The Money Lender’s Daughter

The Chanura Kol team ensures that women undergoing rehabilitation receive a great deal of trust and respect from each other and from staff members at Chanura Kol’s short stay home. In this photo,  a women at the short stay home hugs another resident.  (Photographer: Prashant Panjiar)

Sheena (name changed) is 36 years old and resides in Imphal East which is located in the drug riddled state of Manipur in northeastern India. Sheena is the youngest of four siblings, all of whom have spent the last seven years watching their sister endure the severe turmoil that accompanies heroin addiction. Her wealthy family background is where Sheena’s story of addiction begins.

The daughter of a prosperous money lender, Sheena was the perfect target for her first husband who used her family’s wealth to support his heroin addiction. He introduced Sheena to heroin and over the next three years, her life fell apart as she grew addicted to the drug. Ultimately, her husband left her when they realized that Sheena was infertile and could not bear children. In a desperate attempt to escape the heartbreak that followed, Sheena ran away from her home to North AOC, a place in Imphal which is notorious for easily accessible drugs and is a hub for sex work.

In her new home, Sheena met her second partner, Sandeep (name changed), who was also a heroin addict. Over the next three years, Sheena and Sandeep used heroin frequently, a habit that left them drowning in debt. Sheena remembers working as a rag picker, and sleeping on the streets with Sandeep because they could not afford accommodation of any other kind. Sheena also recounts the financial desperation that forced them to steal money from their neighbours so that they could pay for their next high, something that Sheena says she is embarrassed to confess especially since the stealing continued even after the couple was caught numerous times and publicly humiliated.

Sheena cannot remember the specific point at which she realized that she had hit rock bottom but she does remember feeling a growing sense of urgency that motivated her to seek help. She also tried to convince Sandeep to enter a rehabilitation programme but soon realized that he had no desire to change his life.

With her mother’s support, Sheena became one of the first women to enter Chanura Kol’s short stay home where she went through detoxification treatment and also received counseling, economic support and vocational training. Sheena says that the support that she received from the staff members at the short stay home and from the other women who were also going through detoxification treatment was invaluable to her progress. Sheena has stayed off drugs since she left the short stay home. Her partner, Sandeep, unfortunately, passed away while she was in the rehabilitation programme.

Sheena says that she feels like a stronger person emotionally, psychologically and physically, and is currently trying to help a friend who is addicted to heroin seek rehabilitation. Sheena says that, for the first time in a long time, she is excited about her future.

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The India HIV/AIDS Alliance in partnership with SASO, implements the Chanura Kol project in Manipur. This project is funded by the Elton John AIDS Foundation and serves to expand interventions to decrease HIV transmission and reduce drug relapse among female injection drug users (FIDUs).

Listening to the Needs of Female Injecting Drug Users: Housing for children enables more FIDUs to enrol in short stay home

A resident at Chanura Kol’s short stay home checks her phone for messages. (Photographer: Prashant Panjiar)

When female injecting drug users (FIDUs) in Manipur cited a lack of accommodation for their children as being a major deterrent to enrolling in Chanura Kol’s detox programme, the Chanura Kol team responded quickly. Team members piloted a short-stay home which provides housing to two children five years of age or younger for each woman enrolled in the detox programme.

Toys, space for playing and child appropriate nutrition is provided at the Drop in Centre (DIC) where women who inject drugs undergo detox treatment. For further care, children of FIDUs, who are enrolled at the short stay home, are referred to government-supported Aaanganwadi Centres (AWCs) which offer existing pre-school, nutrition and health services.

The short-stay home provides a safe and supportive space to help women reintegrate into their families and society. So far, 45 women have accessed the services offered at the Chanura Kol short-stay home. 41 women have been provided vocational training, and 16 women have initiated income generating activities with Chanura Kol’s support.

This short stay home exemplifies the flexibility with which the Chanura Kol team operates, and highlights the programme’s belief in customizing solutions based on the needs of the women it seeks to help.

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The India HIV/AIDS Alliance in partnership with SASO, implements the Chanura Kol project in Manipur. This project is funded by the Elton John AIDS Foundation and serves to expand interventions to decrease HIV transmission and reduce drug relapse among female injection drug users (FIDUs).

Verbal screening of TB for at-risk populations – A case study

Tuberculosis poses a huge public health challenge in India, with an estimated 2.3 million incident cases of TB occurring every year. It is estimated that between 5% and 6.4% of incident TB cases in India occur in people co-infected with HIV.  In 2010, an estimated 41,500 people living with HIV were co-infected with TB, the second-highest national caseload in the world after South Africa. This is particularly significant considering that India alone accounts for 49% of all cases of HIV in Southeast Asia.

