Gender Sensitive HIV-TB "Are You Well" Program
Project funded by World Health Organization
Nalamdana had applied for a short term grant and was approved by World Health Organization/South-East Asia Regional Office (WHO/SEARO) to create a gender sensitive programming through participatory, innovative communication at their on going project site - the largest Government Hospital where free ART and TB treatment is given to men, women and children at Tambaram, on the outskirts of Chennai, Tamilnadu.
The Are You Well program's main objective was to: strengthen the women's component of the program by connecting the TB women's wards that are were unconnected to the cable radio; create a special gender-curriculum of messaging over the cable radio to specially address the practical and psycho social issues faced by women and include FGDs and support group meetings for women on campus; and continue with direct interpersonal counselling, which will help to empower them and bring women on par with the men receiving these programs.
The project was a unique one and helped Nalamdana create special messages and program through role plays, drama's and daily cable radio to reach newly connected wards where TB and HIV infected women were being treated on campus. This project was funded for a short term of three months (Oct - Dec 2009).
This grant not only helped connect four TB wards, where women patients were interned, but also helped the core team at Nalamdana create special tools based on collected feed back from target women, which was again made possible due to the support group meetings. A counsellor was identified and appointed exclusively to run these support group meetings which happened twice a week.
The intention of the support group meetings was to address the specific emotional issues women face and create an inclusive environment to bring them on par with men, so that they may return to their communities with the confidence and knowledge to live life positively.
Baseline questionnaire was administered to both TB & ART interned patients and based on the needs assessment from the FGD - a gender specific radio programming (including jingles & radio talk show) was developed and relayed from December, 2009 to all the connected wards.
New scripts for ART & TB role plays were created and enacted during this project period
Informant interviews conducted with Doctors, Nurses and Counsellors regarding specific case studies of women patients, helped in the development of an Audio CD containing basic info and songs on adherence for women patients.
These specially developed and delivered gender sensitive HIV-TB programs; role plays, drama scripts as well as recorded radio programs will be shared with various stakeholders such Positive Networks and women's colleges where Nalamdana holds training programs. Indeed, all programs and theatre workshops run by Nalamdana will benefit greatly from these newly created and evaluated gender-sensitive scripts.
Are You Well programming at the Government Hospital of Thoracic Medicine has been very successful in educating TB and HIV patients about proper care and in creating a nurturing environment conducive to healing. Eliminating gender disparities in health and harnessing the transformative power of art, the Gender sensitive HIV-TB Are You Well program envisions creating a hospital environment that is more than just a treatment center, but transforms into a holistic healing abode.
R.Jeevanandham, Project Director
The Nalamdana YRGCare-APLA partnership at Tambaram
A very special training manual developed by APLA and YRGCare on the psychosocial aspects of ART counseling for women, got a new avatar - with Nalamdana being funded to develop hands on creative radio messages, roving street plays and group meeting formats - to address this very special need - the psychosocial support of an HIV positive woman and her family.
This short term project ran between January and May 2010 and produced some excellent results (documentation submitted to funders and partners). Nalamdana welcomes donations to continue some of the exciting programs already developed at the same site and new sites.
Nalamdana & YRGCARE Sub Award Project
Project funded by AIDS Project Los Angeles
Nalamdana has been providing radio messaging - "Thendral" with support from Make Art Stop AIDS (MA/SA) at the Government Hospital for Thoracic Medicine - the largest HIV public hospital and ART Center treating and managing tuberculosis over several decades. Trained on using Mothers' Voices, the Nalamdana team was interested in taking forth Mothers' Voices, a psychosocial support group program into the inpatient care facility. A novel approach compared to previous interventions within the district and for outpatients, the program has brought smiles to many young and old women and to their accompanying family members.
The main objective of this project was:
To expand Mothers' Voices training among role play implementers and onsite counselors for women affected by HIV who receive services at the hospital wards.
For many persons living with HIV visiting public hospitals, the initiation of ART mandates a 14 day hospitalization to better manage common side effects to first line and second line antiretroviral therapy. Along with these PLHIV are the usual patients requiring treatment of tuberculosis and other opportunistic infections. However, long hours and hospital atmosphere, lack of friends and family support can lead to depression and anxiety. This forced hospitalization provides opportunity for healthcare personnel to address issues relating to stigma, adherence, prevention and treatment education to these patients.
During the project period, support group meetings and role play performances were held from February to May 2010 - accessible to inpatients and outpatients and their attenders.
The role plays highlighted issues of HIV awareness, mitigating stigma and dispelling myths and misconceptions; gender issues and inclusion of women in treatment access; familial and social issues faced by those affected by HIV. Nalamdana has developed this program with support from Make ART Stop AIDS (MASA) and have continued to provide such lively information and education at GHTM through weekly presentations at the ART OP unit and Female ART wards.
Patients, caregivers and care providers are drawn by the lively songs and music and stay on to listen and see the role plays as they are so similar to their own lives; the fun, the sadness, the everyday rituals, etc. They are much able to relate to the topics that are discussed in a lucid manner. At the end of the role plays, audience stay back to voice their concerns to the actors and to receive guidance and psychosocial support.
Support Group Meetings
The Support group meetings are conducted every Tuesday and Thursday for those receiving inpatient care services at the GHTM ART Female Wards. Both patients and their care givers attend these meetings. Selected sections from Mothers' Voices were used in these support group sessions. Ms. Loretta Jhona and Ms. Surekha facilitated these session. Those women who had attended earlier support groups on TB/HIV supported by WHO also actively participated in these psychosocial support groups.
Approximately 135 women attended these support group programs over a period of 4 months; twenty eight sessions brought together a cumulative number of almost 400 women. The support groups included information extracted from Mothers' Voices: gender issues, psychosocial care, health, nutrition, medication and adherence, family and caregiver information.
The participants stated that they were happy and that such programs provided space for ventilating and share their concerns and feelings with other women who faced similar trials and problems. Women patients and caregivers are informed about and invited to join the support group meetings.
Additionally, patients were also offered an audio CD to take back with them. The CD was developed as part of an earlier grant with support from MASA and WHO TB Grant and covered issues on HIV, nutrition and healthy positive living for persons living with HIV.
"After coming to this meeting I have gained new information about HIV/ART which I have never heard before. Both my parents are positive but never have they disclosed their status to me nor have they told me anything about HIV & AIDS. I am glad that I was part of this meeting and now I am confident that I can share this information to people like me who are still ignorant"
- 16 year old young woman, attender to patient of Ward No: 22
"These few hours with you, makes us forget all our worries and relax. I like the games (energizers) we play; it’s been longtime (only during my childhood) since I played. All the days I am here in this hospital, surely I will not miss the Tuesday & Thursday sessions."
- A 43 year old widow, inpatient at ART Ward No. 20.
"Crucial information on HIV/AIDS is very well conveyed through this Role-play. Depicting how women affected with HIV are treated at home and workplace is really good. Most of the scenes enacted are true and similar to what we really go through in our own life. Wish Nalamdana takes these messages to many people who are ignorant about HIV."
- 29 year old female ART patient
"More than the message part, I liked the songs in the CD very much. Some of the song I keep hearing it again and again – it was very soothing. I have also written down the lyrics of the songs and keep singing along with the CD. Thanks…"
- Female ART patient
"I have been hearing the cable radio program regularly. The songs on ART are good and my favorite one is - ART marundhu irukku chellakiliyae… which means "There is ART medicine my dear" in Tamil
R.Jeevanandham, Project Director