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ORGANIZATION: Durbar Mahila Samanwaya Committee
LOCATION: Kolkata, West Bengal, India
STUDENT: Emily Feher
YEAR: Summer 2012

This summer 2012 I completed my field studies in Kolkata, India with Durbar Mahila Samanwaya Committee (DMSC, or Durbar). My project included contributions to the XIX International AIDS Conference and an evaluation of Durbar's task sharing activities. Durbar is a community-based non-profit organization that works for the health and human rights of sex workers and other marginalized workers in West Bengal, India. Durbar is managed by a collective of over 65,000 sex workers in more than 60 sites in West Bengal, and is a model for HIV prevention and women's empowerment programs worldwide. In addition to sex workers, Durbar has expanded to include other marginalized groups where this multi-level program targets individual, community and environmental factors to reduce the marginalization and vulnerability various groups in India by empowering its members.

I was fortunate to have had the opportunity to complete my fieldwork with Durbar this summer as Durbar hosted the official international Conference Hub for the International AIDS Conference in Kolkata, India. Dubbed the "Sex Workers' Freedom Festival", this was one of the highlights of my fieldwork experience. I prepared a participant satisfaction evaluation tool and completed various internal feedback reports regarding the conference to help inform future international events and conferences hosted by Durbar. I also compiled an official conference report that will be published on Durbar's website.

Another key component of my fieldwork with Durbar was to begin an evaluation of Durbar's task sharing strategy. Task sharing is the process by which professional staff members share progressively larger proportions of essential program tasks with community staff members. Durbar's ultimate goal is to shift all authority, responsibilities and capacity to deliver the program to the community members themselves. Thus, task sharing is a critical component of Durbar to evaluate because the success of Durbar as an organization depends on the ability of sex worker or community staff to effectively manage and implement the program. Since task sharing has yet to be evaluated in any systematic fashion, my primary objective was to develop a framework, or process, to assess Durbar's task sharing strategy so that subsequent evaluators can continue with a thorough evaluation of task sharing within the context of the organization.

My field studies experience was incredibly rewarding and I learned many lessons about what I want to strive to be as a public health professional. My preceptor, Dr. Smarajit Jana, was a valuable mentor as I worked to achieve the objectives in my scope of work in a new and foreign environment. I am grateful for Bixby funding, which made this unique international opportunity possible.

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ORGANIZATION: Urban Health Resource Centre
LOCATION: Indore, India
STUDENT: Shahrzad Yavari
YEAR: Summer 2012

Urban Health Resource Centre (UHRC) is an international, nonprofit organization based in India that works towards improving quality of life, health, nutrition and wellbeing of the disadvantaged urban populations living in the slums. My project, based in the city of Indore, was focused on women's health and empowerment. The program forms women's groups in each slum and trains them to build community-based collective funds through monthly savings, to manage the funds, and to give the loans in a systematic manner. Loans are utilized for various needs among the members such as: a) maternal and child health, b) health emergencies, c) prevention of their children's school drop-outs, and d) food insecurity. The women's groups participate in health education and promotion workshops that UHRC holds periodically on topics such as reproductive/maternal and child health, nutrition, immunization, hygiene, and environmental health.

During the summer of 2012, I worked on the following 3 projects: data collection through conducting group interviews, developing health education materials, and strengthening UHRC's social media websites. My activities throughout my 10-weeks internship include the following: learn about implementation and evaluation of the women's groups program, edit proposal, conduct interviews to assess slums' conditions, collect and analyze data, write case-studies, further develop social media websites, create educational materials and organize health education workshops for women's groups. Additionally, I provided assistance in implementing events and training programs for new children's groups.

I conducted group interviews among 15 women groups using the World Health Organization (WHO) Urban Health Equity Assessment and Response Tool, to assess the urban health condition of the slums. The Health Group Information Matrix was another tool used by UHRC to evaluate the access of women's groups to ration cards and social entitlements. I organized the new collected data in the existing excel matrix, which was formed in 2009, and translated the whole document from Hindi to English. The matrix gave me an opportunity to analyze the implications of collective funds on the wellbeing of women's groups. I made weekly visits to the slums with my co-workers to conduct interviews, organize health education workshops and to oversee the collective saving efforts among the women's groups. I conducted an extensive literature review on reproductive and maternal health, and created educational materials for women's groups. I put together a "Premarital Coaching" curriculum, which covered information on puberty, pregnancy, sexual/reproductive health education, HIV/AIDS prevention, healthy relationships and family life education. My brochures and posters included topics on nutrition for iron-deficiency anemia, oral rehydration therapy, hygiene, and care during pregnancy. I also contributed to the agency's efforts to improve its social media websites to raise awareness and to advocate for women's health and empowerment in the slum communities of Indore.

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ORGANIZATION: Durbar Mahila Samanwaya Committee
LOCATION: Kolkata, West Bengal, India
STUDENT: Annie Fehrenbacher
YEAR: Summer 2011

For my summer internship, I had the opportunity to work with Durbar Mahila Samanwaya Committee, a trade union for sex workers in Kolkata, India. Durbar's mission is to enhance a process of social and political change to promote and strengthen the rights, dignity, social status, and quality of life of sex workers and their communities. Durbar operates a multi-component structural intervention that targets individual and community level risk factors that marginalize sex workers and increase their vulnerability for HIV. Durbar has been recognized by the Bill and Melinda Gates Foundation as a model for replication in HIV prevention and women's empowerment. The Durbar model now operates in more than 60 sites in West Bengal, India and is allied with sex workers' rights organizations worldwide. Although the program's initial goal was to reduce the prevalence of HIV among sex workers, it has expanded its scope to address other concerns of sex workers including structural violence, economic vulnerability, and human trafficking.

