EHSAAS at SNEHA: How this NGO is enabling youth to become change-makers

Umar Khan, a peer educator with SNEHA at Dharavi

Umar Khan, a peer educator with SNEHA at Dharavi

At the end of his weekly sessions with a group of adolescents from Dharavi, Umar Khan noticed that Faisal* had taken to hanging around long after the others had left.

“I felt he had something on his mind, so I would find reasons to stay back,” says Khan, 21.

After three weeks, the 10-year-old blurted out that a neighbourhood “uncle” was giving him the bad touch — a concept that had been discussed at the sessions.

It turned out that the “uncle” abusing Faisal was a neighbour. Faisal would be left in his care at night, while his mother worked as a security guard. A widow, she struggled to make ends meet. Faisal didn’t know how to talk about his plight.

With Khan’s support, Faisal did eventually tell his mother. She got the abuser arrested.

“I know what it’s like to feel alone and vulnerable,” says Khan who was 11 when three older boys from the slums he grew up in started abusing him sexually. Raised by a single mother, he was mostly left to his own devices while she worked multiple jobs to make ends meet.

“The abusers were people I considered friends, so I was very confused and ashamed. I suffered for three years before I worked up the nerve to tell my mother,” recalls Khan.

It is this empathy that Khan brings to his role as peer educator for the Society for Nutrition, Education & Health Action (SNEHA), an NGO. Since 2013, SNEHA’s youth programme EHSAAS has reached out to 6,000 adolescents and youth between the ages of 15-24, in Mumbai’s slums.

Through theatre, sports and workshops, SNEHA focuses on rights-based education to help explain the importance of physical, sexual and reproductive health.

At 243 million, India has the largest number of adolescents in the world, comprising a third of its population. But they do not receive the due attention of government health programmes.

That needs to change. A 2012 Population Council report says that 85 per cent of young people in India lack access to sexuality education, which exposes them to risky or forced sexual activity, multiple partners, early pregnancies, even HIV.

“Unless you show youngsters how to negotiate their sexuality, you are not empowering them with skills to prevent early marriage and violence,” says Programme Director Dr Nayreen Daruwala.

Awkward topics like masturbation are discussed at the sessions, using terms youngsters employ.

“There is a lot of shame and guilt about natural bodily functions,” says Shahid Shaikh, a 19-year-old peer educator. “They don’t know whom to ask, and believe that watching porn regularly helps build a good physique”.

Shahid Shaikh, Peer Educator, SNEHA

Shahid Shaikh, Peer Educator, SNEHA

Sessions on body image are especially popular. “All the girls want to look like Katrina and the boys like Salman,” he says. To dispel popular notions of beauty, pictures of stars sans make up are shown. “We encourage them to look at their strengths and build on that, instead of worrying about skin tone or height,” says Shaikh.

A preliminary impact assessment shows encouraging signs. A 2013 survey in the slums showed that only 64 per cent of boys believed that when a girl said ‘no’ she meant it. By 2014, this had grown to 84 per cent. Knowledge of reproductive health among adolescents had risen from 44 per cent to 82 per cent, while 88 per cent showed improved gender attitudes, as against 69 per cent.

Since late 2014, SNEHA has tweaked its approach. “Given how gender inequality plays out in many subtle ways, we decided to involve the parents for a substantial attitudinal change,” says Daruwala.

She points to the case of two siblings. The girl, a TB patient, needs good nutrition, but it is the brother who gets the eggs and meat, while she is fed dal-roti. There are many such instances, says Daruwala. “With school-going children, only sons get tuitions and pocket money”.

Parents are asked to fill out forms with questions about their children, to gauge their awareness of their children’s lives. “We talk to them about communication,” says Gouri Ambekar, a programme coordinator. “What to tell children when they are going through difficult situations, and the importance of staying engaged with their kids.”

Ambekar cites the instance of a 14-year-old, whose uncle raped and impregnated her. Although her condition was visible, the girl’s mother wouldn’t take her to a doctor because she didn’t want to acknowledge what was happening. “The mother felt powerless and had no idea how to cope because it would have meant confronting the elders in the household.”

Findings apart, there are others signs of hope. Like Faisal, many children are coming forward to report instances of domestic violence and sexual abuse.

“An 11-year-old approached us recently, saying her father beat her mother,” says Sanna Meherally another programme coordinator. “The mother was reluctant to seek help, but the child insisted and brought her to the centre”. In another instance, three children sought help for a girl who was being sexually abused by an older boy.

