Letter to the Chief Minister of Kerala

[Guest guest]

12-7-2001

From: Maitreya & Dr Jayasree A.K

To

Sri. A.K. Antony

Chief Minister

State of Kerala

Sir,

We are doing Sexual Health Intervention (ISH) Projects among different

sections of the society under the State AIDS Control Society, which is

an offshoot of the Ministry of Health. As talking about sexual health

is a taboo in the society, the Government faced a dilemma on the wake

of the onslaught of AIDS. The PHCs and CHCs are ill equipped to handle

this situation. Moreover international aid started to pour in to

contain the epidemic. Immediate action was necessary to avail it. In

that scenario, the Ministry of Health chalked out a plan to engage the

NGOs working in the sexual health area to start projects under it.

Back in 1996, we are among the very few NGOs who were ready to do it.

Now more than forty projects are working in the state. After four

years of hectic experience in the intervention projects, we are facing

an impasse in our activities. To cut through it we need first, a

patient hearing from you, then, an intervention with an understanding.

Otherwise, the sustainability of the projects and the level of

achievements gained by them will go down the drain. We could

definitely boast about the arrest of growth and containment of AIDS in

Kerala. The level of awareness among the general public is at par with

the international standards. So the necessity of intervening

positively at this juncture is the need of the hour. These are some of

the areas you have to look into:

Z The interventions are targeted among the high-risk groups,

especially sex workers and sexual minorities including gay community

(MSM). These two communities have responded to the challenge with

vigor and enthusiasm. They are the most neglected and stigmatized

groups. The sex workers are considered as criminals and gay activities

are illegal in the eye of the law. During the first years they

expected some changes in their lot but to their surprise, the projects

aimed only at the prevention of AIDS, and not their well-being, which

means they should not die of AIDS but can die by any other disease or

torture.

Though we talk a lot of enabling environment, sustainability and

delegation of project management to the primary stakeholders, the

attitude of the arms of Government, especially Police and Judiciary is

worse than ever. The sex workers are arrested daily and punished with

imprisonment. The gay community is hounded out and is detained in the

lockups. If this situation is to continue the projects started among

them is bound to fail. To fight the human rights violations the sex

workers formed an organization but this did not help them from being

arrested. The NGOs took up their case and complained to the State and

National Women's Commission, State and National Human Rights

Commission, Law Commission, Chief Justice of Kerala and the concerned

authorities at all levels.

But all fell into deaf ears. Already these two communities are losing

interest in the activities of the projects because of this neglect and

apathy from the side of authorities. Moreover, sexual health is a

touchy subject, members of one NGO, SAHAYOG, were arrested and

detained in prison for printing sex education materials in Utharanchal

and recently the members of another NGO were arrested allegedly

running a gay club in Lucknow. If it is going to be this risky the

NGOs involved will quit the efforts. It is by wooing and coaxing by

the concerned authorities the reluctant NGOs are brought into the

scenario.

If the Home Department and Health Department, under you, can't come

together and start a meaningful dialogue and develop a strategy to

cross over the difficulty, we, the people of Kerala, are going to face

the music. If the Government is going to hide behind moral double

standards for the sake of votes, not many will be left to vote in the

coming elections. The Health Department, Police, Judiciary and the

concerned NGOs should sit together and workout a successful strategy

without any delay.

Z As there is no cure or vaccine to control AIDS the only

strategy developed is the practice of safe sex. This primarily means

the use of condoms. In the initial years the distribution of free

condoms by the project staff was an integral part of the project. In

fact the rising number of distributed condoms and ensuring its use

were taken as the criterion to assess the success of the project.

Later introducing social marketing, which means to supply condoms with

reduced rate, played down this part. That was okay as it was a good

strategy to sustain the habit of using condoms.

But recently the project staffs were asked to get the condoms from the

PHCs, which supply the brand 'Nirodh'. 'Nirodh' is the official brand

of the Government, which is mandatory to be supplied by all the condom

manufacturers. But that brand has an ill reputation among the public

as 'substandard'. So asking the NGOs to supply the condoms rejected

already by the public is a useless activity. As the core of the

projects is the use of condom, if we fail in this activity, millions

of rupees are wasted and the epidemic will get out of control. So

please take initiative to supply other brands of condoms to the

project to be distributed to the public.

We know that all brands of condoms are safe and good and it is only

the popular perception that 'Nirodh' is not good; we are not

suggesting supplying highly priced condoms. But, if consensus can be

arrived that the self same condoms can be wrapped in glossy and

attractive covers, it can help to attract the users again. This can be

done without incurring much cost difference.

