Introduction
The Society for Working Life was set up in 2002 with the aim to add quality and years to the life of working women through efforts at improving health conditions of the working population in a holistic manner. The society was the nodal agency in organizing the IV International Congress on Women, Work and Health in November 2005. As a result, at the Congress a unique concept Women Work Health Asia Initiative (WWHAI) has been initiated to concentrate on issues which emerged during the meet.
The recommendations of the Congress emphasized that HIV/AIDS is increasingly becoming a workplace issue. This program is in collaboration with the Embassy of Finland. International Metal Workers Federation (IMF) and South Asian Regional Development Initiative (SARDI) is providing technical support to the project. Partner organizations include NGOs, Academics, Trade Unions, Researchers and workers. A series of workshops are being organized in major cities of India. The first workshop was held at Lucknow.This workshop organized at Patna is second among the series of five workshops to be held at Hyderabad,Jamshedpur, Nagpur and Ambala.
Organizers
The second workshop at Patna was a joint effort of Azad India Foundation Kishanganj an organization based in Kishanganj district of Bihar. It was formed in the year 1998 attempting to transform its beliefs into reality. AIF work in the fields of female literacy, formal education for children, nonformal education, rural employment, income generating skills, SHG formation, community health and awareness programmes on various social issues.
The activities reach out to poor and marginalized women, adolescents and children from rural and urban areas of Kishanganj district and Manav Samajik Seva Santhan Patna an organization working with the people at grass root level spreading education, health awareness and vocational training.It gives special attention to women who are the nuclei of families. MASSES was registered in 1988 and are run by a team of enterprising and dedicated group.
Goal
The main goal of the workshop was to promote sensitivity and awareness about HIV/AIDS among women and workers in the community, organized and unorganized sectors.
Objectives of the Workshop
To understand the current status of HIV/AIDS in Bihar.
To train trainers of NGOs to carry out active training about HIV/AIDS.
To conduct HIV/AIDS training for trainers from Trade Unions for targeting and accessing workers in the unorganized and organized sector.
To network with government agencies and other nongovernmental agencies and NGO HIV/AIDS programs, accessing appropriate training and awareness creating materials like NGOs.
The Target Group
The intended beneficiaries were women and workers in community and unorganized sector.
The direct beneficiaries were: Trainers from NGOs and Trade Unions with experience in occupational health, safety and environment who were trained on HIV/AIDS issues.
DAY 1: 30th MAY 2006
Inaugural Session
The workshop was inaugurated by Shri Chandra Mohan Ray Hon'ble Minister of Health Govt of Bihar who lighted the ceremonial lamp. Ms Yuman Hussain Executive Director AIF welcomed the participants and Mrs Sunita Kaistha Secretary SWL and Ms Amita Sahay Secretary WWWHI.
In her inaugural presentation Dr. Sunita Kaistha (Sec. SWL & President. WWH I) said that she had come to Patna for the first time and was hopeful that people would realize that the talking about HIV/AIDS can only create awareness about the HIV/AIDS. She talked about the rationale dictating the choice of the target towns and expounded on the magnitude of the pandemic facing us. Sharing hard facts, she said that in India, there are more than 10 million people affected by HIV/AIDS. It is the young population, approx 35% who are among the most productive age group of 15-45, which is directly affected. It has become a serious workplace issue. It reduces the supply of labor while affecting the productivity followed by low income levels. PLHAs (People Living with aids), especially women, require
Access to Medication.
Counseling once detected with the disease.
Alternative employment
Awareness building on how to prevent the disease
Dr. Kaistha lastly emphasized upon the need for a linkage between Trade Unions, Employers, Researchers and NGOs. She felt that there should be combined sensitization and awareness programmes. While sharing her experiences she talked about the importance of cross-sharing of experiences between different stakeholders.
Ms. Amita Sahaya Secretary (WWHAI) explained the objectives and aims of the workshop and talked about how the concept of training of trainers for HIV/AIDS emerged from the recommendations of IV International Congress on Women, Work and Health which was held in New Delhi last year. She laid emphasis on the gender perspective, which is a vital component in any intervention regarding occupational health and women workers both in the organized and the unorganized sectors. It is the women who really suffer at both the work place and at home.
