For my internship, I worked in Vijayawada, India for an organization called Vasavya Mahila Mandali (VMM). This non-governmental organization is dedicated to empowering poor women and children in the state of Andhra Pradesh by providing vocational training, income generation, educational sponsorship, and shelters for battered women and street children. VMM has also recently started working to provide services to families affected by HIV/AIDS, with a focus on children and women who are affected.

The state of Andhra Pradesh is now a high prevalent state for HIV, with more than two percent of the general population being infected. The Clinton Foundation recently launched its Pediatric AIDS Initiative in India, providing health, nutritional, and educational support to children with AIDS. VMM is a lead partner in the Pediatric AIDS Initiative, providing funding, materials, and technical support to NGO’s serving these children.

During my eleven weeks in India, I worked on a project entitled, “The Evolution of Community Driven Approaches for the Care and Support of Children Living with HIV: An Empirical Study in Andhra Pradesh.” The goal was to evaluate the services that children living with HIV are receiving, and figure out ways to fill any gaps in services through community driven initiatives. My main task was to create the data collection tools, including a questionnaire for children living with HIV/AIDS, a questionnaire for NGO and government service providers, and focus group guides for caregivers of children living with HIV. After I created and field tested the tools, I was given the opportunity to accompany staff members on site visits to observe focus groups and one-on-one interviews. I also learned how to tabulate the data and start conducting analyses.

Through my internship, I gained great hands-on experience conducting research and insight into the global HIV epidemic, namely how poverty, gender inequities, and class inequities contribute to its spread. The internship has also fueled my interest in pursuing a career in global health.

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For my internship, I worked at Durbar Mahila Samanwaya Committee (DMSC), a non-profit organization in West Bengal, India dedicated to the empowerment of all sex workers and the recognition of sex work as legitimate work. While DMSC started out in Sonagachi, the largest red light area in Kolkata, it has now expanded to include over 65,000 sex workers from all over West Bengal. Its initial projects were aimed specifically at HIV and STI prevention, and now projects include anti-trafficking initiatives, vocational training for retired sex workers and their children, cooperative banking, and more.

During my time there, I was able to work on several projects with the monitoring and evaluation staff. My main tasks were to conduct capacity building training sessions on proposal writing and research methods for evaluation. Although the staff at DMSC was very familiar with writing proposals, there were only a few key individuals who were responsible for this, and my preceptor wanted to strengthen the abilities of other staff members to write proposals for their respective projects. The staff was also familiar with process evaluation, but was eager to learn about research methods for outcome and impact evaluations, especially as they had been involved in working with outside research institutions, including UCLA. I conducted sessions 3 times per week with a group of 5-8 people to give an overview of these topics. I also edited current proposals and drafted monitoring and evaluation frameworks for several projects.

Additionally, I was involved in an evaluation of their cooperative banking program. The USHA multipurpose cooperative has existed in Sonagachi since 1995, allowing sex workers to deposit money without official papers and using a daily collection scheme. No baseline data had been collected upon program inception, but my preceptor wanted to collect data now and again in the future to track changes as the program expands. The aim was look at how the availability of this program has increased condom negotiation skills with partners and clients. I helped develop a survey instrument and a focus group guide. I conducted 3 focus groups with a translator to gain a sense of women’s current economic concerns and savings and loan behaviors, and I compiled my findings with past research and fiscal information into one report. Unfortunately, the quantitative survey had not been completed by the time my internship ended, so I was unable see what the results were.

The internship at DMSC provided me with an opportunity to be exposed to the different approaches and perspectives in HIV prevention and women’s empowerment in India and learn about the driving forces and factors behind its success. Working for DMSC gave a whole new meaning to “community based programs,” as the entire organization and all activities were lead by sex workers themselves. The women I met were inspiring and showed me the power of community organization. I consider my internship as a very positive experience that could be valuable in my future career in international health. I would like to thank the Bixby Foundation and Global Health funds for making my summer 2007 fieldwork possible.

