Of Spices and Silk: Sharing stories of technical support to Global Fund grants in Asia by International HIV/AIDS Alliance

Supporting community action on AIDS in developing countries

OF SPICES AND SILK Sharing stories of technical support to Global Fund grants in Asia

The International HIV/AIDS Alliance The International HIV/AIDS Alliance (the Alliance) supports communities in developing countries to play a full and effective role in the global response to HIV and AIDS. It is a partnership of 39 Linking Organisations (national, independent, locally governed and managed NGOs) around the world that supports approximately 2,300 community organisations delivering HIV prevention, treatment and care services to just under three million people. www.aidsalliance.org

Editors and reviewers: Megan Gaventa, Maria Cecilia Millado, Jenny Berg, Greg Munro, Joydeep Sen Copy editor: Kathryn Perry Illustrations: Rebekah Thompson For further information, contact the editors of this report at mail@aidsalliance.org. © International HIV/AIDS Alliance 2012 Design by Progression Design Front cover images, clockwise from top: Clients relax at a drop-in centre which provides services for men who have sex with men (MSM) in India © Jenny Matthews for the Alliance A sex worker in Bophaleakkloun, Cambodia © Eugenie Dolberg for the Alliance A married man and MSM tells his personal story through a Photovoice project, India © Jenny Mathews/Alliance/ Photovoice project Peer educator in Viet Nam collects used needles to reduce risk to other people © Pham Hoai Thanh, SCD

Any parts of this publication may be reproduced without permission for educational and non-profit purposes if the source is acknowledged. Registered British charity number 1038860

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

INTRODUCTION Of spices and silk: sharing stories of technical support to Global Fund grants in Asia is a collection of 11 case stories reflecting the experiences of technical support providers within real-life contexts. They demonstrate the rich and sometimes complex processes and contexts in which these Global Fund grants operate.

Background The Global Fund portfolio of grants has increased dramatically over the past decade, with its value now reaching US$22.9 billion in commitments to over 151 countries. This significant amount of funding provided in country, coupled with the need to show value for money and achieve impact, has resulted in a greater degree of sophistication and, of necessity, complexity in managing grant funds for the grantees. Technical support (TS) to grantees (both government and civil society alike) has been essential in supporting and strengthening their abilities to manage, implement and report on Global Fund grants. An array of TS providers has developed from the private sector, multilaterals such as the UNAIDS technical support facilities, and civil society groupings such as the International HIV/AIDS Alliance (the Alliance) and Civil Society Action Team (CSAT). Bilateral agencies such as the German BACKUP Initiative, the US governmentâ&#x20AC;&#x2122;s Grant Management Solutions and, more recently, the French governmentâ&#x20AC;&#x2122;s 5% Initiative, have played a pivotal role in funding much-needed TS to grantees across the world. The provision of TS has evolved over recent years, incorporating a number of key lessons, including the need for more south-to-south TS, and an increasing need for localisation so that the TS is provided within the context of understanding

the local dynamics and challenges within which Global Fund grants operate. Other lessons include the need to improve the capacity of local and regional consultants, and to recognise that longer-term capacity development is ultimately more beneficial than short TS assignments. TS in this context has also emerged as a process rather than a discrete event, and the manner in which we articulate our TS should capture and share the richness inherent in these processes

Alliance Global Fund capacity development programme The Alliance supports HIV programming through regional technical support hubs based within seven Alliance Linking Organisations across the world: in the Caribbean (Jamaica), Latin America (Peru), West, North and Central Africa (Burkina Faso), Eastern and Southern Africa (Kenya), Eastern Europe and Central Asia (Ukraine), South Asia (India) and South East Asia and Pacific (Cambodia). These hubs provide TS to civil society using consultants from the region where they work. In the past three years, over 12,000 days of TS have been provided by these hubs collectively, of which 25% has been direct Global Fund grant support. Developing, supporting and maintaining a pool of skilled local and regional consultants across the hubs are critical to the success of a south-to-south model of TS support. Changing Global Fund grant architecture, the increasing importance of risk management and the need to develop enhanced and robust support systems for grantees, require an investment in developing the capacity of local consultants. In response, the Alliance, with funding from the German BACKUP Initiative and AusAID, has developed and implemented an innovative capacity development programme for consultants providing TS on Global Fundrelated issues. During eight months in 2012, a cohort of consultants from the Allianceâ&#x20AC;&#x2122;s