There is a breakdown of the women's support structure, making them highly vulnerable to physical and mental abuse. While talking about HIV/AIDS she mentioned that it is not just a serious problem confined to sex workers or migrant workers but is slowly affecting all sections of the society. Women as housewives are in the most vulnerable position. Women suffer the most as either they get infected from their husbands who go to sex workers and as sex workers themselves when they get infected from their clients who refuse to use any protection like condoms. Women in both the conditions are unable to negotiate their safety. Awareness building and consciousness building is what is required in the present scenario and it is equally important to show solidarity with such women. In the present scenario more than 40 million people are affected with HIV/AIDS .It is a global phenomenon.
Shri Trivedi Ambrish President C.F.T.U.I spoke about the role of the Trade unions and NGOs in spreading the HIV/AIDS awareness to the community and the workers. He said that it is not possible to remove all the social ills through laws and legislations .It is here the role of social workers become very important. He concluded by saying that whatever the participants learn in this workshop they should percolate the information down the lowest rungs of the society.
Shri Sheo Nandan Prasad President of MASSES also spoke about the need for spreading awareness about HIV/AIDS in the community. He talked about the selfless service of the social workers for success of any work.
This was followed by the introduction of the participants by Mrs Amita Sahay secretary WWHI.
Introduction of the Participants by Mrs.Amita Sahay
It was an innovative way of introducing participants where they were asked to introduce their colleagues. It was basically an ice-breaking exercise to familiarize all the participants for better communication. The participants introduced each other's name, area of work, job profile or designation and experience within the community. They were also asked to give their expectations from this workshop. Through this activity all the participants got to know each other and it really helped in better communication between various participants during the three days of the workshop. Shri Chandra Mohan Ray Hon'ble Minister of Health also participated in the activity.
Address by Shri Chandra Mohan Ray Hon'ble Minister of Health, Govt of Bihar
After this activity Shri Chandra Mohan Ray Hon'ble Minister of Health, Govt of Bihar addressed the participants and congratulated the organizers for holding such workshop in Patna. He said that spreading HIV/AIDS awareness is the biggest challenge of the present government. This has to be tackled by NGOs, Government, trade unions and all the other agencies together. He also spoke about the opening of first model blood bank in Patna.He also said that Government will look into the recommendations which come out of this workshop positively.
The session ended by the vote of thanks by Mrs Sarita Sahay, treasurer, MASSES.
Technical Session I
Presentation by Mr. Gautam Dey Project Manager HIV/AIDS Bihar Voluntary Health Association
Mr. Gautam Dey spoke about the activities of BVHA in Bihar.BVHA is running many projects in various districts .It is running one HIV/AIDS awareness project in Raxaul near Nepal border. He spoke about the challenges and difficulties faced by the social workers while disseminating the information to the community.
Activity I
Filling up of Questionnaire at the Workshop
The participants were given pre-test questionnaires for filling which had questions on HIV/AIDS. This questionnaire was meant to assess the information level of the participants regarding this disease. The questions were like: what do you know about HIV/AIDS? List the modes of transmission, why it is a workers concern? Etc.This activity was followed by Presentation by Dr Gitanjali Kumari (BSACS).
Presentation by Dr Gitanjali Kumari Additional Project Director Bihar State AIDS Control Society.
Dr Gitanjali Kumari gave an overview about HIV/AIDS in Bihar. According to her first case of HIV was detected in 1992 in Bihar. There are 70 reported deaths from AIDS in the state. However most people die from opportunistic infections like T.B, viral infections and Hepatitis B which makes the body weak. She gave general information about the spread, causes and symptoms of HIV virus. She said that two ART centres are being opened at Patna and Muzzafarpur.
There are 63 VCTC centres, 44 PPTC centres and 51 STD clinics .A community care centre is functioning at Nazareth Hospital Mokama.A state of art model blood bank is being opened at Patna .There is a provision of opening blood bank in 27 district hospitals. She said that the timely treatment of OIS is important to enhance the life of HIV patients.BSACS is also implementing school AIDS education programme where 2805 schools are covered so far. She also gave information about different government schemes for the treatment of HIV/AIDS patients which will start from 1July 2006.
Technical Session -II
Activity - II
Group activity on communication skills with Dr Diwakar Tijaswi
This activity aimed to identify needs to equip trainers with knowledge and skills to facilitate interactions with workers and community level to deal with HIV/AIDS. The purpose was to make use of the information received during workshop and practice notes taking and presentation of group work. The participants were divided in three groups -ART, VCTC and NACO and each group were given cases - Dealing with an HIV+ person and Conducting an education and awareness raising session with workers. They were asked to present role play. All the groups presented their role-plays which were commented by Dr Diwakar Tijaswi.