Like Khan, many peer educators see the initiative as an opportunity to pay it forward.

“When I was 14, I was confused and helpless and felt I was worth nothing,” says Shaikh. “So I am happy that I am making a difference. Even at home I have been able to bring about a change. I convinced my father to let my sister study and wear what she likes to. It may not sound like much, but it makes a world of a difference to me.”

* Names have been changed to protect identity

This article was published in the Indian Express on 25 August 2015

Doctors say high usage of morning-after pills by Indian women a cause for concern

In a world where attention spans flicker like a cursor, romance is reduced to a roulette. Blender, Tinder, Grindr gamify intimacy into a casino for quickies. People are matched by math not the flutter of the heart. We swipe for sex at scale, and manage its `side-effects’ with the dangerous morning-after pill.

But risky ain’t sexy when it comes to deeper biology. By way of contraceptives, Indian women are spoilt for choice, be it pills, gels, injections or implants. Why then are so many of them popping the morning-after pill?

Recent data from Euromonitor International, a UK-based market intelligence firm, says the market for emergency contraceptives soared to Rs. 667 Crore between 2009 and 2014, a jump of 88%, making India the world’s third-highest consumer of emergency contraceptive pills, after the United States and China. India, the report says, is among the fastest-growing markets for these contraceptives.

Since 2005, popular brands of emergency contraceptive pills (ECP) like iPill and Unwanted 72, are being sold OTC (Over-The-Counter) across India, barring Tamil Nadu. The Centre approved the sale of a two-pack pill of 0.75 mg, a dosage widely regarded as safe, and approved by the WHO.

However, Tamil Nadu later backtracked following pressure from the police, women’s commissions and NGOs, who argued that the sale would promote free sex.

Their widespread popularity, gynecologists say, is not surprising. For one, they are marketed as cool, easy to use and private.

“I come across far too many women who use only emergency contraception”, says Dr Vijaya Sherbet, senior gynaecologist at Bengaluru’s Columbia Asia Hospital. “Easy access, OTC availability, casual sex and presumed safety are factors that promote its use”.

The impression that ECPs are safe to use is misleading and dangerous, warn experts.

“They are supposed to be taken only in an emergency but I find a lot of people pay no heed”, says Mumbai-based gynaecologist Dr. Nitin Narvekar. “When women come to me complaining of irregular menses or difficulty in conceiving, they don’t even mention that they use ECPs regularly. I find that a lot of married couples use it frequently. There are many safe birth control methods like Intra Uterine Devices (IUDs) and oral contraceptive pills that women can use, but there are myths that they cause weight gain or mothers-in-law forbid their use”.

Regular use of ECPs, on the other hand, disrupts hormonal patterns if used at the wrong time in the menstrual cycle.“ECPs contain progesterone, a hormone that makes the inner uterine lining shed itself. In my experience, the most common feature in young women who report to the emergency room with tubal pregnancies is a history of ECP use’’, adds Dr. Sherbet. “Women using ECP should seek help if their periods are delayed or irregular”.

However, there is little awareness of these side effects, and women continue to use them indiscriminately. A major reason for their popularity, experts say, lies in the conservative attitude towards sex in India. “Sexual behaviour may be changing, but talking about sex is still mired in morality issues, sadly, even among health care professionals”, says a Chennai-based gynecologist who did not wish to be identified.

Mumbai-based media professional Reena*, 25, concurs. “I went for a general health checkup about a year ago and the gynaecologist asked me if I was married. When I said I was single, she just assumed that I wasn’t sexually active. And yes, I would definitely avoid going to a gynaecologist in my neighbourhood. And because I dread the looks I would get if I discuss contraception with a doctor, I have left it entirely to my partner”.

According to a 2014 study titled Emergency Contraception – Potential for Women’s Health, there are 210 million pregnancies annually worldwide, of which 46 million end in induced abortions and 20 million in unsafe abortions. Ninety-five per cent of these abortions occur in developing countries, while 13% of the women die from unsafe abortions. This indicates a significant unmet need for contraception.

Where termination of unwanted pregnancies are a threat to women’s lives, emergency contraception has emerged an easy alternative for women whose contraception has failed or who have had unprotected sex.

However, going the way of Tamil Nadu is not the correct approach, say experts. Instead, “there is an urgent need to promote meaningful public discourse on safe sex and contraception, coupled with access to answers on questions relating to sexuality”, says Dr. Sherbet.

