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Indian Health Organisation's 'Project Saheli' for Sex Workers

A Replicable Model
By Dr. I. S. Gilada

With 14 years experience of innovative IEC approaches from street–corner meets to the World Congress, health care and support services, targeted intervention, NGO networking and training, Indian Health Organisation (IHO) has been described as a torch–bearer and watch–dog in the AIDS control efforts in India and the Asian continent.


Sustainability of any NGO is crucial and depends on its philosophy, achievements, and wider acceptability and focused approach, for which financial support needs to be guaranteed.

Indian Health Organisation, a non–profit, apolitical and secular NGO with 19 branches in 8 states has whipped up an unparalleled campaign to provide succor and hope to the poor and hapless.

IHO has been spearheading the fight against child prostitution since 1982 and HIV/AIDS ever since it started India’s first AIDS awareness campaign in 1985. Indian Health Organisation is uniquely positioned to understand dynamics of these issues, accurately predict their socioeconomic fallout and intervene effectively.

Indian Health Organisation – Project Saheli
The Saheli Project, a peer education model for the prevention and control of HIV/AIDS among the sex workers (SWs), has been internationally acclaimed as the “BOMBAY MODEL” for HIV prevention at the 9th International AIDS Conference held in Berlin, Germany in June 1993. Initiated in 1991, this project covers 5500 casual sex workers (CSWs) in Bombay and 3500 in Pune.

Objectives
  1. To educate casual sex worker (CSWs) on HIV/AIDS and STDs.
  2. To systematically distribute condoms to CSWs and ascertain usage.
  3. To teach CSWs client negotiation techniques for use of safer sex.
  4. To empower CSWs to run the program to make it cost–effective and sustainable.
  5. To provide health care to SWs, network for referrals, options for free/confidential HIV testing.
Components
After evaluating various approaches for condom promotion like social marketing, door–to–door vending, we opted for the "Peer education" model for our work among the SWs. The need for their empowerment, adequately supported by STD/AIDS education is vital. The organization of prostitution is multi–layered and the casual sex worker (CSW) is at the lowest end of scale lorded over by brothel managers and brothel owners.

To intervene effectively, we had to influence the entire hierarchy, with a final goal to empower CSWs to change their destiny. We have a three–tier system of peer leaders: Saheli (friend) from CSWs for 25 girls, A Tai (sister) from the brothel managers for 10 sahelies, Bai (mother) from the brothel owners for each major area.
Saheli: Rs.150/– p.m. for 1 hour daily time.
TAI: Rs.700/– p.m. for part time & Rs.1500/– p.m. for full time work.
BAI: Being usually an influential & affluent lady from their community, we do not pay nor does she expects monetary compensation.


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