Presentation by Dr Diwakar Tijaswi Director, Regional AIDS Training Centre and Network in India, Patna
Dr Diwakar Tijaswi spoke about the activities of RATNEI in Bihar. According to him RATNEI has a multi level training program focused at different levels starting from the State Level which is meant for the doctors, Medical officers, senior members of NGOs, District Level which is meant for paramedical staff/middle level health workers from NGOs and finally at the Village Level for the general population where the training is provided to the grass-root people including adolescent boys and girls.Dr Tijaswi gave comprehensive information about the spread and growth of HIV virus.
He defined AIDS as
A- Awareness
I- Intervention
D- Drugs
S - Support and Care
He further said that if there are more than 5% cases in any area it will be considered as high prevalence district. Lack of awareness, illiteracy, poverty, substance abuse, unscreened blood and large scale migration are the main causes of spread of the disease. In 55% of children there is no possibility of transmission of HIV virus from their mother where as in 45% children there is possibility of HIV transmission. There is three months window period for the growth of HIV virus. He also talked about Western Blot and ELISA test for HIV testing.
Activity - III
Learning together - a Game facilitated by Dr Diwakar Tijaswi
In this activity a bowl containing questions on HIV/AIDS were circulated among the participants and they were asked to answer questions. The other participants were asked to add to the information. The main objective of this activity was to bring out the collective of the group and promote sharing of knowledge.
The focus was on different ways of facts presention. This game aimed to create friendly atmosphere and working in groups. The questions were like HIV can be cured, why it's a worker's concern, how do people get infected with HIV, why is HIV epidemic considered so serious etc? The participants answered the questions and wherever there was any confusion Dr Diwakar Tijaswi clarified the doubts.
Activity - IV
Screening of Film on HIV/AIDS -A workplace issue.
The participants were shown a film on HIV/AIDS a workplace issue sponsored by International Labour Organization. This film depicted the life of workers and how they are socio-economically affected once they are infected with HIV. It also had interviews with HIV+ persons who are leading their lives with dignity.
The film also showed that sexual contact is not the only cause for the disease sometimes people get infected due to other reasons like infected blood transfusion. This film was an eye-opener for the participants. Then participants put forward their views regarding the film.
The Day I ended with the summarization of days activities by Mrs Vandana Sinha secretary of MASSES.
DAY-II: 31st May 2006
The second day began with a brief recap of first day's activities by the participants. DAY-II: 31st May 2006
Technical Session III
Presentation by Mr. Ashok Priyadarshi Advocate and associated with Human Rights Law Network on Legal and Ethical issues related HIV/AIDS
Mr. Ashok Priyadarshi spoke about the legal issues associated with HIV/AIDS. He defined LAW as L- Let, A- All; W- Work. He led an interactive session with the participants asking them questions like what is the need for a law. According to him there are more than 50,000 people infected with HIV/AIDS in Bihar. In the last few years with the development of ARV drugs HIV is seen as chronic manageable disease. The right to treatment and health vis-Ã -vis introduction of ARV drugs /ART facilities within the state of Bihar for the persons and others who are infected with HIV under the aegis of violation of their fundamental right to life and equality under articles 21,21A and 14 of the Indian Constitution.
Mr Priyadarshi said that discrimination is one of the most significant human right abuses individuals and communities faces with respect to HIV/AIDS. It includes denial of right of employment, denial of right to marry, denial of treatment, arbitrary HIV testing, right to privacy etc.The concept of informed consent is not fully developed in India. There are several problems like lack of counseling, availability of ARV drugs, lack of adequate testing centres, inadequate CD4 machines etc.In the end he said that in the present scenario the existing laws do not restrain an infected person from leading a normal life surely with a caution that the immunity carried by the infected person does not spread.
Presentation by Dr.Md Jawaid Former Minister of State, Govt of Bihar on social responsibility as a citizen while dealing with HIV/AIDS.
Dr Md Jawaid spoke about AIDS as a social issue. It is a responsibility of every citizen to spread awareness about the disease. The need of the hour is to involve local PRIs and elected bodies who can influence the people .Since no cure has been found information is the only solution preventing the spread of the disease. He said that after the workshop the participants should go back and spread the message in the community. They should involve respected village elders and religious leaders also to get wider acceptance.
Presentation by Dr Diwakar Tijaswi RATNEI on management and monitoring of HIV infection
Dr Diwakar Tijaswi spoke about the management and monitoring of HIV infection. HIV destroys a certain kind of blood cells--CD4+ T cells (helper cells)--which are crucial to the normal function of the human immune system. In fact, loss of these cells in people with HIV is an extremely powerful predictor of the development of AIDS. He said that more than 70% of the people infected with HIV are likely to get TB.The high risk countries are India, Russia, China, Ethopia and Nigeria which are sitting on HIV/AIDS pandemic. He also gave information about mother to child transmission and if a person doctor or nurse accidentally jabs himself with needle infected with HIV, he should be given Niverapin.
