Enhancing Capacity Building of CBOs. Lessons from Humsafar Trust

[Guest guest]

Hello Members and Friends,

I have been waiting for well over a week to read an answer to complement my

first posting on how CBOs identify their problems and then work around issues

with different gate-keepers, mentors and funders functioning in different

capacities..

Now I shall write how these inherent energies, once identified, can be

encouraged and enhanced by different players. For this I have taken many inputs

from my staff, among them is our CEO Vivek Anand, our HOD Counseling Pretti

Prabhughade and our Program Coordinator Ernest Noronha along with our other

admin staff. This has taken some time and I'm going to make this as brief yet

informative as possible.

Once a CBO/NGO has identified issues and problems around which it starts

working, a totally different paradigm comes into play. Now it is no more just a

community based organization (CBO) or NGO, for it has to start learning

corporate methodologies by dissection of its various functional components to

become a successful delivery agent.

This is what happened to the Humsafar Trust in 2000 as a new millennium dawned.

We tried to prepare ourselves by organizing a consultation with 32 sexual

minority groups across India. A modest report describes how difficult the path

was going to be. Anybody wishing to read it can ask for 'Looking Into the Next

Millennium – How Can Sexual Minorities Face the Future in India'. This report

first looked at the inherent strengths and weakness of the LGBT movement in

India. It was funded by a host of private donations from our foreign " family "

like Winger and ph McCormack in the USA to SIDA, MDACS, DFID and

others. It became our guidebook to go ahead bravely into the future.

In that year something momentous happened. Knowing how we were sitting on the

cusp of a crisis, FHI stepped in with USAID-IMPACT with an intensive assessment

initiated by Bethanne Moskov, the then head of USAID in India. I still remember

Bethanne visiting sex sites along with us and shaking her head anxiously asking:

" When can you get this off the ground? " This multi-faceted woman is a huge

(literally) bundle of energy and I saw her working at close quarters in the

establishment of Avert Society, the USAID arm in Maharashtra.

But I would be failing in my duty if I did not explain the amazing way that

Family Health International (FHI) went about identifying our inherent strengths,

building them up and turning even our weaknesses into our future strengths. It

was FHI which decided that the two TIs (2,000) that had been awarded by

MDACS-NACO were just not enough to reflect any kind of evidence-based behaviors

change within the MSM sector in India.

What this means is that if there is an estimated population at high risk or

high-risk group (HRG) of X in a certain locale, it is no use just giving one or

two TIs if that does not cover even 10 per cent of the X estimated HRG.

If anybody would like to read more about the history of the emerging sexual

minorities in India, I recommend Ruth Vanitha and Saleem Kidwai's " Same Sex Love

in India – Readings from History and Literature " to see how effervescent and

culturally energetic India's homosexuals have been throughout Indian history.

The first step USAID-FHI, under its IMPACT program, took was up-scaling the MSM

project in Mumbai metro to 14 TIs, a quantum jump as it were. Simultaneously

MDACS-NACO not only gave us an STI clinic but also embedded a VCCTC within it.

This would dock the expanded outreach program to feed our clinic/VCCTC and also

link up the public health system through our understanding with the LTMG Sion

Teaching Hospital.

We are indebted to Dr.Hemangi Jerajani, HOD, Skin and Dermatology, LTMG Hospital

who sent in the first MD interns to understand the issues faced by homosexuals

and MSM. We also realised that many MSM would not feel comfortable coming to an

openly identified homosexual space and for those MSM who did not wish to come to

our VCCTC/STI clinic could utilise our services at the LTMG hospital in Sion.

Today we have 6 such referral centers in Mumbai and two in Thane District. The

public private partnerships with these hospitals started working effectively

when Humsafar Trust posted their health workers and Counselors in their referral

linkages and a two way partnership began.

To bring things on an even kneel, FHI brought in the low profile hard

task-master Sharad Malhotra, the present finance Director of FHI in the Delhi

head office. He whipped us into shape by teaching us hands-on financial

management from scratch. I still shudder at his sharp remarks on the one major

weakness of CBOs – our lack of financial management skills.

Ms. Kathleen Kay, the Country Director of FHI India sent in an international

evaluation team of epidemiologists, scientists, finance guys along with an

Indian expert, who have all become dear friends and well wishers today. What

they taught us in capacity building is still irreplaceable. – a CBO must build

upon its own strengths and make a general effort to turn its weaknesses around

by looking inwards and training its own, even if took a long time. I still

remember Lou Macullum telling us: " Look guys, it's for you to set up your

systems yourself. Don't expect to be spoon-fed like babies all the time " . That

led us to set up our own MIS which is till today our greatest strength and has

made Humsafar Trust a highly documented NGO.

