SUMMARY REPORT OF LAHORE WORKSHOP

 

ON

 

DEVELOPING A FRAMEWORK FOR

OUTREACH AND COUNSELING PROTOCOL IN URDU

FOR MSM COMMUNITIES

 

November 1st – November 13th 2001

 

 

 

 

 

 

 

Workshop venue: Sunfort Hotel

                               Liberty Market

                               Lahore, Pakistan

 

 

 

 

                                       Organizers: AIDSALLIANCE, UK

                                                            AKBAR FOUNDATION, USA

                                                            VISION, PAKISTAN

 

 

 

 

 

 

 

 

 

 

 

 

 

Glossary

 

 

 

 

 

Zenanas   Identified as kothi in India and Bangladesh

 

Chava       Identified as do paratha or double decker in India and Bangladesh

 

Kokla chapati  a sport that children play

 

Pugna             a sport that children play

 

 

 

 

 

 

 

 

 

 

 

 

Summary Report of Lahore Workshop

 

 

1.      Background:

 

Vision AIDS Initiative (VAI) is a step towards developing materials on HIV/AIDS prevention that are comprehensive in nature and far reaching in scope.

 

The ministry of health in Pakistan along with UNAIDS in a recent situational and response analysis on  HIV/AIDS in Pakistan has acknowledged men who have sex with men (MSM) a high risk group within the context of HIV/AIDS.

 

VAI’s first workshop in the series of workshop is an effort to develop a process manual for the specific high risk group of MSM.

 

 

2Methodology:

 

2.1 identification/selection process of non governmental organization for the Initiative

 

The selection process of non governmental organizations (NGOs) was initiated  in February 2001 at the Population Council’s consultative meeting held in Bhurban, Pakistan to identifying the NGOs working on HIV/AIDS in Pakistan.  Vision was also a participant at the meeting.

 

At the consultative meeting Vision team got the opportunity to meet with and share work experiences with several NGO heads and representative who were working with MSM.  During the meetings three organizations were identified as possible partners in a future project that Vision may undertake at a later point.

 

The remaining one organization was selected through the UNAIDS directory of NGOs working on HIV/AIDS in Pakistan.  The directory lists the NGOs with their respective projects.

 

The NGOs selected were:

 

Names of NGOs                    City/Province                Focus          Source of ID

 

1. AWARD                               Peshawar (NWFP)         Zenanas       Bhurban

 

2. CARITAS                             Lahore(Punjab)               Eunuch        UNAIDS

 

3. DARES                                Quetta(Balochistan)        Zenanas       Bhurban

 

4. Rasti                                     Karachi(Sindh)                Youth           Bhurban

 

5. Gajar                                     Karachi(Sindh)                MSM            Bhurban

 

 

2.1.1 Process:

 

For the first two days the methodology used to facilitate the workshop mirrored the process used in the Manual for training Community workers in Maternal and Child Health (MCH) and Nutrition.”   This Manual was developed for counseling mothers for MCH by MotherCare, The Asia Foundation and partner NGOs in Pakistan. 

 

However, upon realizing the limitations of the process the methodology was changed to more self-reflective thinking and intense dialogue and interaction amongst the group on issues surrounding male-to- male sex (MSM).

  

2.2 Names of participants:

 

Following were the participants in the workshop:

 

Names of the Participants                       Organization

 

1. Maimoona Massod Khan (Ms)             AWARD

2. Nighat Kamdar (Ms)                             AWARD

3. Habiba (Ms)                                         CARITAS

4. Naveed Bhatti (Mr)                              CARITAS

5. Qamarudin (Mr)                                    DARES

6. Zia (Mr)                                                 DARES

7. Rufi Sardar (Mr)                                    RASTI

8. Imran Siddiqui (Mr)                               GAJAR

9. Faisal Javed (Mr)                                  Vision

10. Amina Kamal (Ms)                              Vision

11. Dr. Hassan Raza (Mr)                         Vision

12. Dr. Arshad (Mr)                                    Vision

 

2.3 Names of Facilitators:

 

Names                               Organization

 

Naheed Khilji (Ms)               Vision

Tahir Khilji (Mr)                    Vision

 

 

 

3. Brief Summary of workshop proceedings

 

3.1 Workshop duration: 12 days

 

3.2 Framework:

 

Issues                                                              Timeframe

 

Identity formation

Socialization processes                                

Selfesteem and self-worth                             3 days

 

Outreach protocol

Counseling                                                      3 days

 

Self-reflection

Empathy                                                         3 days

 

Community issues                                          3 days

 

(Detailed agenda-Annexure1)

 

4. Day 1 &2

 

4.1 Group assessment

The first two days were spent on assessing the group and their level of clarity on issues around MMS. 

 

Method: This was done through brainstorming on some very broad issues as listed in the agenda for the first two days. 