Films on HIV/AIDS awareness -BSACS
A short film on the spreading HIV/AIDS awareness was screened in which different themes taken up.The participants were presented their views on the subject matter and way the messages were put across the audiences. There was an interactive session on the efficacy of media as strong communication tool within the participants.
Activity - V
Building Legal, Medical and Ethical perspectives and understanding of the Participants facilitated by Dr Diwakar Tijaswi and Mr. Ashok Priyadarshi
The main objective of this activity was to build the legal, medical and ethical perspectives and understanding of the participants and to understand the issue of HIV/AIDS at the workplace. The participants were divided into three groups .Each group was given one scenario to enact and answer the questions related to the case study. The time was 30 minutes.
Each group presented their views through role-play. In the end Dr Tijaswi and Mr. Priyadarshi commented on the presentations.
Experience sharing by PLWHA
Mr. Kailash Bhagat member of Indian network for people living with HIV/AIDS and HIV + himself shared his experiences with the participants. He said that he became infected in 1998 and in anger and depression he infected two persons. He also shared how people affected with HIV/AIDS are discriminated at all levels in the society. He had gone for tooth extraction in the hospital .When the doctors came to know his status they refused to do it. So he had to get it done by hiding his status. According to him 10-15 persons get infected every day at Patna junction. He said that nobody writes about the agonizing death of the AIDS patient. His experience revealed that people including doctors are biased towards PLWHA due lack of awareness.Mr Kailash then answered the questions and queries of the participants.
Field Visit
The field visit was a very important component of the workshop as it provided an opportunity to the participants to interact with the workers in both organized and unorganized sectors. Accordingly post lunch the participants were divided in three groups .They were taken to three different organizations- Automobile Union, Maurya hotel Union and Charkha Samiti to interact with the workers on the issues related to the HIV/AIDS. The main objective was to assess their level of awareness and to provide first hand experience of talking about the disease in the community and workers.
Presentation by Mr. Amrendra Prasad and Mr. Nand Kumar Chaube on Yoga and HIV/AIDS Post tea session saw presentation by Mr. Amrendra Prasad who talked about controlling HIV with yoga. He spoke about different Asanas through which HIV+ person can keep himself fit and prolong his life.Mr Nand Kumar gave live display of the Asana and Yog Mudras.Participants found the presentation very innovative as it presented a totally different aspect of combating the disease.
The Day II ended with summery of day's activity by Mrs. Vandana Sinha secretary MASSES.
DAY-III: 1st June 2006
Activity - VI
The third day began with the presentations of field trip of different groups. The group which had gone to Automobile union presented that they got full support from the president of the Union .The members asked several questions regarding the spread of the disease from ape to humans, availability of the drug, difference between HIV and AIDS, how to insure that the girl/boy one is marrying is not HIV infected .The second group had interacted with the hotel Maurya trade union members. Hotels' employees were not very cooperative and refused to answer many questions. The third group had interacted with the anganbari sevikas of Charkha samiti.They were very open about the issues concerning HIV/AIDS. They also suggested that there should be regular training of anganbari sevikas so that they can talk about the disease in the villages at the grass-root level.
Technical Session IV
Presentation by Prof Arif Ali Head Dept of Bio-Technology, Provost Jamia Milia Islamiya on HIV/AIDS technical information.
Prof Arif Ali gave information about the growth and spread of HIV virus within human body. He spoke about anatomy of HIV virus and its replication and mutation in human body. He gave information about AZT which is common drug available for the treatment. He said that women are more vulnerable then men and it is the young productive population which gets affected more. He gave answers to several questions like can you tell whether a person is infected with HIV/AIDS, are there other ways to avoid getting HIV, are some people at greater risk of HIV infection, how can I reduce my risk of having HIV/AIDS. He also spoke about infection during pregnancy, child birth and breast feeding.
Activity - VII
Why HIV/AIDS is a workplace issue facilitated by Mr. Ashok Priyadarshi and Mrs Yuman Hussain
The main objective behind this activity was to understand the issue of HIV/AID at the workplace. The participants were divided into three groups .Each group was given one role play which they were asked to act .The situations were based in workplace and in the community. After the group presentation Mr. Ashok Priyadarshi gave his comments .He said that one should not hate, insult or make the HIV+ person vulnerable to discrimination. He explained that one should not have to tell everyone .The choice lies with the patient how and to whom he wants to disclose his status. One has to learn to live with it without isolating him/herself from the society.