This article appeared in online news site The News Minute

For Indian gay men finding love online, apps are a blessing and a curse

Singles looking for love in a big city will tell you they have it hard. Dating is a drain on money and time, and romance invariably gets the short shrift in the rat race.

For gay singles, it gets that much harder, given the stigma that is widely prevalent across India, forcing a majority to stay in the closet and keep their sexual orientation a secret from families and friends. Legally too the community is in a bind. Section 377 of the IPC makes sex with persons of the same gender punishable by law.

For Anand*, coming out to his parents was the toughest battle.

“When my parents accepted me with open arms, I celebrated. I felt that had crossed the biggest hurdle”, says the Mumbai-based content writer for a news portal. “I thought I would now be free to meet and date men openly and find a companion the natural way”.

He realized just how farfetched that dream was in a matter of months.

“It is so hard to meet people when you are in a minority”, says Anand*. “I may have out-ed, but most people in the gay community have not which makes it impossible to meet anyone. You can’t exactly go out and announce that you want to date someone of the same gender”.

He eventually chose to do that online on Grindr, a dating app that a friend recommended. “I had my doubts about signing up because it’s not my scene. But now I am glad because I have found a space where I can meet likeminded people.”

Grindr, which claims to have over 69,000 average active monthly users in India, is among the most popular mobile phone apps for gay men in India.

“Grindr is successful with the gay crowd because it solves one of the biggest problems for the gay man: determining who is gay around him”, says Joel SImkhal, founder and CEO, Grindr. “Guys today are increasingly using their smartphones to connect and would prefer to meet men spontaneously who are nearby. It’s a great example of how technology is helping guys become more social.”

Some other widely used apps include Planet Romeo and Gaydar. Also popular is Tinder, which is targeted at both straight and gay communities.

The way they work is simple. The apps utilize the GPS technology on mobile phones to enable users to find interested parties. All one has to do is download the app and build a profile which shares personal details including location. The app then shows you a list of men who are in the vicinity and available to meet.

“There are options – you can meet for coffee or dinner”, says Anand*. “It shows you who is available within a 1 kilometer radius and can meet you right away.”

Pawan*, 38, a Mumbaikar working with a leading travel portal, says that using mobile apps for dating is now as routine as booking flight tickets or hotel rooms on your phone.

He calls them a kind of ‘gay Facebook’. “Largely its time pass where you are looking at photos and commenting on them but sometimes you end up having a decent conversation.”

Pawan* who returned to India from the U.S. in the late nineties used to go online under an assumed name but stopped that after he came out to his family.

“Earlier I used the apps for casual sex but now I rely on it to meet people”, he says. Men his age are hugely sought after, as they are “more well established and mature and regarded as good providers”.

Of the four relationships he has been in so far, Pawan* met three online, an approach he prefers to attending random parties.

“Gay parties are a meat market and don’t really lead to meaningful relationships”, he says. “By going online you are not leaving everything to chance entirely. You have the opportunity to check someone out and decide how to take it further”.

The risks attached are huge. Few are honest about their personal details, even lying about age, weight, qualifications and job status. Worse, incidents of extortion and robbery by men who lie about their sexual orientation online have been reported.

“On one occasion I found that a man I had invited to my place had lied about being a doctor”, says Henry*. “I felt uncomfortable and asked him to leave. He threatened to go out and tell my neighbors that I was gay unless I paid some money. I was equally aggressive and he backed down but things could have gotten out of hand”.

Sonal Giani, Advocacy Officer with The Humsafar Trust, a Mumbai-based NGO that promotes LGBT rights says they are frequently asked to intervene in such instances.

“We get the maximum complaints regarding Planet Romeo and Grindr”, says Giani. “All one needs to do to mess with someone is establish a contact with a user, get their details and create a fake profile. You hand out their details randomly and when they complain, you demand money”.

Another common trap is to agree to an intimate rendezvous and then resort to blackmail using Section 377 as a threat.

“People come to us with such complaints and we counsel them and often talk to the blackmailer as well”, says Giani.  Few want to go to the police out of fear of exposure.

Despite the risks aside, experts say the apps have opened a new world for the gay community.

“For one, you don’t feel so alone”, says prominent LGBT rights activist Harrish Iyer. “On your cellphone you can now see a gallery of pictures of people just like you around the country. You can communicate with them and share your thoughts in a private, intimate space. Imagine how empowering that must be, especially for someone in small town or rural India”.

