Supporting community action on HIV, health and rights to end AIDS
BREAKING TABOOS: Young people’s ‘Action Project’ on sexual and reproductive health and rights in Bangladesh and India
International HIV/AIDS Alliance The Alliance is an innovative global partnership of nationally based, independent Linking Organisations supporting community action on HIV, health and human rights to ends AIDS. HASAB (Bangladesh) www.hasab.org hasab@bdmail.net India HIV/AIDS Alliance www.allianceindia.org info@allianceindia.org International HIV/AIDS Alliance (international secretariat) mail@aidsalliance.org www.aidsalliance.org Registered UK charity number: 1038860 Published: 2013 Š International HIV/AIDS Alliance This publication has been produced with the assistance of the European Union. The contents of this publication are the sole responsibility of the International HIV/AIDS Alliance and can in no way be taken to reflect the views of the European Union. Unless otherwise stated, the appearance of individuals in this publication gives no indication of either sexuality or HIV status. Cover photo: Shilla, a young mother and youth group member, with her baby Shimon, in Sylhet, Bangladesh. This page: Lipi, a radio jockey trained on sexual and reproductive health and rights issues, in Munshiganj, Bangladesh. Both images Š International HIV/AIDS Alliance
Design by Progression Design
Armed with enthusiasm, passion and the facts young people can play a pivotal role in changing attitudes and influencing policy.
INTRODUCTION
Globally, young people account for 40% of new HIV infections. In India and Bangladesh cultural taboos have resulted in a pervasive silence when it comes to sexual and reproductive health issues, making it difficult for young people to access information and services – or for services to even exist. An ambitious three year project (2010-2013) Community Action for Sexual and Reproductive Health and Rights in Asia, also known as the Action Project, has been addressing this silence. Armed with enthusiasm, passion and the facts young people are able to play a pivotal role when it comes to changing attitudes at community level through to influencing policy at local and national level.
During the project, which was made possible through funding from European Commission, over 160 youth groups were established in India and Bangladesh, and over 300 peer leaders trained. The youth groups included people who are most vulnerable to HIV infection, which equates to those who are most marginalised such as sex workers, people who inject drugs, men who have sex with men (MSM) and transgender people. In addition, Bangladesh and India have two of the highest rates of child marriage in the world, a practice which also places young girls at higher risk of HIV infection. The International HIV/AIDS Alliance-led project was implemented by Alliance Linking Organisations (India
HIV/AIDS Alliance and HASAB) and community-based partners, and in each community the young people set the agenda based on the issues most important to them (see page 33 for thank you’s). Often working in highly conservative areas, this collection of photos provides some highlights of how the project was able to raise awareness, reduce stigma and make a significant contribution to community-led advocacy – ultimately improving young people’s access to sexual and reproductive health information and services, and reducing risk of HIV infection for this generation as well as those to come.
Allahabad, India
Chitra: Changing generations Discussing issues such as contraception, early marriage and HIV is not easy in a conservative community. Chitra’s confidence and leadership skills have not only helped her have open conversations with her peers, but also with the village elders. The Action Project, although optimistic from the start, was surprised at just how open-minded the elders were to the outspoken ideas of youth group members. Photo: Prashant Panjiar for India HIV/AIDS Alliance
Allahabad, India
A sign of commitment Youth members from the Action Project sign their commitment to fight HIV through raising awareness. This act is empowering, a big move in Allahabad. Outreach and information activities of a similar nature are frequently organised by the project’s youth groups. And advocacy efforts are paying off. For example, in Allahabad, young people successfully advocated to secure iron folic acid and tetanus toxoid supplements for all adolescent girls, previously only supplied to married and pregnant women. This was made possible by youth participation in the District Health Society’s monthly meetings. Photo: Prashant Panjiar for India HIV/AIDS Alliance
Sylhet, Bangladesh
Rita: Rejecting early marriage Rita lives on a tea estate in the Sylhet region of Bangladesh where girls are often forced to marry at a very young age. She was able to prevent her early marriage with support from the peer leader of her youth group and she now helps others to fight for their rights and avoid early marriage. “When my father died, my uncles thought that marriage was more important than education. But I stood up for myself and now I help others to fight for their rights. Without knowledge you’re just born here and die here, only knowing the green of the tea plantation.” Tea gardens act as a state within a state with their own norms and regulations. The fact that a youth group was established here with a permanent youth centre is testament to the importance of engaging gatekeepers. The community-based organisation, the Reliant Women Development Organization (RWDO), held discussions with the tea garden’s key management and religious and community leaders. Photo: International HIV/AIDS Alliance
Imphal, India
Imprinting messages about sexual health Youth group members have increased the awareness levels in villages at a scale that few believed possible in such a short time. One simple activity, the impact of which is not to be underestimated, is taking out printed materials and talking to young people at their homes, playgrounds, clubs, colleges, cultural evenings and youth festivals. The materials, developed by the Action Project, are handy sources of information on sexual and reproductive health and rights and also encourage young people to visit youth centres and take part in activities. Photo: Sunita Devi for Social Awareness Service Organization (SASO)
Allahabad, India
Youth centres: A safe space The youth centres of the Action Project provide a safe place for both girls and boys to enjoy recreational activities and have open discussions. Information and guidance presented by peers has equipped young people to deal with issues that are important to them, including how to resist peer pressure to use drugs and alcohol, about contraception, HIV prevention and HIV care and support, and child marriage. The young people often continue the discussions with friends outside the group and back home with parents. Photo: Prashant Panjiar for India HIV/AIDS Alliance
Mymensingh, Bangladesh