Open Session with Resource Persons
Post lunch saw open session where Dr Gitanjali Kumari BSACS,Mr Rajan Varma BSACS,Dr Diwakar Tijaswi and Mr. Arif Ali and Mr. Ashok Pridarshi participated. In this session participants asked several questions from the resource persons.Dr Gitajali gave analysis of the pre-test questionnaire and clarified many doubts lingering in the minds of the participants.Mr Ashok Priyadarshi answered legal questions.Mr Rajan Varma gave information about the funding for the projects by BSACS.
Activity - VIII
Workshop Review and Recommendations with Mrs Sunita Kaistha and Mrs Amita Sahaya. This main aims of this activity were to
To discuss the outcome of the workshop.
To assess the effectiveness of the workshop.
To suggest improvements for the future activities
This individual activity raised certain questions about the methodology and follow-up work of the workshop. The participants were asked to give their opinion whether this workshop fulfilled its goal of follow up work which will be done at community and union level.
This was again a very interactive session with different viewpoints being put forward. Some recommendations which came up during the discussion :
Training of SHG members on HIV/AIDS.
Training of Anganbari Sevika after every six months.
Sharing of information and resources between NGOs and Trade Unions.
Networking with the Govt officials for better services like free medicines and more testing centres.
Special provision for testing at block level.
Valedictory Session
At the Valedictory session Dr U.C Tripathi Director State Institute of Health and Family Welfare Patna was the chief guest. He distributed certificates to the participants .In his speech he said that this workshop on HIV/AIDS awareness for the NGO workers and trade union members would very useful when they will work at grass-root level. He praised the efforts of the organizers Azad India Foundation and MASSES for bringing people from different sections of the society together for generating awareness. He also gave brief information about various new government schemes in the health sector which will be beneficial for the people.
The workshop ended with Mrs. Sunita Kaistha, who briefly recapitulated the three days sessions and hoped that participants would use the information and communication skills developed in this workshop in their respective work areas for spreading awareness about HIV/AIDS. She also hoped that long-lasting partnerships between NGOs, and trade unions would lead to the success of this project.
Mrs Yuman Hussain then thanked the participants and resource persons for their support and total involvement in the workshop.
List of the Participants
Mr .Pervez Raza
Azad India Foundation
Kishanganj
Mr Qamruzzaman
Azad India Foundation
Kishanganj
Mr Kaisar Alam
Azad India Foundation
Kishanganj
Mr Akhil Prasoon
Azad India Foundation
Kishanganj
Ms Bandana Kumari
Madhubani
Ms Sakshi Sri
Madhubani
Ms Shweta Jha
Madhubani
Kumari Sarita
Hajipur
Ms Mala Choudhary
Madhubani
Ms Indu Chaudhari
Hajipur
Ms.Pratima Kumari
Muzzafarpur
Ms Kumari Geeta
Vaishali
Mr Anil P Sirivastava
C.F.T.U.I
Patna
Mr Anil Das
HMS
Madhubani
Mr. Kailash Bhagat
BNP+
Patna
Mrs Sunita Kaistha
Secretary SWL
New Delhi
Mrs Amita Sahay
Secretary WWHI
New Delhi
Mr Pradeep K Sinha
Principal Advisor
Manav Samajik Seva Sansthan
Patna
Mrs Yuman Hussain
Executive Director
Azad India Foundation
Kishanganj
Dr Diwakar Tijaswi
Director
RATNEI
Patna
Mr Sanjay Singh
Program Associate
Population Foundation for India
Patna
Dr Gitanjali Kumari
Additional Project Director
BSACS
Patna
Mr Rajan Varma
Joint Project Director
BSACS
Patna
Mr. Ashok Pridarshi
Advocate
Patna High Court
Ms.Kalyani
Advocate
Patna
Dr Md Jawaid
Kishanganj
Mrs Vandana Sinha
Secretary
MASSES
Mrs. Sarita Sahay
Treasurer
MASSES
Dr U.C Tripathi
Director State Institute of Health and Family Welfare
Patna
Prof Arif Ali
Head Dept of Bio-Technology,
Provost Jamia Milia Islamiya
Mr Amrish Trivedi
President
C.F.T.U.I
Mr. Sheo Nandan Prasad
President
MASSES
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