The ruthless way Dr. dissected our clinical process and methods are still

in writing, whereas Senthil, a dear friend and critic even whacked our outreach

into a working army today. Thus comforting without compromise was what we got,

sympathy with support, mentoring with methodologies were Ms. Kay's contribution

that helped us in identifying first our weaknesses, converting them through

concerted action into our strengths.

In early 2002, the entire team of Humsafar Trust brainstormed for three days and

deconstructed our entire work into 11 components like Community work, Outreach

and Condom Distribution, STI Services and HIV testing facility, Care and

Support, Advocacy, Networking, BCC strategy ( IEC development and Distribution)

Research, Training and Project Management. These components were thoroughly

reviewed and set of indicators (around 100) were split into 15 formats and MIS

using excel sheets were developed. Each component was tackled through a

concerted effort from within the organization itself. Outside help was

discouraged. Today our recruitment policies, even our behavior change strategy

and our human resource policy was pushed into place by our CEO Vivek Anand

Also, it was in the second phase of the programme that we learnt how to sharpen

our vision and get back to goal oriented programmatic planning. What started as

a haphazard condom distribution program in the early 1990s become a

sophisticated social marketing instrument and daily outreach forms, describing

in detail how a 'initial contact' became a 'client' and how that 'client' would

be tracked to a clinic to be followed up, became Humsafar Trust constructs and

specialties which we have now taught to numerous others..

In the second phase of the USAID-FHI-IMPACT a whole care and support program

evolved (that was not there in our initial proposals) even as the pool of MSM we

reached out to returned through the clinic as HIV+ and sick men needing

treatment for OIs and help in hospital settings. Today the Humsafar Trust is

well equipped not only to back its positive person's group " Safe Sailors Club "

but has accessed the government rollout of ART and is dovetailed into the

layered paid treatment program of the Global Fund.

Wherever USAID-FHI-IMPACT could not possibly fund us, like in buying STI drugs,

condoms etc we were supported by MDACS. Thus our Condoms, STI drugs, HIV test

kits came from MDACS-NACO whereas USAIDS-FHI- IMPACT money paid for the doctors,

additional Lab Technicians and consumables offering our clients a holistic

treatment program. The Humsafar Trust VCCTC / STI clinic is an example of

collaborative efforts of MDACS and USAID–FHI, three agencies. Today Humsafar

Trust has trained more than two dozen doctors in medical issues around MSM.

Our own IEC materials, pre-testing the print material and bringing out high

quality behavior change material is something we have now got slightly addicted

to and will sorely miss as the IMPACT program comes to an end this year.

My advice to all CBOs and NGOs is not only do you need to strive to stand on

your feet but you have to manage support of the right funders and mentors to

hold your hand at the right time. I would like to personally say a big thank you

to Bethanne Moskov and Meri Sennit and their team in USAID, Kathleen Kay and her

team in FHI, Dr. J.V.R Prasad Rao, Dr.P.L.Joshi, Ms. Ms.Meenakshi Dutta Ghosh,

Dr. Qureshi, Sadhana Raut and the present PD of NACO, Sujata Rau, the PD and the

entire team of Goa SACS, PD Dr.Sapatnekar, Add PD Koliwad and the entire team of

Avert Society, Mr. Ashok and his team at BMGF, the Maharashtra

Director Dr. Sanjeev Singh Gaekwad and the entire team of FHI Mumbai, the team

at FPAI Mumbai and finally our first mentor, the ex PD of MDACS Dr. Alka Gogate

and the current PD Ms. Nirupa Borgess. We also take this opportunity to thank

every person who helped us during our journey and whom we may not mention this

on an everyday basis but would like to convey to

them that we are what we are because of them and their unflinching support.

Lastly it's very strange but worth mentioning that the greatest friends of us

hapless male homosexuals, infected hugely by STIs and HIV – nowhere are

prevalence rates below the critical five per cent – dying by the drove,

silently, the wives and female partners of MSM who are themselves hopelessly

unaware of their partners sexuality, our greatest friends have been women !

Whatever would we do without them?

Ashok Row Kavi

Humsafar Trust

Mumbai Metro

E-mail: arowkavi@...