South Asia and South East Asia and Pacific hubs participated in a comprehensive process that included distance (online) and face-to-face training. The training included technical skills specific to the Global Fund, such as Principal Recipient management, sub-recipient and financial management, monitoring and evaluation, and CCM support. The technical aspect was complemented by training in consulting skills, addressing the essential role and tasks of a successful consultancy, organisational change, facilitation skills and the role of the consultant as a change agent. Subsequent to the training, some consultants were matched to Global Fund TS assignments where they could practise their expanded skills, and were given mentoring support from a more experienced consultant. The capacity development process culminated in a writeshop held in Bangkok in August 2012.

The writeshop A writeshop is an established methodology of documenting real-life experiences (in this case TS activities) through an intense participative process, producing documentation that is easy to understand, with the aim of identifying and sharing lessons learnt. The five-day facilitated process involves guidance and exercises in creative writing, and repeated revisions of draft case stories, with peer reviews and support from people with professional writing skills. A team of facilitators, resource people and editors guide and assist participants in the writing process. The end product is a series of case stories based on real Global Fund-related TS assignments. Like case studies, case stories focus on a particular activity or set of activities. They describe a particular problem faced by the people participating in the activity, and the processes and strategies used to address that problem. They also include reflections on challenges faced, lessons learnt and future plans.

Case stories are written as stories, not as standard reports. They are prepared in a narrative structure and use vivid description and characters, helping readers understand and learn from the situation, work done and resulting changes. Case stories are often more engaging, user friendly and accessible to a wide range of readers, making them powerful learning tools. The writeshop held in Bangkok involved a sub-set of consultants trained in the Allianceâ&#x20AC;&#x2122;s capacity development programme. It aimed to reflect on and draw out the lessons learnt from their work as consultants, and share it with others for their learning. It also built their capacity to write about their work in an engaging way that makes their intended audience want to read it! The participants were from South Asia and South East Asia, and included representatives of population groups most affected by HIV and AIDS. For all of them this was their first venture into creative writing, and many were not writing in their first language â&#x20AC;&#x201C; this must be borne in mind when reading their stories.

These are real-life experiences of Global Fund-related TS, written by local TS providers in the form of a story, with the aim of reaching the widest possible audience. The processes and real-life challenges faced in these assignments provide a rich and inspiring backdrop to the excitement of Global Fund grant implementation in Asia. Enjoy the read.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

CONTENTS 1 Grinding the seeds Grant negotiation and implementation challenges

The Frontline by Sakina Sultana Playing the peacemaker

by Veena Lakhumalani

Go for green by Carlos L Calica

2 Finding the right fit Supporting capacity development among Global Fund grantee key population groups

Sisters (and brothers) doing it for themselves – with a little help from their friends by Kevin Nicholas Baker Transcending boxes: Unity and uniformity in defining trans diversity by Zaki Arzmi YOU’RE A LEADER! by Harjyot Khosa

3 Smoothing the silk Experiences within the risk management arena

EXPECT THE UNEXPECTED by Dechen Wangmo Listen to ME: it’s not bad to be bad by Maria Cristina Vinas-Ignacio LET THE FLOWER BLOSSOM by Lasantha Kodituwakku

4 Counting the chillies Monitoring and evaluation

GREEN LIGHT by Ritu Kumar Mishra a perfect smile? by Anindita Biswas

GRINDING THE SEEDS

the frontline sakina sultana

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

When Manbira visits the frontline of a project supporting people who use drugs she knows that the sub-recipient who sent her has been forced to cut costs. Surely that won’t affect communities hundreds of miles away? Faced with exhausted outreach workers and angry clients, Manbira knows she has to look for solutions from those who know the challenges and opportunities best.

