Long Distance Truck Drivers and the Structural Context of Health: A Culture-Centered Investigation of Indian Truckers’ Health Narratives

Abstract

Long-distance truck drivers (truckers) in India have been identified as a “high-risk” group for the HIV/AIDS epidemic, and are consequently the targets of prevention and education-based interventions. While such interventions have addressed risk at the level of individual behavior, little attention has been paid to the structural barriers to health for truckers. Research among truckers in India has ignored the economic, social, and cultural context of health. In this article, I employ the culture-centered approach (CCA) to health communication in documenting truckers’ narratives of health, which are innately connected to social and institutional structures around their lives. The data included 36 narrative interviews that I conducted as part of my fieldwork with Indian truckers, in addition to field notes and a reflexive journal. Through a reflexive analysis of these narratives, I present three themes: (a) the everyday violence of trucking, (b) health as sacrifice, and (c) migration and HIV/AIDS. I discuss how communication interventions can attend to the relationship between trucker health and the structural barriers they encounter.

Notes

¹ The NACP updates its programmatic agendas and thrust areas every five years. NACP-III refers to the third (and most current) phase.

² For instance, Agrawal et al. (2012) describe the trucker context as such: “During their journeys the drivers often stop at ‘dhabas,’ roadside hotels that usually provide food, rest, sex workers, alcohol and drugs. They pick up the women, use them [emphasis mine] and leave them at some other ‘dhaba,’ where they are used by other drivers and local youths.”

³ A recent cross-sectional assessment of India’s national trucker-based sexually transmitted infection (STI) prevention intervention revealed that nearly 50% of truckers that plied targeted routes reported zero exposure to any prevention messaging (Pandey et al., 2012).

⁴ More details about the program can be found at the TCI foundation website (http://www.http://tcifindia.org/health.html).

⁵ The word naaka literally means “cordon,” or “barrier”: a place where vehicles are stopped and inspected for the commercial tax or excise duty that they owe. Commercial vehicles like trucks often have to pay excise duty according to the nature of the goods they are carrying. Since the estimation of excise duty is a long, bureaucratic process, often requiring supporting documents, invoices, and other paperwork, there is a “yard” just off the highway, where the trucks (and drivers) wait until their papers are signed.

⁶ All names have been changed in accordance with the IRB privacy measures communicated to the participants.

⁷ These were instances where the participant had to leave the yard, or was called to process his papers, or chose to end the interview. Data from these interviews were not used, in accordance with maintaining voluntary nature of participation.

⁸ The research study was deemed “exempt” by the IRB at the institution where its approval was sought; therefore, information sheets were provided to the participants.

⁹ In India, matriculation is often colloquially used to refer to the completion of a high school degree, or what is sometimes called a “matriculate degree.”

¹⁰ Among those truckers that reported being married.

¹¹ It is outside the scope of this article to discuss in detail the reflexive intricacies of navigating different ideologies related to HIV/AIDS. Often, my self-identified privileged discourses clash with localized etiologies. At times these allow for more engaged conversations and deeper questioning, while at others, these create a rhetorical impasse.

Additional information

Funding

This research was supported in part by a dissertation fellowship from the Purdue Research Foundation.