Reaching out to People Living with HIV/AIDS in India

Spring 2006

United Nations Update Population Award Laureate

Reaching Out to People Living with HIV/AIDS in India

“The doctor was very loving and only 35,000 were receiving ART. patient. It’s rare to get doctors like Weak supply systems, prohibitive him. I have a lot of respect for him. costs, and lack of information He was not only my doctor, he was about HIV treatments all con- also my counselor—he helped me tribute to this treatment gap. Even disclose my status to my wife. Thanks people who receive ART face to him, I could counsel others who ongoing challenges due to side saw my side effects and were scared effects, a dearth of treatment to start ART (antiretroviral therapy).” information in local languages, —HIV-positive client and/or lack of support on how to manage treatment regimens. menting an integrated training With the second highest number The good news is that a nation- initiative that includes establish- of people living with HIV/AIDS in al effort is underway to address ing two Continuing Education the world after South Africa, India these issues. EngenderHealth’s and Training Centers (CETCs); is facing one of its biggest public India Office is part of a diverse these will serve as model training health challenges. India accounts consortium of local Indian non- centers for the consortium for nearly 10% of the 40 million governmental organizations throughout the six states. The people living with HIV/AIDS glob- (NGOs) working to improve the centers will also provide ongoing ally and more than 60% of the quality of care and support ser- training and support to providers 7.4 million such people in the vices for people taking ART. The at all levels in the NGO sector. Asia and Pacific region. These facts project aims to increase the num- As part of this initiative, underscore the critical needs in ber of health providers who can EngenderHealth is developing India for prevention and treatment provide high-quality HIV/AIDS three comprehensive training for millions living with the disease. care and support services, in curricula in six languages. One is The current HIV/AIDS treat- accordance with the national uniquely designed for peer educa- ment situation is disheartening. treatment guidelines. The project tors who are HIV-positive and Many people living with HIV/AIDS will reach 137,000 HIV-positive who will use their treatment expe- need antiretroviral therapy (ART), people in the states hardest hit riences and skills to educate other and for those currently receiving in India by HIV/AIDS: Andhra people living with HIV/AIDS. It ART, treatment support and edu- Pradesh, Karnataka, Tamil includes guidance on how to con- cation are extremely limited. In Nadu, Maharastra, Nagaland, duct sessions with people living 2004, UNAIDS estimated that of and Manipur. with HIV/AIDS and their care- 770,000 Indians living with As a core member of the con- givers, as well as presentations and HIV/AIDS and needing treatment, sortium, EngenderHealth is imple- continued on page 4