Slap! The vendor smacked the fish’s head onto his stall, while pulling out his knife. Manbira barely gave it a glance. She was used to this market. She came here every time she visited Kamalgonj to work with New Life, the community-based organisation she supported. Walking alongside Jahangir, New Life’s project manager, she stepped over the muddy water filling the holes in the road, and around the carts stacked high with vegetables. “So Jahangir, how are things going? All well in the project?” Manbira asked, after the usual exchange about the weather and her journey from Dhaka. Jahangir was slow to reply. “Apa,” he said quietly, using the respectful Bengali word for sister, “you know there have been some changes recently. Better that you see for yourself.” Manbira felt the muscles in her neck tighten. She had been looking forward to this visit – any excuse to get away from the traffic and pollution of Dhaka. She had been sent by Social Service Organization (SSO), the sub-recipient of a project designed to support people using drugs in Bangladesh. New Life had been working for years with people using drugs, and had grown to become a sub-subrecipient of the project. Manbira knew SSO had been forced to make difficult decisions about the project recently, but surely those wouldn’t affect the work here, all the way up in Kamalgonj? Manbira’s thoughts returned to three months ago, when she had visited the SSO team in Dhaka. They had been preparing the budget for Phase 2 of the project, and had stayed up late at night in the office, poring over piles of papers and endless streams of figures. But the numbers just wouldn’t add up. The project had been asked to take over eight drop-in centres previously run by the government. Plus they had to open ten new centres, trying to reach the growing numbers of people using drugs. With these additional 18 centres to run, SSO had already spent almost a quarter of its budget for Phase 2, and no more funding was on its way. No wonder these numbers didn’t add up.

With less money available per client, SSO had been forced to cut costs where they could. But surely, Manbira reflected, that wouldn’t affect New Life too much? They were at the frontline of the project, working directly with clients and communities. Decisions made in Dhaka wouldn’t make too much of a difference here, would they?

Entering Adalotpara “Apa!” Jahangir grabbed Manbira, pulling her out of the way of a passing rickshaw. They had reached their destination, Adalotpara. Home to many thousands of people, signs of life were spilling out everywhere. Buildings were crammed together, practically falling into the road. Children ran after balls and jumped over drains. Groups of women sat in front of their houses, stirring curries in shiny metal pots or braiding each other’s hair. Men were out too, standing in groups in the road, hands holding cigarettes or placed firmly on their hips. As Manbira and Jahangir walked up the road, loud voices sounded ahead. “Busy today,” Manbira murmured. Jahangir laughed, “Every day, Apa!” Manbira smiled. Of course, why was she worried? Today was just like any other day in Adalotpara.

Visiting the pusher Turning up a narrow path from the road, Jahangir led Manbira into one of the houses. Ducking her head under the curtain, she followed Jahangir into the darkness. As her eyes slowly adjusted to the light, the heavy smells of sweat, mould and monsoon rain reached her. The room was small, but crammed with furniture. The corners were stacked with newspapers and bags overflowing with empty bottles, waiting to be sold for a few taka in the market.

GRINDING THE SEEDS

the frontline sakina sultana

A man stepped out of a room at the back, and Manbira could see that the space there was even smaller and filled with bodies. “This is Nuru,” Jahangir announced. Nuru stood in the middle of the room in a crumpled shirt that did little to disguise the size of his belly. “He’s a pusher,” Jahangir murmured to Manbira. “Yes,” boomed Nuru, “there is no one who can push drugs like me. Ask them,” he added, inclining his head towards the back. “I can give injections without any pain. I was even hired by that organisation last year – you know, that group that came with the white jeeps.” “Yes,” Jahangir confirmed, “during the last serological surveillance, Nuru was hired to help take blood samples. He knows how to find the drug users’ veins better than any doctor.”