In light of the magnitude of the problem that TB presents for people with HIV, the WHO recommends intensified screening for symptoms of TB among HIV-infected individuals. Evidence shows that symptom-based TB screening, which looks for chronic cough, fever, night sweats, and weight loss, is a reliable method to identify TB in HIV-positive adults. Early diagnosis and treatment of TB co-infection in people living with HIV is critical to reducing TB morbidity and mortality, and may lower the rate of TB transmission as well.

India HIV/AIDS Alliance, the lead partner in the Avahan India AIDS Initiative in Andhra Pradesh, introduced verbal screening for TB. These screenings were conducted at the service delivery level by peer educators responsible for HIV and sexually transmitted infection (STI) prevention outreach. Activities that focused on integrating verbal TB screening into HIV and STI services were then initiated. Symptom-based verbal TB screenings were performed for key population members in the field and at STI clinics. Those suspected of having TB were sent to referral clinics for treatment.

During the three-year implementation period, 2008–2010, an annual average of 53,749 key population members, consisting of female sex workers, men who have sex with men, and transgender people, received at least one type of service from the project, i.e. HIV, STI, or TB prevention, treatment, or care. On average, 88% of service recipients were screened verbally for TB every year. In addition to this, peer educators provided a total of 35,086 referrals to STI clinics following verbal TB screening during the implementation period.

This case study by Alliance India demonstrates the need for TB screening among key populations, and presents lessons learnt from the implementation of a verbal TB screening programme. You can read the study here.

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The author this post, Dr. M. Ravikanth, is Documentation and Communication Specialist, India HIV/AIDS Alliance, Andhra Pradesh.

The Avahan India AIDS Initiative (2003-2013) is funded by the Bill & Melinda Gates Foundation. The programme aims to reduce HIV transmission and the prevalence of STIs in vulnerable high-risk populations, specifically female sex workers, MSM, and transgenders, through prevention education and services such as condom promotion, STI management, behavior change communication, community mobilization, and advocacy. Avahan works in six states, and Alliance India is a state lead partner in Andhra Pradesh.


Understanding the Sexual and Reproductive Vulnerabilities of Female Sex Workers

As part of the Avahan India AIDS Initiative, Alliance India recently conducted a study to identify the sexual and reproductive health (SRH) needs of female sex workers (FSW). The study, conducted in Andhra Pradesh, also aimed to determine the factors that contribute to increased vulnerability and rights violations of FSW with regards to SRH. In addition to this, this research served to study the barriers to access to SRH services by FSW.

The study found that condom use by FSW was low with regular partners, and that forced sex and sexual harassment by various segments of society, including policemen, was common. Even though a third of those interviewed reported using oral contraceptives, unintended pregnancies occurred frequently which then led to self-induced abortions and post-abortion complications. Only a third of the respondents felt they possessed the right to make decisions related to their pregnancies.

The study emphasizes the need to provide services beyond STI and HIV prevention and treatment for FSW, including those related to dual protection and contraceptives, safe abortions, and safe pregnancy. To create better access to SRH services for FSW, establishing good linkages with service providers and advocating with key stakeholders is essential.

You can read the entire report here.
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The Avahan India AIDS Initiative (2003-2013) is funded by the Bill & Melinda Gates Foundation. The programme aims to reduce HIV transmission and the prevalence of STIs in vulnerable high-risk populations, specifically female sex workers, MSM, and transgenders, through prevention education and services such as condom promotion, STI management, behavior change communication, community mobilization, and advocacy. Avahan works in six states, and Alliance India is a state lead partner in Andhra Pradesh.

Absolutely Ours : The importance of community-owned responses to HIV in India

“Communities are assisting State AIDS Control Societies to train police and health officials on their specific needs and concerns. It is not uncommon during police trainings for sari-clad hijras and MSM to lead sessions on why and how police services can be made more friendly and inclusive for the community. Media advocacy has yielded results, and instances of stories that accurately and respectfully portray sexuality and gender identity differences are penetrating into the homes and minds of the media consuming public. The richness and value of the results are evident on multiple levels: with the project implementors themselves; in the populations they target; and in society at large. The process of working on an HIV prevention project itself can increase community pride and self-esteem, helping them to see latent strengths and capacity they might have thought they didn’t have. And a community that loves itself, protects itself.”

This is an excerpt from an article by Jonathan Ripley, the former Manager for Advocacy and Policy, Pehchan. In this article, he discusses how MSM, transgender and hijra community members are registering themselves as legally recognised organisations, and why this growing sense of community ownership matters. Jonathan’s article also emphasises the complexity behind defining what a ‘community’ really means, and why Alliance India strives to be viewed as unnecessary by the communities it supports. You can read the entire article here.