Apart from hooking up, the dating apps are also being looked at a means of imparting messages about safe sex and HIV prevention.

“Our outreach work in the LGBT community involves telling them about the risks involved”, says Pallav Patankar, Director, HIV Services, The Humsafar Trust. “Earlier we had workers who would go to the field and impart education on the field but with more people using the Internet and dating apps and sites, we realized that there is a huge population disappearing from the physical site and meeting people online”.

The NGO now has a dedicated Internet Outreach Worker who monitors these sites and apps and messages users about HIV prevalence and safe sex practices.

As part of its advocacy, The Humsafar Trust also conducts workshops on being safe while dating online. “We offer them simple tips – don’t reveal too much information or watch out if someone uses their phone a lot during private moments as they may be filming them”, says Giani.

Patankar, however, has a word of caution for those looking for long-term happiness.

“The big pro is that a lot of people are able to access others like them anonymously. But let’s face it the relationships are mostly synthetic. You are in a bubble restricted to your phone. Unless it translates into something in the real world it means nothing”.

This article first appeared in the online news site The News Minute

How the youth of Bihar are rising to fight child marriage

Pooja Kumar was just a 10-year-old when she dropped out of school. Her father, a poor farmer from Bihar’s Gaya district, could afford to educate only one of his five children. He chose the youngest – the only son.

Pooja’s sisters were married off when they were 14, a common practice in Bihar, which along with Rajasthan, is among the states that reports the highest number of child marriages in India. The practice is illegal under the Prohibition of Child Marriage act. However, according to the most recent national survey in 2005-2006, 58% of girls marry before reaching the legal age of 18, and 74% before they are 20.

It is a fate that Pooja is determined to avoid. At 17, she is still single despite strong disapproval from some family members and some neighbours.

Pooja has taken her battle into the community as well. She is a youth leader with The Jagriti Trust, an NGO that is trying to motivate and train boys and girls from the community to get involved in local issues and become agents of change.

Through workshops they are taught to question rigid societal norms that lie behind practices like early marriage which bolster gender inequalities.

“Who says girls are born only to marry and have children?” asks Pooja at a meeting held in Vaishali district. “Look at our history, at women like Jhansi Ki Rani. All women can be Jhansi Ki Ranis and we have to help each other realize that”.

Pooja’s conviction comes at a personal cost.

“My grandmother wanted me to marry when I turned 12” she tells TNM. “I told her that if I am not mature enough to vote until I am 18, then I am not mature enough to marry either. She doesn’t talk to me anymore.”

Volunteers, Jagriti Trust

Volunteers, Jagriti Trust

Her father disapproves of her work and tries to stop her from attending meetings. “My mother believes in me but she can’t take my father on all the time.I draw strength from childhood friends who tell me that their lives ended when they married early,” she says.

Jagriti Trust has set up youth leadership councils across three districts in Bihar. Some of their members are as young as 13 years of age. They use different platforms to educate people about issues like sanitation and even family planning.

The causes they take up are sensitive, but the response in many areas has been largely positive. Some villages even have all-women councils.

“We initially faced strong opposition from village elders”, says Premnath, 19, a youth leader from Ismailpur who too came under immense pressure to marry after he finished school. “It was particularly hard to convince girls’ parents. But we were patient and they eventually came around”.



“In my experience adolescents are looking for inputs and guidance but there is no one to show them the way,’’ says Dr Rema Nanda, founder of The Jagriti Trust.“We need to equip them with the tools to question stereotypes, mobilize and become community leaders”.

This approach, of targeting boys alongside girls, is a shift away from the decades old approach of government programmes targeting girls. But over time there has been growing acknowledgement of the need to engage boys and try to change their attitude.

A 2012 UNICEF Report highlighted just how urgent the need for such an intervention is. Among other things it revealed that 54% of men in India believed that wife beating is acceptable. “Our assessments have shown that changes in behaviour are much deeper and substantial when we reach out to boys and girls at a young age” says Nanda

It is a view echoed by other experts. “Men too are victims of masculinity and patriarchy”, says Dr Nayreen Daruwala, Programme Director, Society for Nutrition, Education & Health Action (SNEHA) which runs youth empowerment programs in the slums of Mumbai. “They are under immense pressure to always be macho, strong, and virile and not show their emotions. We need to address these notions when they are young,” he says.

This article appeared in the online news site The News Minute