Lessons Learned

I have learnt that a child who comes depressed will one day put a smile on its face. A hug goes a long way. It is not about just talking, it’s about love – love from the support group leaders – it’s about being in a family and having something to look forward to. –Mrs. Sarojini , Headmistress.

Being HIV positive does not have to be a disability. These children are full of life, multi-talented. Sometimes they are wise beyond their years. –Mr. Thushar, Dance Master.

Meaningful involvement of children in projects that affect them helps ensure the effectiveness and sustainability of projects. Great things can be achieved from humble beginnings. One does not need a lot of money to offer the service of psychosocial support. Ordinary people with a dream really can make a difference and make their dream a reality. It seems that most of the implementers, when asked about the “lessons learnt”, wanted to share that their greatest lesson was that “There really was hope for these children”. Working in the support groups has changed their lives too. It is important to follow protocol carefully, especially when dealing with children. The organisation is now benefiting from the initial hard work of setting up transparent reporting systems and liasing with Officials, thereby ensuring trust amongst the stakeholders.

The connection with Chicalim cottage Hospital has been a particular source of strengthened continuity, particularly due to the availability of trained health professionals able to participate in the project when needed. An important feature of the project is its management by local people. The majority of members are either HIV-positive or are directly affected in some way by the virus – for example, having had a family member who died of AIDS.

Dependence on overseas donors and recognised medical staff is far from ideal. Yet the area is a poor one, and there are few options for greater resource mobilisation locally or nationally .As yet, the project has not been successful in enlisting the active support of local volunteers or village health workers (passive support or tacit acceptance, however, essential to the project’s work. The volunteers are from a good background and they don’t expect any regular salary now. The project does not have the financial resources to provide any such payment, and this lack of involvement has resulted in less community participation than might otherwise be possible. A promising sign is that, while the leaders are not inclined to talk publicly about HIV/AIDS, many of their children attend meetings arranged by the project.

Faced with the problem of providing information in an area of low literacy, the project has chosen three forms of communication that are most cost-effective: Meetings, dance, and – sports. The creation of dance team for young people appears to be a highly effective way of getting public attention in a place where over half the population is under the age of 20.

HIV testing and counselling on an on going basis can reduce risk behaviours. Such one-on-one intervention is relatively expensive in physical, human, and financial terms. For this reason, it is feasible for focused use in specific groups, but less so as a prevention measure for large populations.

“Individual counselling and testing approaches to HIV prevention can bring about behaviour change. It was found that on going counselling that reinforced desired behaviours and aimed at sustaining those changes over time did have a positive outcome with a large proportion of the children. However, counselling and testing, which provides information about HIV transmission and sero status, is not sufficient for changing behaviour for the majority of the individuals seen. Social and cultural factors, such as poverty, lack of access to health, low self-efficacy of most women, and belonging to marginalised or stigmatised communities make it difficult for individuals to fulfil the intention to change behaviour. The ultimate goal of HIV prevention efforts must also focus on efforts to change the behaviours and norms of entire communities.”

Project staff agree that women volunteers are highly interested and effective participants. Women in their communities are willing to confide important issues regarding HIV/AIDS that they would never raise with their husband. Females also play a critical role in reaching out to and educating teenage girls, who in Goa are considerably more likely to be infected with HIV/AIDS than boys of their own age. (The numbers balance out as they grow older.)