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During my internship this summer, I spent 10 weeks in India working with 2 organizations: Urban Health Resource Center (UHRC) in New Delhi and Indore, Madhya Pradesh and Balaji Education and Medical Charitable Trust in Vadodara, Gujarat. Both organizations are dedicated to improving the lives of women and children living in urban slums.

UHRC empowers local women to organize community action groups in their slums. The women are trained to educate their community about immunizations, child health, safe delivery practices, childcare, sanitation, and hygiene. They then begin performing needs assessments, monitoring their community progress, and making connections with local politicians. I helped UHRC by documenting the work of these slum based CBOs. I interviewed the women about how they began working, how they organize themselves, and what their future goals are. These interviews will be used to create a template of how a successful slum based CBO operates. This template can then be offered to other CBOs to improve their community building projects. The success of these CBOs (and many of these CBOs were extraordinarily successful) can also be used to tout the power of local women to improve the health status of their own communities. The stories of their work were incredible. For example, one CBO used their wiles to convince the nurse assigned to immunizing the children of their community to actually do her job. The nurse had been neglecting their community. The women told her that they would send their children elsewhere to be immunized unless she agreed to immunize all of the children. The nurse acquiesced and is now actively working with their community. Furthermore, many women were thrilled at the opportunities that participating in this CBO presented them. They said that now they could go out of their houses and meet people. They felt that know they were smart, knowledgeable, and could do things to help their community. It was incredible for me to talk to these women and learn from their hands-on action. Their lives were so hard and, yet, their voices were full of hope and enthusiasm.

I also began filming a documentary of the work of these CBOs. Unfortunately, I was not able to complete it because the monsoons began. Poor timing!!

The second organization that I worked for, Balaji, organizes women’s education and children’s literacy and social skills groups free of charge in the slums, and trains village schoolteachers on the importance of gender equity. The women are taught about childcare, communication skills, child nutrition, and parenting. They also can participate in vocational skills classes, which are very popular. The children receive much needed extra tuition and participate in social skills building games and activities. During my internship, Balaji was approaching a new community with the hopes of starting a women’s group. I developed a reproductive health education plan for this women’s group. I also assisted with the children’s literacy and social skills classes. In addition, I assisted with community health and sanitation monitoring that was necessary due to the heavy monsoons. I accompanied the field workers on door to door visits in the slums assessing flood damage, illness, and sanitation concerns.

My experiences working with UHRC and Balaji were life changing. I am more inspired than ever to continue to work in international reproductive health. I am so thankful to the Bixby Program for giving me this opportunity to intern for these amazing organizations.

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Herbertpur is located in a mainly agricultural part of North India. The project at Herbertpur started in the 1980s as a response to the prevalence of village-level tuberculosis. It has slowly expanded its activities from being solely focused on health to include several development activities in 47 of the surrounding villages. Its projects include setting up self-help groups, literacy programs, adolescent sexual awareness groups, weekly medical and mobile clinics, and capacity-building among government health workers and local medical practitioners.

My time at Herbertpur can be divided into two phases. During the first phase, I became acquainted with the different projects by visiting several village self-help groups, assisting in the mobile clinics, and helping with training. I attended development-related workshops, which gave me insight on how NGOs are managed and navigate within certain national policies. I also was exposed to the language and became sensitive to cultural norms. During the second phase of my internship, I helped to evaluate one of the main community health projects, "CHASINI," an adolescent health-awareness program conducted by local peer educators. Using previously-collected data from pre and post tests, I was able to determine the efficacy of the program and provide suggestions for improvement. The evaluation will be used to refine and improve the sustainability of the health education program.

My experience in India this summer has been life-transforming. I had always dreamed of working internationally, and going to India this summer reaffirmed my interest. I learned a great deal about development work and how to address the variety of health issues in Northern India. Being able to witness the challenges, frustrations, and joys of working internationally, my eyes were opened to the reality of international health work and I am more excited than ever before about working internationally.

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