I just wrote a blog post on World Health Day that talked broadly about the current funding crisis for health programmes, the false arguments being provoked between AIDS programmes and other health programmes… and the basic underlying fact that, in the developing world, nearly all health problems are grossly underfunded… just that some are less underfunded than others. Anyway, my computer crashed and it all disappeared and I can’t redo it. Hey ho.
It also talked a little bit about “practice”, and the general lack of attention to good, evidence based practice in HIV prevention programmes. One of the most important principles is to support people to develop their own solutions rather than dictating to them what they should do.
So sticking to the theme, I’ve dug up this poster, which describes a workshop a few years ago during which sex worker associations, in Madagascar, developed some materials to support their HIV, health and human rights work. To my mind this is still one of the most useful activities I’ve had the privilege of being involved with. In AIDS programmes, big bucks are spent on developing “perfect” messages to inform people about the risks of HIV and how to prevent it. Often, these messages overlook the tricky issues about sex and vulnerability and focus instead on anodyne, detached messages. In many countries you see crowds of people wearing red-ribbon t-shirts, without much of an idea of what might make them vulnerable to HIV and what to do about it.
But, as this meeting showed, if you get the people most concerned to decide what sorts of messages and materials they need – and what they don’t need – the results are quite different. The group did produce some health promotion materials, but also produced a number of materials aimed at changing the attitudes of the police and of health care providers who, they argued, had quite a big influence on their ability to protect themselves and to get treatment for STIs and HIV. They also argued, compellingly, that the materials aimed at sex workers should talk not just about health, but also about stigma, human rights, and how to avoid and address violence.
The poster gives a quick summary and a few nice pics… I’m happy to provide more information to anyone who needs it!
Please note also the acknowledgements – this work was carried out jointly by International HIV/AIDS Alliance and by FIMIZORE, the malagasy network of sex worker associations.
You can also find tips on how to facilitate a process like this one here.