Shamim: Supporting young MSM groups In Mymensingh, peer leaders are working with marginalised groups of young people including men who have sex with men (MSM). They’re supported with training by a community-based organisation, Alliance for Cooperation and Legal Aid Bangladesh (ACLAB). Shamim, a teacher and a peer leader, meets with an MSM youth group that helps young people assert their rights, deal with discrimination and understand how to protect themselves and others against HIV. All group members testify to their families now accepting them for who they are, and gradually achieving greater acceptance in their communities. Photo: International HIV/AIDS Alliance
Allahabad, India
Making government connections The Action Project has successfully created a number of ties with government health care departments, and working with the government is key to all of Alliance India’s programmes. Here, the District Programme Manager of the National Rural Health Mission speaks on International Youth Day. He articulates his commitment towards furthering the sexual reproductive health and rights of young people. Photo: Prashant Panjiar for India HIV/AIDS Alliance
Syhlet, Bangladesh
Shilla: Protecting herself and clients from HIV In Syhet, a community-based organisation, RWDO, supports marginalised young people including sex workers to learn about contraception, HIV transmission and their rights. Shilla (not her real name) has been a sex worker for four and a half years and joined a sexual and reproductive health and rights youth group a year ago. Now she knows about HIV and safe sex and she talks frankly and assertively with clients explaining how HIV is transmitted. She regularly gets tested for HIV and supports other sex workers to protect themselves. Photo: International HIV/AIDS Alliance
Imphal, India
From role-play to rock: Taking it to the streets Major Indian festivals such as Holi, Janmashtami, and Diwali provide opportunities for the Action Project to reach a wider audience. Youth members use these public holidays to collaborate with other local clubs and arrange cultural activities on the streets - with the aim of increasing awareness of sexual and reproductive health and rights. Activities have included drama and role-plays, rock concerts and World AIDS day rallies. Photo: L. Lupeshor for Social Awareness Service Organization (SASO)
Allahabad, India
Innovation: Creating platforms for youth voices South-to-south collaboration between young people has been central to the Action Project. Peer leaders from Bangladesh and India met up during an exchange in Allahabad and were able to share successes and learn from each other. As well as sharing their experiences between them young people have been taking their experiences to the wider world through social media, including Facebook. In Bangladesh, young people received training to turn their powerful personal stories into digital stories, which are reaching an international audience online. In both countries sustainable Youth Partnership Platforms (YPP) have been established, through which young people meet with key leaders in the areas of health, education, media and business to identify sexual and reproductive health issues and work together to address them at community or district level. Photo: Prashant Panjiar for India HIV/AIDS Alliance
Mymensingh, Bangladesh
Rashida: Challenging attitudes Rashida is a transgender woman who has been a member of an Action Project youth group in Mymensingh for over two years. She previously experienced abuse from her family who struggled to accept her identity. “The peer leaders went to my house to talk to my parents and explain about the youth group sessions. It took a year for them to be convinced but now we talk frankly and openly. Before it was horrifying at home but now it’s changed.” Photo: International HIV/AIDS Alliance
Imphal, India
Groundbreaking curriculum Through the Action Project, and in collaboration with Manipur’s Department of Education, youth group members have organised life skill education sessions in schools. Participatory exercises engage the students and communicate the importance of sexual and reproductive health and rights. The sessions have become so popular and enriching that they have now been introduced as part of school curriculum from 6th grade onwards. Photo: Sunita Devi for Social Awareness Service Organization (SASO)
Munshiganj, Bangladesh
Lipi: Reaching rural areas through radio Every Saturday on the outskirts of Dhaka a local community radio station, Radio Bikrampur, hosts a two hour programme called Friends’ Circle, devoted to sexual and reproductive health and rights issues. With a reported audience of 300,000 it is extremely popular with young people. The show receives around 500 text messages a day from listeners, and local guests such as government officials take part in discussions on air with young people. The programme’s content is designed by HASAB, the Alliance Linking Organisation in Bangladesh, who also train young people like Lipi to become radio jockeys. Friends’ Circle motivates young people to initiate discussions about sexual health among friends and families in a culture where it is difficult to talk about it. Photo: International HIV/AIDS Alliance
Allahabad, India
Exceeding expectations Youth group members have said that they feel proud of the important role that they play in the development of their villages. And rightly so; young people have created a change in the awareness levels within communities at a scale that few believed was possible in such a short amount of time. Photo: Prashant Panjiar for India HIV/AIDS Alliance
Thanks
IN INDIA the project was led by India HIV/AIDS Alliance. Alliance India’s implementing partners were:
IN BANGLADESH the project was led by the HIV/AIDS & STD Alliance Bangladesh (HASAB). The implementing partners were: • Reliant Women Development Organization (RWDO) in Sylhet
• Health Institute for Mother and Child (MAMTA) in Allahabad and Etawa, Uttar Pradesh
• Association for Community Development (ACD) in Rajshahi
• Social Awareness Service Organisation (SASO) in Imphal East & West, Manipur
• Khulna Mukti Seba Sangstha (KMSS) in Khulna • Alliance for Cooperation and Legal Aid Bangladesh (ACLAB) in Dhaka
EUROPEAN COMMISSION The project was made possible through funding from the European Commission. The European Commission is the European Community’s executive body. Led by 27 Commissioners, the European Commission initiates proposals of legislation and acts as guardian of the Treaties. The Commission is also a manager and executor of common policies and of international trade relationships. It is responsible for the management of European Union external assistance.
For more information, please visit; http://ec.europa.eu For more information regarding the work of the Delegation in India, please visit: http://eeas.europa.eu/delegations/india Our thanks to everyone involved in this project particularly our partners, community support organisations, peer leaders and the young people.
www.aidsalliance.org
Without knowledge you’re just born here and die here, only knowing the green of the tea plantation. Rita, Syhlet, Bangladesh