Why truck drivers spread COVID-19

What it means for taxis, bodaboda

Kampala, Uganda | THE INDEPENDENT | On average, each cross border truck driver in Uganda has contact with at least two sex partners per week, according to research.

Given that over 31,588 long distance truck drivers are estimated by researchers to be living in Uganda at any given time, the numbers of sex contacts of truck drivers can be staggering. That poses grave danger in the country’s battle to contain the coronavirus disease COVID-19.

In her address to the nation on May 14, the Minister of Health, Dr. Jane Ruth Aceng said the rapid assessment survey done in the country showed that there is no COVID-19 transmission within the Ugandan community. Another 303 community samples tested were found negative for COVID-19.

But on the day Dr. Aceng spoke, the Ministry of Health announced 21 new COVID-19 cases from 1,593 samples of truck drivers.  The new COVID-19 cases were truck drivers from Ugandan, Kenyan, Tanzania, and South Sudan. They pushed the total number of COVID-19 cases to 160 in Uganda.

“Uganda’s coronavirus risk, for now, remains cross-border truck drivers,” she said.

Long-distance truckers and other transport workers are known to be a risk in acquiring and spreading infectious diseases; especially sexually transmitted diseases, and are now being considered to be contributing to the spread of COVID-19 along trucking routes.

Beyond targeting truckers

The situation is worsened because the truck drivers mainly make sex contact with female sex workers who are another equally high risk group. According to the research, a female sex worker has contact with seven truck drivers a week; that is a different truck driver every day.

Apart from the sex workers, truck drivers make contact with many other people along the routes they ply.  Studies have shown that people living in the vicinity of truck stops along major highway corridors tend to have higher prevalence of communicable diseases like HIV/AIDS than the general community population.

The high risk of COVID-19 spread that truck drivers pose is mainly because of their high mobility. Earlier studies on HIV and other Sexually Transmitted Diseases (STDs) prevalence among long-distance truck drivers from East and Central Africa have shown that prostitutes, truck drivers and other highly mobile populations, characteristically have multiple sex partners.

Apart from Long Distance Truck Drivers and sex workers, the other highly mobile groups in Uganda are the taxi operators and the boda-boda motorcycle taxi operators. The government on March 25 banned taxi and bodaboda operation. As the Ministry of Health signaled that there would be no extension past expiry of the latest lockdown on May 18, focus was on whether taxis and bodaboda would be allowed to resume operation in the phased lifting. That decision is not easy to make.

There are relatively few studies conducted on disease spread among and by local transportation workers, such as taxi drivers and boda bodas.  There is one titled “High-risk motorcycle taxi drivers in the HIV/AIDS era: a respondent-driven sampling survey in Kampala, Uganda” done in 2014.

This study found that although 60% commercial motorcycle drivers in Kampala were not married, up to 52% had at least one child.  They also had a higher HIV prevalence than population estimates for men. Overall, 7.5% were infected compared to an HIV prevalence of 4.5 % and 4.1% for men in Kampala. The prevalence of syphilis, 6.2%, was about twice that of the syphilis prevalence of 3% among men and women.

This indicates that bodaboda are at greater risk for acquiring and transmitting diseases than the general population. But these are old studies done on HIV/Aids. They can only offer windows of conjecture about what could possibly be happening with COVID-19, which is not even a sexually transmitted disease. A bodaboda rider from Wakiso District was among the 11 positive cases of Covid-19 declared in early April. That single case led to contact tracing of at least 38 cases.

Truckers, bodaboda and taxi drivers and sex workers pose COVID-19 risks for different reasons. The high risk of truck drivers is attributed to transactional sex that occurs due to pro-longed time away from families or partners.

This makes it inevitable that the Long Distance Truck Drivers (LDTDs) will solicit sex along transport routes. And sex workers are usually their target.

The sex workers are driven to enter the risky business because of poverty, according to many researches done. As national-level income inequalities grow, women along transport routes and are poor and unemployed turn to sex work as a means for survival.

The meeting between the truckers and sex workers is once again proving to be the perfect combustive mixture for COVID-19 as it has been for other diseases such as HIV/AIDS in the past.

And so the numbers of COVID-19 infections continue rising, day-by-day, mainly fuelled by infections among tested cross border truck drivers.