Meeting Mokhles Outside, the shouting had grown louder, so Manbira and Jahangir quickly made their excuses and emerged back into the light. “Mokhles,” Jahangir said quickly, his voice clearly concerned. Mokhles was one of New Life’s nine outreach workers. Like the rest of them, he had spent years working with drug users in Kamalgonj. He knew them, their families and their communities, and knew how to talk to them. So it was unexpected to see him now surrounded by a crowd of men who were angrily waving their arms. Manbira could see Mokhles’ hand twisted tightly around the strap of his bag, covering the logo of New Life that usually he was proud to display. As Manbira grew closer she could see the sweat dripping down his forehead. The circle of men around Mokhles was growing tighter, until Jahangir stepped in. “Mokhles,” he said reassuringly, “Apa is here.” Mokhles’ face lifted,

relieved. The men turned to look at Manbira, gradually falling silent as they noticed the embroidery detail on her salwar kameez. Manbira cleared her throat, “What’s going on? Mokhles, are you ok?” Looking at Manbira, Mokhles nodded hesitantly. Manbira turned to the others. “So, tell me…?’” she began. “Apa,” one of the men interrupted, his voice softer now that he was addressing her, ‘where are our needles and syringes? He used to come every day, but now – not even a few times a week. He’s taking them and selling in the market.” Some of the men nodded in agreement, shaking their stubbly chins emphatically. Manbira took a deep breath, knowing she needed to intervene. As the sea of voices started up again, she forced herself to sound as controlled and confident as possible. “Listen to me, I understand your concerns. But this is not Mokhles’ fault. Hasn’t he been working with you for years? Hasn’t he come to your homes? You know he supports you. There must be another reason for this. Jahangir, do you know what it could be?” Jahangir whispered something in her ear, and Manbira’s face grew even more serious. “Actually, there are some problems with funds,” she told them gravely. “New Life are doing more and more work, and are struggling to find the resources they need. We are managing it, but we need your support.” Inclining their heads to one side, the men made sounds of reluctant agreement. “Yes Apa, but remember us. You may be there, in the big city. But this is where we are, here in Kamalgonj, in Adalotpara.”

She had prided herself on her relationship with New Life and its outreach workers. And now they were taking the blame for decisions made hundreds of miles away. She knew the changes in the project would bring challenges, but she didn’t expect it to be like this.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Taking tea Back at the hotel, Manbira stood on her balcony holding tea in her hand, and looked down at the quiet streets below. Her cheeks were still flushed as she thought about the events earlier. Did it all really happen? She had prided herself on her relationship with New Life and its outreach workers. And now they were taking the blame for decisions made hundreds of miles away. She knew the changes in the project would bring challenges, but she didn’t expect it to be like this. “But there’s simply no more money,” she thought to herself, wondering what she could possibly say at the meeting at New Life’s office tomorrow. Jahangir had said that all the outreach workers would be attending – those who hadn’t already left, that is. In an effort to cut costs, New Life had already been forced to let three go. Since then, two more had resigned, worn out by the extra work expected of them, and another was threatening to go soon. Why was this happening? How would they react to her? And with no funds to offer, how could she reassure them?

Listening to the outreach workers The next day Manbira awoke to the sound of birds. She missed that in Dhaka. As she lay there, the events of yesterday flooded back to her. “There must be a way,” she muttered to herself, climbing out of bed. Walking into New Life’s office an hour later, she saw that everything was ready for the meeting. The walls needed a fresh coat of paint, but the noticeboard was still there, with an announcement of next week’s holiday in the centre. The tables had been pushed back, and two rows of chairs were arranged in a U-shape. Manbira moved quickly to the empty seat next to Jahangir, greeting the outreach workers on her