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With support from the Global FundPehchan builds the capacity of 200 community-based organisations (CBOs) for men who have sex with men (MSM), transgenders and hijras in 17 states in India to be more effective partners in the government’s HIV prevention programme. By supporting the development of strong CBOs, Pehchan will address some of the capacity gaps that have often prevented CBOs from receiving government funding for much-needed HIV programming. Named Pehchan which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement,’ this programme is implemented by India HIV/AIDS Alliance in consortium with Humsafar Trust, SAATHII, Sangama, and SIAAP and will reach 453,750 MSM, transgenders and hijras by 2015. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.

Going Beyond HIV : Fighting for Social Entitlements for the MSM, Transgender and Hijra Community

Discrimination prevents members of the MSM, transgender and hijra community from receiving social entitlements, a trend which Pehchan is working hard to reverse. In this photo, Divya Sagar, right, waits to perform during the first National Hijra Habba held on June 2nd in New Delhi. The event, organised by Pehchan, brought together members of the transgender and hijra community, government representatives and non-governmental organizations to discuss ways of achieving equality for members of the community in India. (AP Photo/Kevin Frayer)

In the course of their work with members of the MSM, transgender and hijra (MTH) community, Pehchan team members have become all too familiar with the constant discrimination faced by community members. A lot of this discrimination, however, goes beyond HIV. This has formed the basis for Pechan’s commitment to fighting for social entitlements owed to the MTH community, in addition to their health needs.

An example of how Pehchan is doing this is visible in its efforts to meet the needs of transgender and hijra community members who struggle with issues around identity, gender and social entitlements. Pehchan has ensured that this community has access to outreach and peer teams who educate community members about their human and legal rights, social welfare schemes, right to health care and other similar social entitlements.

Over the last quarter, the Pehchan team in Andhra Pradesh helped 84 members of the MTH community apply for ration cards, 49 members for voter ID cards and 10 members for unique identification cards. In addition to this, Pehchan helped 40 homeless MTH members apply for plots of land.

Fortunately, Andhra Pradesh is not a unique case –  Pehchan is currently building the capacity of its implementing partners in all 17 implementation states to provide similar services to MTH community members.

The provision of these services is invaluable since these essential needs are yet to be addressed by the Government for sexually marginalized communities. The National Hijra Habba, recently held by Pehchan, has also helped create national awareness about the MTH community’s lack of social entitlements.

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With support from the Global FundPehchan builds the capacity of 200 community-based organisations (CBOs) for men who have sex with men (MSM), transgenders and hijras in 17 states in India to be more effective partners in the government’s HIV prevention programme. By supporting the development of strong CBOs, Pehchan will address some of the capacity gaps that have often prevented CBOs from receiving government funding for much-needed HIV programming. Named Pehchan which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement,’ this programme is implemented by India HIV/AIDS Alliance in consortium with Humsafar Trust, SAATHII, Sangama, and SIAAP and will reach 453,750 MSM, transgenders and hijras by 2015. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.

A Multimedia Feast for the Senses : The latest news on Hijra Habba!

Since news on the first ever National Hijra Habba still continues to roll in, we decided to highlight some of what we’ve recently received (which includes the brilliantly emotive photo of Abhina and Yadavendra above)!

In addition to the articles covered by the Hindu and the Deccan Herald which you can view on our Facebook page, Jezebel.com’s recent article, India’s ‘Third Gender’ Community Demands Social Equality and Its Own Passport Designation proved to be as interesting a read as the article published by the Asian Tribune, Landmark meet on sexual minorities: National Hijra Habba Consultation.

In case you haven’t seen it or would like to view it again, we have re-posted a very moving video on the Hijra Habba which was created a few days ago! You can view it below.


And now for our photos! These photos, which include the image at the beginning of this post, have been collected from various news sources and really capture the spirit of the event! In addition to Abhina, Yadavendra and Simran, other members of the Pehchan family have also been beautifully portrayed in these pics.

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Stay tuned for more news on the great work that Pehchan continues to do!

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With support from the Global FundPehchan builds the capacity of 200 community-based organisations (CBOs) for men who have sex with men (MSM), transgenders and hijras in 17 states in India to be more effective partners in the government’s HIV prevention programme. By supporting the development of strong CBOs, Pehchan will address some of the capacity gaps that have often prevented CBOs from receiving government funding for much-needed HIV programming. Named Pehchan which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement,’ this programme is implemented by India HIV/AIDS Alliance in consortium with Humsafar Trust, SAATHII, Sangama, and SIAAP and will reach 453,750 MSM, transgenders and hijras by 2015. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.