Z The NGOs are called project partners and in the initial years

we did feel like partners. In fact a partners forum called PFK was

formed at the out set of the projects. But now that forum is

non-functional. The forum lost its vigor as the donor agency DFID

entrusted the running of the projects to the National AIDS Control

Organisation (NACO).

But now we are being transformed into mini governmental departments.

The voluntary nature of the NGOs and its flexibility are undermined by

strict control, just because Government funds them. It is not that we

are against control, monitoring and auditing but there is now four

types of auditing, which is a waste by itself. If this number of

auditing could curb corruption, we wonder how the government bodies

remain corrupted top to bottom.

In fact the monitoring and auditing neither did not prevent corruption

nor did it allow the government bodies to act with freedom and

intelligence. This causes undue delay in sanctioning projects and the

free flow of funds at the proper time. If the Government bodies are

good, why in the first place the NGOs are necessitated? Everyone knows

that in most of the PHCs the condoms are buried in the earth to show

stipulated quotas to be distributed.

Moreover the PHC staff could not be moved to face such an emergency,

as they are ill equipped in knowledge and flexibility and they will

resist any movement to make them do things which they don't like with

their unions. This situation necessitated the active participation of

the NGOs. We, NGOs, work with trust and voluntary spirit. If you kill

it by this kind of control, the NGOs won't remain as NGOs but sub

departments of Government, as inefficient as Government Secretariat.

If it is to check paper organisation not to siphon off the funds, the

government could check the history of the organisation in the initial

stage itself. If the Government departments are not corrupt then only

you could check false organizations. Now the concerned authorities

interfere with the internal affairs of the NGOs and controls,

threatens just like police.

In the course it hampers the smooth functioning and cause much delay

in the execution of the project. If things are going to remain this

way, the active and trustworthy NGOs will leave the projects and what

you fear, the coming of paper organizations will happen. In fact, the

Government staff itself will take the initiative to form their own

organisations instead, as has happened in every other field, for

example, the irrigation, and electricity departments. The coalition of

corrupt officials, paper organizations can transcend all auditing and

scrutiny. Learn to trust the NGOs to keep them active and flexible.

Z Recently, the authorities brought a new rule that the NGOs

should contribute 10% to the project fund. The spirit of the rule is

to ensure that the NGOs should do their part. This is another idiocy.

Being an NGO means doing work voluntarily. How can anyone instill

voluntarism by making a rule? Lot of work has to be done for the

smooth functioning of the projects, which never can be accounted. Who

will value those? Here again we can see that the whole procedure is

initiated from the lack of trust.

By the rule you are forcing an NGO to write false documents to raise

the money from the project itself. What I am trying to convey, Dear

Chief Minister, is that these rules to check and monitor the

trustworthiness of the NGO is making it more false, inflexible,

incompetent and on the long run useless. After the demise of the

socialist block, all over the world the role of the NGO grew into a

different level. The United Nations singled out the participation of

the NGOs and promoted it into its developmental activities. The case

being this, the role of the NGO will increase in the coming years. So,

if for future programmes, NGO co-operation is a necessary component,

the government authorities should learn that trust is the key. They

should ensure that the autonomy, flexibility and efficiency of the

organization are kept. They should learn to respect the NGOs.

Z As the AIDS Control Society directly handles the projects, the

existing system of PHCs and CHCs are not involved and sometimes are at

loggerheads with the projects. So there should be a co-ordination in

their activities and integration is necessary. The Government arm

won't be able to do the job, so the NGOs are a necessary component.

But this situation is not well understood. The NGOs are called

partners but handled as secondary citizens. The Director of Health

Services, DMOs, Doctors of the District Hospitals and the NGOs should

act together to co-ordinate their work. District level meetings of all

these sections should be called with immediate effect to smoothen out

the differences.

We request you to take the initiative to call a meeting of the

concerned officials and NGOs in the immediate future to sort out the

above and allied problems to fight the scourge of AIDS in our state.

In good spirit and love

Maitreya & Dr Jayasree

jayasree@...

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Copies to: Minister of Health; Secretary of Health; Principal

Secretary of Health; DHS; SAPO; SMA; PFK; DGP; Chief Justice of

Kerala; SHRC; NHRC; SCW; NCW; NACO; Ministry of Health and Family

Welfare, India; DFID and Media

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Cross posting from:

aabinand

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