way and asking about their families, as was the custom. They were dressed smartly as usual, their shirts neatly ironed despite being faded from too many washes. It wasn’t until she sat down that Manbira noticed the tiredness on their faces and the silence in the room. Usually when she came the outreach workers were full of jokes and stories. This time the silence made her nervous, so she spoke quickly. “Tell me,” she said to the room, stumbling over her words, “how are things?” It was Mokhles who spoke first, “Apa, you saw the situation yesterday, you could see how things are. We are working every day, all hours, but we can’t keep people satisfied. We just don’t have time to reach everyone. And when we don’t, they come to us like that, making threats.” Shahajan, one of the oldest outreach workers, interrupted, “Five years I’ve been working with New Life. I’ve seen this organisation grow and I’ve helped build the projects. And now my workload is going up and my salary is going down. I can’t even keep up with the price of rice in the market.” As Shahajan spoke the others joined in, and soon everyone was talking at once, their voices getting louder and their faces flushed. “There’s no transport,” they explained. “We work all day, and by the time we finish there’s no way to get home except by rickshaw, and that’s too expensive. We arrive home so late we have no time with our children, and we don’t get to eat meals with our families. Now our families are criticising us, asking why we work so late every day but bring home so little.” Manbira felt the eyes of the outreach workers on her. It was unusual for them to speak like this, particularly in front of her. These had to be

GRINDING THE SEEDS

the frontline sakina sultana

serious complaints. “OK,” she intervened, “one at a time, please. If everyone speaks at once we can’t hear each other. I’m listening.” The voices gradually grew calmer but the words still came quickly, bringing with them months of tiredness and frustration. As each outreach worker spoke, the others nodded and muttered in agreement. In worn-out voices they described going from house to house, pusher to pusher, working late at night trying to reach their everhigher target numbers of clients. They spoke worriedly about the lack of needles and syringes, and of the urgent need to increase the supply just to meet the basic needs of the people they knew. And they told of the complaints they faced: of walking through the streets only to be met with anger and abuse, and groups of men waving their arms angrily at them. Their efforts to arrange health education sessions were pointless now. “You teach us not to re-use,” their clients told them, “but you don’t give us any new needles. Why should we come to your sessions? Why should we listen to you?” As Manbira sat listening, her thoughts returned to Adalotpara: its confusing, criss-crossing roads and swarm of faces, its contrasting smells of spices, people and sewage. The outreach workers knew Adalotpara and Kamalgonj as well as anyone. And they weren’t just worried about their own lives. They encountered at first hand the problems the project was trying to tackle every day on Kamalgonj’s streets. “What to do, Apa?” they asked her eventually. “What to do now?”

Taking lunch After the meeting Manbira sat with Jahangir in a nearby restaurant. Plates piled high with rice and curries were stacked on the tables around them,

being devoured quickly by hungry customers. But Manbira and Jahangir’s plates were untouched as each of them, deep in thought, ignored their food. Manbira struggled to focus as the morning’s meeting replayed in her head. She knew the difficulties and could see their origins. The budget cuts in Dhaka had forced the numbers of New Life’s outreach workers down, and the expectations placed on those who remained were unrealistic. It would only get worse if more of them left in frustration. Jahangir had already told her how worried he was about finding others to replace those with years of skills and experience. And what about the needles and syringes? Clearly more were needed, but where were they to come from? What was she to do?

Believing in the frontline Back in the office after lunch, they all took their seats, subdued after the morning’s outpourings. The questions continued in Manbira’s mind, as she reached for the right words to begin. “OK,” she said finally, breathing deeply, “we all know the problems now. Thank you for being so open about your worries. But now it’s time for solutions.” She paused, attempting a smile to encourage the room. “There are certain things that cannot change right now. You’ve heard about the challenges New Life is facing over its funding. I’m being honest with you, like you were with me. They won’t be able to increase your salaries or increase the numbers of staff. The stock of needles and syringes will be limited for now. These are temporary challenges, but they still need solutions. I understand that. We need to work together to find other options.” Manbira continued, smiling more now, “You know the problems better than anyone. And I believe you know the solutions too. What can we do to manage this? What other resources are