In 1998, Durbar instituted self-regulatory boards (SRBs) made up of sex workers and local stakeholders to identify cases of human trafficking and child labor in the red light districts. I had the opportunity to conduct an internal evaluation of the anti-trafficking program to assess the experiences of sex workers who serve on the SRBs. I conducted in-depth interviews with women serving on SRBs in five red light areas in Kolkata, including the Sonagachi district which is home to more than 11,000 sex workers. The objectives of my project were to gather information from board members on how the SRBs could be more effective at identifying and repatriating trafficked persons, and to document the ways in which sex work communities in Kolkata have changed since the inception of the SRBs. I also collected information about board members' own pathways to sex work and the ways in which serving as a leader in Durbar has affected their personal life and work.

The women attested to the power of the SRBs to change the social and structural landscape in the red light areas so that human trafficking would no longer be a viable practice. Additionally, the women spoke extensively about the ways in which the SRBs helped them to articulate their rights to customers, madams, and local officials seeking to take advantage of their marginalized status. Because the Durbar office is located in the middle of Sonagachi, I was able to see the women at work and observe their interactions with clients and community members on a daily basis. I was also fortunate to have the opportunity to visit several brothels, street-based worksites, and a temporary hostel for underage trafficked girls, which greatly enriched my understanding of the interview data.

Funding from the Bixby Fellowship allowed me to conduct fieldwork that is guiding my dissertation proposal on labor, migration, and gender. As a PhD student in Community Health Sciences, I am interested in community-based participatory research to empower marginalized groups and alter social perceptions of exploitative labor practices. My field placement with Durbar allowed me to see an academic-worker partnership embedded within the community that is incredibly effective at mobilizing its constituents and reshaping power structures to strengthen the autonomy of sex workers. I am immensely grateful for having the support from Bixby to pursue my research in Kolkata, and I look forward to maintaining a long-term partnership with Durbar throughout my career.

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LOCATION: New Delhi, India
STUDENT:
Melissa Pickett
YEAR: Summer 2008

I was privileged to spend the summer volunteering for Population Council (Pop Council), a well-established, international organization, renowned for its efforts to improve local capacities through research and programs in HIV/AIDS, poverty, and reproductive health.  Throughout Pop Council’s over 50 year history, it has helped the developing world achieve many health milestones, from aiding India in establishing the world’s first family planning program in 1955 to the recent creation of the International Contraceptive Access Foundation in 2004.  It spearheads research and education programs to improve reproductive health and prevent the spread of HIV/AIDS among disadvantaged populations within developing countries, and is currently working to improve health outcomes through directed programs in over 60 nations. Pop Council has earned worldwide recognition as an organization that “changes the lives and expectations of hundreds of millions of people.” (The Lancet, 7 June 2003).

As an intern in the Pop Council’s New Delhi office, I collaborated with a team of epidemiologists to determine the results of a recent cross-sectional study of healthy HIV+ men and women conducted in Mombasa, Kenya. HIV+ persons with CD4 cell counts too high to warrant antiretroviral therapy have been identified as a population that could pose a high risk of transmission to other members of their community. They are not frequenting the doctor’s office for therapy like their less healthy HIV+ counterparts, so they are harder to identify and less likely to be receiving the transmission prevention messages that others receive during doctors’ visits. The study was part of the Pop Council’s program, Prevention with Positives (PWP) that works to prevent the spread of HIV by teaching HIV+ persons the importance of always practicing safer sex methods with their sexual partners. I was given the raw dataset and the responsibility to analyze the data and determine associations between characteristics of the study population and the practice of unprotected sex. We were especially interested in the predictors for having unprotected sex with a partner of known negative HIV status or of unknown HIV status. The results of our study will be used to help community health program planners know how to identify healthy HIV positives in the community and build HIV health education programs that target the needs of this important group.

I consider my internship experience to be an invaluable addition to my scholastic efforts at UCLA. I learned firsthand about the barriers and challenges for successful HIV prevention. I gained experience in cleaning and analyzing datasets and improved my technical skills using data analysis software. I experienced the importance of well-written questionnaires and methodical data collection practices. I was able to be mentored by a team of Pop Council’s brilliant and experienced epidemiologists, who were so gracious to impart some of their hard-earned knowledge and patient guidance. Together with my preceptor, I helped prepare a manuscript for publication, so I gained knowledge of the intricacies involved with manuscript drafting and submission. My internship validated my past year of classes and showed me the applicability of the skills I have gained thus far. It also helped to reveal my strengths and weaknesses so that my last year of classes could be aimed at fine tuning my skill set and gaining the most from my time at UCLA.

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ORGANIZATION: Vasavya Mahila Mandali (VMM)
LOCATION: Vijayawada , India
STUDENT: Reema Shah
YEAR: Summer 2007

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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ORGANIZATION: Durbar Mahila Samanwaya Committee
LOCATION: Kolkata, West Bengal, India
STUDENT: Michelle Horejs
YEAR: Summer 2007

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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ORGANIZATION: Urban Health Resource Center (UHRC) in New Delhi and Indore, Madhya Pradesh and Balaji Education and Medical Charitable Trust in Vadodara, Gujarat
LOCATION: India
STUDENT: Natasha Desai
YEAR: Summer 2006

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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ORGANIZATION: Emmanuel Hospital Association (EHA) Herbertpur Christian Hospital

LOCATION: North India
STUDENT: Christina Ha
YEAR: Summer 2004

This summer I was given the opportunity to work with the Emmanuel Hospital Association (EHA) at their second largest hospital, Herbertpur Christian Hospital. EHA was founded in 1970 as an indigenous Christian health and development agency serving the people of North India in primarily focused on the poor living in rural areas. With a catchment population of nearly seven million, EHA treats more than 500,000 patients each year in some of India's most needy areas.

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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