 

Outcome:

 

Positive:

 

·        A highly reflective group

·        Diverse group of participants covering a varied range of education and work experience.  Some of the participants were working with truck drivers and their male partners, others with Zenanas, Chavas and College boys, and some with Eunuch

·        Different participants using varied approaches in their work

 

 

 

Concerns:

 

·        Limited knowledge of participants on issues such as identity formation, and socialization processes

·        Very much socialized to mainstream thinking and drawing lines of “normalcy” and “abnormality” in their work

·        Pronounced and marked fear of stigma and being labeled in working with MSM

·        Conceptualization and implementation of exercises on the bases of previously used models and manuals

 

At the end of second day the facilitators came to the following conclusions amongst several others:

 

·        A more non-structured environment had to be make possible in the workshop for participants conducive to feeling comfortable in reflecting and sharing their experiences

·        Group needed to be de- socialized and re socialized regarding the issues of socialization and formation of identity

·        Sensitivity and empathy had to be experienced and felt by the group rather than just talking about it in abstract form

·        Participants’ fear of stigma and labeling had to be based upon their personal experiences rather than academic discussions

 

4.2 Days 3, 4, 5.

 

The facilitators took the above in consideration and strategized a different approach to the workshop.  In the following three days participants started enjoying the more casual and loosely structured environment of the workshop.  The participants started moving to spots that they felt comfortable in and sat more informally.  They moved around freely during discussions and brainstorming sessions to get tea or coffee from one corner of the room.  The changed and relaxed environment created a more holistic and experiential framework for the first part of the manual. 

 

Participants felt that manual should initially address issues around identity formation and being comfortable with self.

 

Participants were innovative and found interesting ways to talk about their own early childhood, discovery of their bodies, their socialization processes, their teens and their adulthood.

 

Facilitators interactively monitored the process, and at the end of discussions and exercises, recapped the important areas or issues that participants had reflected upon, and guided the participants to probe more into their memories.

 

4.2.1 Framework and Outline for Proposed Exercises:

 

Following three exercises were considered most effective by participant in addressing the issues around identity and self:

 

1.      Kokla Chappati (Ice breaking/getting to know each other)

2.      5 houses (Reflecting upon early childhood, adolesence, teens, growing up and finally the current situation-this also enables participants to talk about the fears they may have about themselves)

3.      Rufi’s story (identifying the different behavior and choices in life and how it impacts life as a whole)

 

All these exercises also act as tools for sharing, venting, feeling and empathizing with each other right from the beginning.

 

4.2.2 Broad areas covered in the three days:

 

·        Male to Male Sex (MMS)

·        Socialization processes

·        Identity formation

·        Stigma and taboos

·        Guilt and reaction

·        Making of self

·        Self respect and self esteem

 

4.3 Days 6, 7 & 8:

 

Participants showed keen interest in going out and meeting the MSM community on their own during these three days.  They decided that they would do this every night after the workshop session.  The facilitators provided them information on some of the common pick up points and cruising areas.  This experience of participants brought richness and lots of insight into the workshop process.

 

Participants evolved their own strategies of picking up MSM and getting picked up by MSM.

 

·        Female participants picked up massage boys

·        Male participant picked up Zenanas

·        One male participant offered himself for sex at a bus stop

 

4.3.1 Feelings and Issues that were discussed after the exercise:

 

·        Actual fear of being discovered and stigma

·        Rejection

·        Humiliation

·        Low self-esteem

·        Lack of negotiation skills

·        What would people think?

·        Insecurity of not knowing the environment

 

 

4.3.2 Emphasis on issues in the framework of the manual:

 

At the end of 8 days participants suggested that following issues have to addressed through the manual in addition to Self and identity:

 

·        Self-esteem and self-respect

·        Negotiation skills

·        Taboo, stigma and labeling

 

The facilitator during the recap highlighted how each of the above component is inter linked.

 

4.4 Proposed exercises:

 

Participants created close to 8 exercises around the above-mentioned issues::

 

1.      Cross the rope (self reflection/venting/sharing/listening)

2.      Pugna (issues around self-esteem and self-respect)

3.      Rhythm exercise (self-esteem and negotiation skills)

4.      Sing a song (self-esteem and negotiation skills)

5.      Picturing (can you use visualizing?) self (taboo, stigma and labeling)

6.      Me and others in a picture (taboo, stigma and labeling, differences and comfort with self)

7.      We are together (support and trust)

8.      Myself and me (differences and comfort with self)

 

 

4.5 Days 9, 10, 11:

 

Counseling and issues in outreach work was the topic of these three days.  Two other major issues amongst others that were exhaustively discussed by the participants were sensitivity and empathy..

 

It was felt that most MSM communities have a support systems, strong sharing and venting mechanisms that should not be disturbed by infusing anything from outside, however, the skills that needed to be included in the framework are as follows:

 

·        Understanding of empathy and distinguishing it from Sympathy

·        Trust and confidentiality

·        Listening

 

On the evening of 11th day, Vision invited some of the community members that it is working with to the workshop venue.  The invitees and the participants interacted freely with each other over a cup of tea and discussed different issues.

 

4.6 Day 12:

 

Wrap-up and final Feedback:

 

First half of the day was spent in wrapping up the workshop and final feed back from the participants. 

 

“No restrictions, no formalities, 12 days is a lot of time but time just flew.  I discovered so many things about myself.  I am taking lots of positive feelings with me.  The working environment was excellent”

 

“A great workshop, excellent facilitators and wonderful participants”

 

“A great start but a uphill task ahead of us.  A wonderful process is developed through this workshop, it would be great if we can take this further”

 

(Excerpts from the final feedback)

 

The second half of the day was focused on identifying the linguistic  challenges and as to how to dilute language when writing exercises.