The strategy had worked and, best of all, the suggestions had come from the outreach workers themselves – the staff at the frontline of the project, who knew the issues, challenges and opportunities best.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

there? Which people can help us – perhaps from the community?” The room went quiet. Manbira waited, hoping desperately that her strategy would work. The outreach workers understood the problems better than anyone, and they knew Kamalgonj too. Surely, if given a chance to speak, they could say what was needed? A chair scraped along the scarred floor as Shahajan stood up. Manbira was relieved. He had been angry earlier, but he was one of the oldest and most experienced outreach workers in the room. If anyone could make suggestions, surely it would be him? “Let’s use the pushers,” he offered, his voice confident as ever. “We can’t get any more staff for our team, so let’s use them to help us distribute and collect the needles and syringes. It won’t be easy, but at least it’s something.” Manbira felt her entire body relax. The strategy was working. Others began to speak too, voicing their agreement. So gradually, with Manbira and Jahangir’s support, the plan developed. It was agreed that the outreach workers would list all of the pushers they knew, and arrange a group education session with them, just as they did with their clients. They agreed to deliver a small number of needles and syringes to the pushers each day. Then they would visit again as part of their daily outreach schedules when the pushers’ houses were at their busiest, to meet their clients and make sure all was going to plan, before finishing work in time to get home to their families. Soon other solutions began to flood in too. Mokhles said he knew some people in Adalotpara who came to the group education sessions. They were no longer using drugs, and knew the issues and community well. Could they replace the outreach workers who had already resigned?

Again, the others voiced their agreement, and Jahangir and Manbira helped to build the plan. The team’s monthly meetings would be used to help train the new staff. And the meetings would also be used to talk through any other problems, look at the options together, and find solutions with the resources, skills and knowledge they already had.

Tasting the fruit At the end of the meeting Manbira walked out into New Life’s garden. Sitting under the guava tree, she took a deep breath. The strategy had worked and, best of all, the suggestions had come from the outreach workers themselves – the staff at the frontline of the project, who knew the issues, challenges and opportunities best. She would be going back to Dhaka soon, but that didn’t matter. She had been right to believe that New Life knew what they were doing. They had just needed space to share their problems, and support to find solutions. Jahangir came outside, holding a plate of guava cut from the tree, sprinkled with salt. Manbira took a piece, holding its sweet and sour saltiness in her mouth. Yes, some solutions had been found, but she hadn’t forgotten those probems that remained. The outreach workers’ salaries were still lower than they should be. And there still wouldn’t be enough needles and syringes for the clients of Kamalgonj. She would talk about these issues with SSO when she returned to Dhaka. But after taking on the new centres and the overspend in Phase 1, the reality was that funding simply wasn’t there right now. The money available to serve each client had still gone down. So then – what to do? What to do next?

GRINDING THE SEEDS

PLAYING THE PEACEMAKER VEENA Lakhumalani

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

The government is counting on the Global Fund grant to implement a national life skills education programme. But the Principal Recipient insists on a rock concert promoting safer behaviour. Which will have greater impact on young people? And how can Shanti settle the argument? Her inspired solution unites the Global Fund grantees, the corporate sector and the arts.

Birth “Hey Shanti, the Deputy Minister of Health, Mr Konstantin, wants to discuss something important with you this evening at 7pm,” called out the receptionist to Shanti, the consultant sitting by the window. Shanti had been working with an international agency in the Eastern and Central European country for five years. She enjoyed being in a completely new environment and culture, and took every opportunity to visit different parts of the country, learn about its history and art, and explore its many mountain and seaside resorts.

The ministry building wore a deserted air, and as Shanti climbed the staircase and walked along empty corridors her footsteps echoed in the evening silence. Mr Konstantin, a short man with deep-blue, piercing eyes and a dimple in his cheek, was greatly agitated. He was pacing up and down his neat room, waving a report and puffing away at his cigarette.

Mr Konstantin was well known for requesting representatives from international agencies to meet him well outside office hours to discuss health issues that he was trying to understand. He was new and keen to learn – something that was much appreciated by all. Perhaps meeting after office hours was the only time convenient for him.

