By Muhammad Fareed
It was April 2007, a European Commission funded four year project namely Best Practice Models of Integrated Prevention and Care and Support with Key Vulnerable Communities in Sindh “Naya Qadam Project” was launched. Interact Worldwide UK is committed to provide its full technical assistance along with the project cycle management throughout the project implementation. Pakistan Voluntary Health and Nutrition Association (PAVHNA) is the coordinating and implementing body along with another implementing partner Pakistan Society. The project has successfully completed in 2.6 years of its duration.
The project aims to reduce the incidence of HIV and AIDS and mitigate the social and personal impact of HIV and AIDS on Key Vulnerable Communities in Pakistan. The project primarily focuses on the empowerment of the Key vulnerable communities, namely Injecting Drug Users (IDUs), Female Sex Workers (FSWs), Men having Sex with Men (MSM), and People Living with HIV and AIDS (PLHAs), and their families. The project has been providing the correct and comprehensive knowledge about their basic human and sexual and reproductive health rights, enabling them to make their own choices about their own development and well being and ultimately leading to decrease in the stigma and discrimination faced by these vulnerable communities. Efforts have been made by the technical advisors and the implementers to ensure that the rights-based approach is evident in each and every aspect of the project. PAVHNA, being a coordinating body, is responsible for overall project while as implementing partner; it is responsible for implementation of the project with FSWs and 50 percent of PLHAs component in Gulshan-e-Iqbal Town, Karachi. On the other hand, Pakistan Society, being the implementing partner of the project is responsible for the implementation of IDUs, MSM and 50 percent of the PLHA component of the project in the New Karachi Town, Karachi.
Naya Qadam Project is the only project which aims to empower the Key Vulnerable Communities through increased awareness of their sexual and reproductive health, increased participation in their own development and decreased vulnerability to stigma and discrimination instead of only focusing on service delivery. Although this project is not merely a service delivery project, but a number of primary healthcare, sexual transmitted infections management, social, referrals and harm reduction services are offered to the clients, so as to make the intervention worthwhile, and to reduce the burden on the tertiary health care facilities in general. The staff rendering these services has been appropriately trained and is well experienced with these communities.
The project’s main strength and back bone are the community organizers, peer educators, and the community advocates, who have been identified and adequately trained as community leaders. Right from the establishment of the demonstration models to the advocacy meetings at the provincial/ national level, these leaders are no doubted playing an amazing role. These community leaders are carrying out all the empowerment activities and are also trained to carry out effective advocacy at all levels on the behalf of their respective communities. The development and capacity building of these leaders ensure the sustainability in the continuity of the project objectives, even at the exhaustion of the project funding. One Community Based Organization (CBO) each for the IDU, PLHA, MSM and TG communities has been formed while support group of FSWs is being strengthened, at reaching the certain capacity level soon, it will be converted into an effective CBO. The community organizers and the community advocates are responsible for organizing regular meetings of their respective CBOs and the support group. These CBOs and the support group provide these communities with the platform, required for the expressions of their thoughts, beliefs, social choices, and their voluntary decisions, regarding their sexual and reproductive health rights and other relevant issues.
Initially there was lot of problems faced to involve the vulnerable communities with the project such as identification of right entry points to address the target groups, sensitized them to play their effective participatory role, fear-free involvement of target groups for their own development, trust building to each other, follow up issues to the project. They were not ready to rely that the project would aim to build their capacity for their own development. But slowly and gradually they are being realized the importance of the project in their life, at present 793 IDUs, 428 MSM, 138 PLHAs and 1,240 FSWs have been registered with the project. Follow up of the beneficiaries is being increased day by day. The vulnerable communities members are always treated as respectable human being by the project; this basic approach is very much supportive to lead a relationship of trust between the communities members and the project. Involvement for their own development is being increased day by day with the project and it’s a long chain to support each other for promoting healthy behaviors to reduce incidence of HIV and AIDS in the country.
Although there have been a number of problems in the implementation of Naya Qadam Project including effective involvement of law enforcement agencies, local body members and private and public health care providers because through engaging their commitment stigma and discrimination can be reduced effectively. However these problems are insignificant as compared to the achievements of this project. This project has proven that by adopting a rights-based approach, and involving the target communities at each and every step of the project, we can get the target communities to own the initiative, and ensure long term sustainability.
Effective advocacy with influential/notables of the communities, law enforcement agencies, involvement of local body members, like minded NGOs, donor agencies and Sindh AIDS Control Program supports the project to overcome the issues.
A registered trans-gender expressed, “Most of the people always try to make a fun of me, and these behaviors make me sad. I always feel guilt and ask question to myself, “Why do people want to play with me? Am I not a human being like others? Don’t I have right to live and spend my life like others? I always find the DIC of the project as heaven for me because of its enabling environment”. A FSW shared, “I never ever thought that someone, who is known me as FSW, can even think about my health and make me aware about healthy behaviors but the project really did, I am being health conscious and have learned to say NO for harmful practices. Thank you Naya Qadam”.