www.engenderhealth.org EngenderHealth’s Board Gains Two New Members 440 Ninth Avenue, New York, NY 10001 1-800-564-2872 EngenderHealth is pleased to welcome two new Board members with global e-mail: [email protected] www.engenderhealth.org expertise in development and finance: Uma Lele, Ph.D., spent the past 34 years of her career at the World Bank, lead- President ing groundbreaking work evaluating global partnerships in sectors spanning the Ana Langer, M.D. environment, health, trade, and conflict. Dr. Lele has worked in Brazil, China, Board of Directors Indonesia, and many countries in Sub-Saharan Africa. Among other achieve- Stasia A. Obremskey, M.B.A., Chair Shahida Azfar, M.A., Vice Chair ments, she recently initiated philanthropic activities to empower women and Allan Rosenfield, M.D., Vice Chair girls in India. Lyman B. Brainerd, Jr., M.B.A., Ed.D., Chair, Michael Stevens, a native of England, recently retired as Executive Vice Presi- Executive Committee dent of GE Healthcare, where he was awarded the CEO Lifetime Achievement Kathleen Heitz Myers, Secretary Mary K. Stevens, Assistant Secretary Award. Mr. Stevens’s extensive career in international finance and management Leigh M. Miller, J.D., Treasurer has taken him to Southeast Asia and Eastern and Western Europe. Robert D. Petty, Assistant Treasurer Charles S. Carignan, M.D. Francine M. Coeytaux, M.P.H. Raising Awareness and Building Community Judith M. DeSarno Grant J. Donovan Support for EngenderHealth Brenda J. Drake, J.D. On January 26, EngenderHealth Board member Fran Snedeker gathered nearly Karen N. Horn Uma Lele, Ph.D. 30 guests at her home in Larchmont, New York, to spread the word about Virginia Ofosu-Amaah EngenderHealth and our work in Guinea. Two staff members from the Guinea Catherine Shevlin Pierce country office, Moustapha Diallo and Dr. Alpha Barry, captivated the audience Nafis Sadik, M.D. with stories about Guinea and about EngenderHealth’s achievements there. Frances H. Snedeker Michael Stevens The audience had numerous questions, leading to lively discussions throughout Kerstin M. Trone the evening. Cecily C. Williams, J.D. Ms. Snedeker also interviewed Mr. Diallo and EngenderHealth president Dr. Janice Hansen Zakin, M.D. Ana Langer on “Future Choices,” the cable television program that she hosts. Director Emerita “EngenderHealth—Growing Choice in Guinea and Beyond” focused on our Anne H. Howat progress toward improving health and reducing poverty in Guinea and throughout the world. It aired several times in February on local cable stations in EngenderHealth Update Staff Westchester County, New York. Terrence W. Jezowski, M.S. Vice President, Development and Marketing Lisa M. Torres Acting Manager, Development On the Congressional Front Beth D. Weinstein Director, Communications and Marketing As part of our continuing effort to increase support for EngenderHealth, Dr. Ana Theresa Kim, M.P.H. Langer and EngenderHealth staff met with Representative Nita Lowey, a Democrat Manager, Communications and Marketing representing Westchester and Rockland counties in New York for more than 16 Michael Klitsch Acting Manager, Publishing years. During the January visit, Rep. Lowey affirmed her support for global health Virginia M. Taddoni and family planning and remarked that after see- Graphics Consultant ing the impact of EngenderHealth’s work on the EngenderHealth Update is published four times a year and Notice of Annual may be reproduced without permission, provided the ground, it would be nearly impossible not to material is distributed free of charge and the publisher support this important work. Meeting and authors are acknowledged. Rep. Lowey, who has been called one of the EngenderHealth works worldwide to improve the lives of Time: 9:30 a.m. individuals by making reproductive health services safe, 50 most effective and influential members of available, and sustainable. We provide technical assistance, Date: Tuesday, June 20, 2006 training, and information, with a focus on practical solutions Congress, serves on the House Appropriations that improve services where resources are scarce. We believe Committee and is the ranking member on the Location: EngenderHealth that individuals have the right to make informed decisions 440 Ninth Avenue about their reproductive health and to receive care that Foreign Operations, Export Financing, and meets their needs. We work in partnership with govern- Helen Edey Boardroom ments, institutions, and health care professionals to make Related Programs Subcommittee. In December this right a reality. 12th Floor 2005, she introduced a bill that would repeal the © 2006 by EngenderHealth. Printed on recycled paper. New York, NY Global Gag Rule (H.R. 4465, “Global Democracy Credits: All members of EngenderHealth Illustration: J. Benston/EngenderHealth, p.1 Promotion Act”). Photo: H. Qaraman/EngenderHealth, p.3 are invited to attend. For further information, contact Ellen Witzkin at 212-561-8449.

2 www.engenderhealth.org Board Profile Fran Snedeker Reflects on Her Twin Passions—Women’s Rights and Africa

EH Update: When and how did you become involved with EngenderHealth?