“You see this report I have in my hands?” he exclaimed to Shanti, shaking the document vigorously. “Teenage pregnancies in the country have more than doubled in the last five years.“ Shanti asked what the numbers were, but Mr Konstantin was too exasperated to respond. “Why is this happening if we’re supposed to have an effective HIV and AIDS programme in our country?” he continued, glaring alternately between the papers in his hand and Shanti. “If girls are getting pregnant that puts them at risk of sexually transmitted diseases and HIV. With all the funds from the Global Fund, European Union countries and bilateral agencies, what is being done to prevent HIV in addition to providing treatment and testing people?”

Since the drive to the Ministry of Health was through an attractive part of the city, Shanti gazed out of the window, noticing as she did the inevitable line of billboards advertising alcohol, cigarettes, designer clothes and luxury products. It annoyed her that billboards promoting harmful and luxury goods were so widespread in a country where a great many people were affected by HIV. The car continued to weave its way through the slow evening traffic, beyond the river and past the imposing concert hall and parliament buidings, before arriving at the Ministry of Health.

His voice continued to rise as he spoke. Shanti had no immediate answer as she mentally raced through the various projects she was involved with, but in any case Mr Konstantin had resumed. “Aren’t you a member of the team that’s assessing our gaps for the Global Fund proposal?” he demanded. As Shanti nodded, he emphasised, “We need ample allocation of funds for implementing the government’s life skills education programme in schools so that young people can make informed choices about their sexual behaviour.”

Although it had been a long and arduous day, and the timing of the meeting was somewhat inconvenient – particularly as Shanti had a social event that evening – she knew that meeting the deputy minister was important.

GRINDING THE SEEDS

PLAYING THE PEACEMAKER VEENA Lakhumalani

Shanti tried to assure him that as team leader for the information, education and communication aspect of the gap analysis for the next Global Fund proposal, she would address his concerns. But Mr Konstantin interrupted, “You know the government has never succeeded in being chosen as Principal Recipient. This doesn’t reflect well on us as a country. I want us to get it right this time.” As she left the ministry, Shanti reflected, “This country has a fast-growing rate of HIV infection, and while the epidemic is mainly concentrated among young drug users, Mr Konstantin is right to be concerned about teenage pregnancy. It also puts so many young girls at high risk of contracting HIV.” She promised herself, “I must remember to take this into account as our team assesses country needs and gaps.” The new government seemed to be more open and willing to look at wider social problems. That could only be a good thing.

Crawling Shanti had been invited to lead the working group on the information, education and communication section of the analysis, possibly due to her experience of implementing a project on HIV prevention among young people. While the budget for these activities was considerably less than for other interventions such as treatment, they played a key role in creating public awareness as well as reaching those at risk of becoming infected. It would involve public campaigns through print and electronic media, developing and disseminating materials, and training teachers, students and young people. Shanti took her responsibilities seriously, as she wanted to ensure that Global Fund monies would properly enable the country to reduce the rate of new infections and disease.

Her team included representatives from the Ministry of Education, local and international agencies, and the media. They all met for the first time at 11am at the Principal Recipient’s office on a surprisingly warm spring day. The teams went into different rooms, some rather small and stuffy. With no fan or air conditioning available, Shanti’s team had to flap their notepads and books to cool themselves constantly. As the discussions continued, Shanti found she had to manage not only the different views of team members but also those of various stakeholders, who were free to walk in and out of the group meetings – listening, sharing their views and challenging the core team. “Should funds be allocated for TV programmes … newspapers are outdated … produce millions of brochures for distribution among the general public … develop a book of stories about people infected with HIV to pull at heart strings … tell stories of children orphaned by HIV and AIDS.” The ideas went back and forth. Each view was heard, with some being rejected while others were put on the list for further discussion. Shanti fully approved of this participatory and democratic process, but somehow she had to keep the discussions focused. It needed all her skills to remain firm but polite. The core team was a good mix of men and women. Some, like Shanti, had come from outside the country, but most were nationals. One of them, Alexander, a senior manager at the Principal Recipient, had worked for many years in advertising. This would be really handy, thought Shanti. He could suggest how messages could be communicated to young people effectively.

