workers and research the results.
Classes for Sex Workers
Sex and AIDS are sensitive topics, but Biswas said prostitutes and their clients pay attention when they hear “Kama Sutra,” because it comes from their own culture.
Although prostitution is illegal in India, it is widely tolerated, and Calcutta claims the country’s biggest flesh trade. The city has at least 11 red-light districts. The largest, with about 9,000 prostitutes, is Sonagachhi, a teeming warren where kids play in the streets while their mothers tend to clients upstairs.
Men sipping bottles of rice beer wait their turn while gambling in curbside card games or watching TV sets propped on crates, near an herbalist selling ground sharks’ teeth to cure bed wetting, powdered sawfish snout to relieve pain, and bits of twisted tree limbs to treat hernias.
Sarkar and his team walk dark stairwells that reek of urine to offer instruction in the rat-infested brothels, in rooms that double as home and work space.
The team holds classes two nights a week. Sarkar hasn’t written a course manual because he’s afraid of being charged with publishing pornography. But he may have figured a way around that.
“We have made a request to the government for prisoners to be used in the photos,” Sarkar said.
Much of the doctor’s advice is better left to the imagination, but it includes yoga exercises to strengthen muscles, and the suggestion that men are better seduced from behind, with back rubs that can induce ecstasy.
On his visit to Chanda Dey, 30, Sarkar offered suggestions about her mattress height and the color of the walls. He also told her that men are powerfully aroused at the sight of a red paste called alta smeared around the soft, pale edges of a woman’s foot. Dey nodded enthusiastically.
Any benefits of Sarkar’s efforts are so far small. At least 300,000 Indians were infected with HIV in the last year -- roughly 6% of the estimated number of new infections globally, the United Nations reported late last year. Only South Africa has more people suffering from the disease.
In the two worst-hit Indian states, Maharashtra and Tamil Nadu, more than half the prostitutes in some cities have been infected, the report said. The epidemic is steadily moving beyond high-risk groups, such as intravenous drug users and prostitutes, to the wider population, the U.N. said.
Preventive efforts appear to be helping in some areas, “but there is not yet persuasive evidence that the epidemic is being curbed in individual states, let alone in the country as a whole,” the report concluded.
Dr. Kenneth Wind-Andersen, a Dane who heads the India program of UNAIDS, said that experts believe AIDS-prevention methods should be adapted to local customs and that Sarkar may have found an effective way to reach Indian prostitutes.
Though the U.N. wants to see more evidence that Sarkar’s techniques get results before directly supporting them, Wind-Andersen said they are worth a try -- and a thorough assessment. “HIV/AIDS is so threatening that we should probably look at as many ways as we can, and not wait to get everything validated,” he said from New Delhi. “We should be open-minded.”
Sarkar has been doing AIDS-prevention work for more than seven years. As West Bengal state’s condom program officer, he is a proud innovator.
To make the state’s free condoms more attractive to prostitutes, Sarkar put the prophylactics in earth-tone packets decorated with leaves and acorns.
They look more like sachets of herbal tea than condoms, which is why the idea was a charm, according to Sarkar. It helps the prostitutes think of something other than work, he said.
The doctor also has studied whether it’s best to have a bed face north or south, and where flowers, a television or radio should be placed to provide a safer sexual experience.
“Non-penetrative sex should be advanced,” he said. “Already 10 to 20% of the sex workers and their clients in our study are having non-penetrative sex.”
Tapping the Kama Sutra has given Sarkar entree with prostitutes, which can be difficult. To get anywhere in India’s red-light districts, AIDS-prevention workers often have to use tactics more familiar to organized crime than charities. They cultivate brothel landlords, pimps and madams to gain access to their turf. Without territory, it’s hard for nonprofit groups to get funding, especially lucrative foreign grants from groups such as the World Health Organization, which Indian AIDS activists use as endorsements to raise more money.
Sarkar works with a small nongovernmental organization, the Institute of International Social Development, founded in 1996 to aid tribal groups in the countryside, elderly villagers and Calcutta’s sex workers. Institute Secretary-General Rajyashree Chaudhuri hopes Sarkar’s message is the start of a revolution that will spread across India to Europe and the U.S.
Theory Faces Skepticism
Some of Sarkar’s colleagues in the public health field dismiss his theory that the Kama Sutra can make sex safer. The idea, they say, is wishful thinking that doesn’t suit the reality of a Calcutta brothel.
“If it did, only song and dance would be going on there,” said Mrinal Kanti Dutta, the son of a prostitute and program director for one of Calcutta’s biggest AIDS-prevention projects.
Most of the Sonagachhi district is Dutta’s realm, and his goal is to give sex workers pride in themselves, and their work, by organizing them into a strong union that defends their rights. He says the campaign has empowered Sonagachhi’s prostitutes so much that few accept clients without condoms. The rate of HIV infection among prostitutes in Sonagachhi has peaked at 10%, according to Dutta, who said the rate ranges from 25% to 80% in India’s other red-light districts.
A celibate yogi, or spiritual teacher, named Mallanaga Vatsyayana wrote the Kama Sutra as a guide to fulfilling kama, or sensual pleasure, one of a Hindu’s three greatest inspirations for a balanced life. The other two are dharma, which roughly translates as religious, moral and social duty, and artha, the pursuit of wealth to support one’s family.
Vatsyayana emphasized the need for harmony among all three quests. But his work is perhaps most famous in the West for recommending 64 positions for lovemaking, several of which strain the laws of physics.
For prostitutes, Vatsyayana offered this advice: “Sleeping with strangers for gain does not come naturally to women. Yet to succeed as a prostitute, you must disguise your love of money as a natural desire for the man himself. Prove to him that he, not his money, inspires your divine lust by always seeming selflessly devoted. Don’t be too obviously grasping; use your wits to fleece him intelligently.”
Sarkar hopes his students will heed that ancient advice, using time-tested techniques to avoid some of the modern dangers their profession presents.
“I am making a compromise with the culture, science and technology, and condom use -- holistically, so that they get the most benefits,” he said. “It’s a difficult job for me, but I’m trying.”