FS: I got involved with reproductive health and women’s equity issues back in the 1960s as a Peace Corps volunteer. I was working in a women’s litera- cy and health program in French West Africa and learned that family planning was absolutely pivotal to women’s welfare. After the Peace Corps, I continued working in reproductive health in different organizations and served on the boards of Planned Parenthood of Houston/Southeast Texas and the National Family Planning and Reproductive Health Association. Throughout the years, I hiked in the White Fran Snedeker makes a stop at Kolaboui Health Center Mountains during the summer with EngenderHealth in Ghana. Board member Anne Howat. We would spend all of our time going up the mountain talking about Planned Parenthood and all the way down talking EH Update: What issues most drive you? about EngenderHealth. So when I moved to New FS: Women’s empowerment, women’s rights, and York in 1987, I was ready fodder for the Board! gender equity. As Board member Virginia Ofosu- Amaah says, unless we undertake that Millennium EH Update: Why did you get involved in the Development Goal first, we can forget about trying Guinea program? to achieve the other goals. Until we learn to treat women not as commodities but rather as people, FS: Because of my Peace Corps experience, I jumped we cannot hope to establish communities based on at the opportunity to travel to Guinea last summer truly democratic principles. Until the health of the with EngenderHealth. I was deeply touched by the woman is seen as a basic necessity for family life, staff’s generous hospitality, and I was overwhelmed poverty will remain at the door ready to destroy our by the depth of their devotion to their work. During dreams. Informed consent, respect for individual the visit, I witnessed a dynamic nexus—stability values, belief in the capacity of people to learn and of government, a cadre at the ministerial level to flourish—that’s what EngenderHealth is all about, committed to modernizing health care delivery isn’t it? throughout the country, and talented and visionary EngenderHealth staff—a perfect recipe for success. EH Update: You have been on EngenderHealth’s Board for 18 years and have supported us in many EH Update: What has made your experience with ways. What advice would you give to a new Board EngenderHealth unique? member if he or she wanted to get more involved?

FS: It has been an honor to work with such mission- FS: Ask questions. Read as much as possible about driven staff. The caliber of the staff is outstanding, our programs. Find the niche where you are need- both in headquarters and on every continent where ed—for me, it has been advocacy. Your subsequent EngenderHealth works. involvement will be pure joy.

www.engenderhealth.org 3 Reaching out continued handouts that can be used during in- Expanding Our Fistula Activities to Reach formal group meetings or one-on-one Rwandan Women sessions. In another manual, providers (doctors, nurses, and social workers) Women in Rwanda face signifi- In response to these critical receive training on a broad range of skills cant risks to safe motherhood due health needs, EngenderHealth has to improve their attitudes and practices to critical shortages in trained expanded its fistula-related efforts to ensure that their clients receive high- health specialists. Most women to Rwanda, to improve treatment quality care. In addition to the training give birth with the help of unskilled services there. Together with its initiative, EngenderHealth is helping its birth attendants, who often do partners, EngenderHealth is work- consortium partners to strengthen pro- not recognize danger signs. As a ing to improve treatment services viders’ skills in delivering home-based result, Rwanda is grappling with at two hospitals, focusing heavily and community-based care for people an increasing number of women on training surgical teams in fistu- living with HIV/AIDS. dying from causes related to preg- la repair and training social work- Together, the contributions of each nancy and childbirth each year ers in client counseling. member of the consortium are making a and has begun to confront the EngenderHealth is also coordi- difference in improving the well-being of harsh reality of obstetric fistula nating a newly formed Fistula an often forgotten but rapidly growing as a major public health problem. Working Group in the country, population. Discussions are also under way An injury of childbearing, an which includes all of the agencies in the EngenderHealth India Office to link obstetric fistula is a hole that (such as UNFPA) working on fis- the HIV/AIDS program with their Men As opens between the birth canal and tula in the country. The working Partners® program, to expand the capacity one or more of a woman’s internal group will ensure that individual of the HIV/AIDS network to address pre- organs, usually her bladder or rec- and collective efforts are maxi- vention more broadly by involving men. tum. Such a hole may develop mized (and duplication of efforts after several days of obstructed minimized) to address this Begun in 2005, the project will continue labor if a woman cannot obtain important reproductive health through 2010 and is made possible through timely medical help—typically, issue. a grant awarded by the Global Fund to Fight a cesarean section to relieve the HIV/AIDS, Tuberculosis, and Malaria. The pressure. The devastating conse- The activities discussed above are NGO consortium comprises EngenderHealth, quences include death for the part of a global collaborative project, the Population Foundation of India, the Indian baby and a lifetime of chronic the ACQUIRE Project, which is man- Network for People Living with HIV/AIDS, incontinence for the woman. aged by EngenderHealth. and the Confederation of Indian Industries.

Nonprofit Org. 440 Ninth Avenue U.S. Postage New York, NY 10001 PAID New York, NY In this issue: Permit No. 8170 HIV/AIDS in India New Board Members On the Congressional Front Board Profile: Fran Snedeker Fistula Activities in Rwanda