Denial, Stigma and Discrimination should be addressed at all levels, we do have manuals, guidelines which are yet to be disseminated or taught to health care providers and people working in the development sector. In fact I know a gentleman who holds a high post in one of the national/international organization working to eradicate poverty and illnesses like Malaria, Tuberculosis, HIV&AIDS etc. who goes and washes his hand in disinfectant when he shakes hand with PLHIVs, this particular gentleman also holds a hanky on his mouth and nose when he goes to MALI SAHI (the only brothel in Orissa), and runs as soon as his organizations event is completed. However this particular gentleman can provide you with textbook definition of each and every issue without imbibing what he speaks within his work or activity or his life style. So I think for us there is a need for us to address all the three, denial, stigma and discrimination separately and at all levels.
We do have only a handful of professionals who seriously try to address issues on DSD, in fact in Orissa only CBOs like Sakha, KNP+, and NGOs like Aruna have been conducting workshops and meetings to address issues related to DSD, starting right from the community level to the State level, however to prevent DSD we do need to collaborate with larger National and International Organizations as well as Government.
Rarely is our focus on establishing quality checks in service delivery mechanisms, or project related activities, because quality checks could be the best way to combat DSD. Our achievements are primarily counted through numbers for e.g Number of STD clinics established, Number of Doctors available, Number of trainings held. Qualitative indicators are rarely included or looked for by donor organizations.
Our MIS fails to include any qualitative indicators. There is a need for us to establish quality checks, and seriously address these through activities and initiatives. Grievance mechanisms need to be established to address clients’ discomfiture or needs of the clients. These grievance mechanisms should be separate, not a part of the existing system.
I am glad that Bismita has talked about Denial Stigma and Discrimination, this is something we need to address especially in the state of Orissa where we are yet to go beyond Targeted Intervention Programme, and address issues pertaining to the rights and dignity of People Living with HIV&AIDS.
I am waiting for Rashmita to speak out, SPEAK UP RASHMITA We love to hear your voice and your ideas.
Sarita
Saturday, April 11, 2009
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Thanks madam for waking me up from a long sleep. I had accompanied to dr Bismita during most of the visits to health providers. Whereever we have gone, we got such a respond like they are favouring us. They have very strong stigma & discrimination relating to SRH. Sometimes I become revolutionary for all these things.
To my experience, Most of the doctors feel that they know many things & what's more this social sector professional can teach them.They tell very bluntly that they can give at best 02 hours in a day. They emphasized on delicious food arrangement in a good hotel, expensive kit with a good honorarium to each partcipant. I just thought that if starting is like this, then what will be the end. we can address them in their review meeting or IMA's seminar where about 60-70 doctors will be there. Again, I doubt about it's quality.
However, we are planning to provide a qualitative training with optimistic thoughts. But training is not enough. Strong Community mobilisation & advocacy also play a crucial role for getting a qualitative services & also to reduce the level of stigma & discrimination.
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