Shanti fully approved of this participatory and democratic process, but somehow she had to keep the discussions focused. It needed all her skills to remain firm but polite.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Shanti told her colleagues about Mr Konstantin’s request for funds for life skills education, but added, “Whatever amount is allocated to this activity, it will not be sufficient unless the government also puts in a large chunk of funds. Do you think we should help the government launch the programme by funding training programmes and printing additional copies of textbooks?” Some were in favour, some not. The discussion that followed was lengthy but inconclusive. However, what they did all agree on was that they needed an analysis of existing materials to find out if there were additional requirements or gaps that needed to be plugged. And so the discussions continued until the tea break – a much-needed opportunity to stretch their legs. When the team reconvened, it was Alexander who began, “One of the suggestions we have in the Principal Recipient is to repeat our annual rock concert in the square, where we bring in top stars to do a live performance. During the gig they’d give out safer sex messages to the audience of mostly young people.”

celebrities, they will definitely consider changing their behaviour. We’ll distribute free condoms to the audience and encourage them to use them properly.” Loud protests from some people in the room followed this latest suggestion. Shanti, who was a small and rather delicate woman, had to stand up to restore order to the meeting and not be overwhelmed either by Alexander, a tall and rather imposing person, or by the noisy stakeholders present. She addressed Alexander calmly, “We appreciate what you’re saying, but we’re not sure whether one concert can help to persuade people to change their sexual behaviour in just one evening. We think it’s a much longer process.” But Alexander kept shaking his head in disagreement. Shanti could feel her frustration rising. Clearly he was not at all convinced. Finally Alexander responded, “You are all programme managers and I’m an expert on how young people like to receive messages. So trust me on this one.” Shanti responded by voicing again the deputy minister’s concern about inadequate support for the government’s life skills education programme. The curriculum was ready, but the government needed funds for teacher training and printing thousands of textbooks. She pleaded, “If we don’t support this, many young people will not learn the skills they need to protect themselves.”

It seemed a great idea. But Shanti first needed to know how much they should allocate for organising and implementing it. When Alexander responded “$100,000!” a lively debate was ignited among the core team members and stakeholders on the value for money of a one-off concert that was supposed to set young people thinking about sexual behaviour change. And if a large part of the total budget were to be allocated to this one event, would there be enough for the roll out of the government’s education strategy?

Walking

However, Alexander kept reiterating, “Believe me, it’s an effective way to reach out to young people. When they hear messages from

Why was Shanti so worried? She’d attended a couple of similar concerts recently, where young people came to listen to live music, dance and

GRINDING THE SEEDS

PLAYING THE PEACEMAKER VEENA Lakhumalani

have a beer with their friends. But she wasn’t sure whether the 5,000-strong crowd would be receptive to messages on safer behaviour during a fun-filled evening. Three days later Mr Konstantin joined the team at their next meeting. He reminded them, “Please understand, the government has no funds to implement a school life skills education programme that includes HIV and AIDS knowledge and skills on safer behaviour. Some non-governmental organisations and international organisations have piloted projects using their own methods, but we need coordination and convergence with them otherwise there will be little impact.” Shanti whispered to Alexander, “Isn’t it interesting that Mr Konstantin from the Health Department is keen that funds should be allocated for educational programmes? Now that’s what I call convergence!” Mr Konstantin pressed forward his argument, “We’re depending on the Global Fund grant to help us with our strategy to prevent teenage pregnancy, sexually transmitted infections and HIV.” “But what about the concert?” Alexander continued to plead. The discussion on the allocation of funds continued late into the evening. Finally, Mr Konstantin conceded, in an effort to placate Alexander, “We do understand that rock concerts play a valuable role in communicating information to young people …” “I am not sure anyone understands,” Alexander interrupted sharply. “Young people don’t want to

learn about HIV and AIDS from teachers. And anyway, how many of our teachers would be willing to stand up in class and talk about safer sex or demonstrate the use of a condom? Music stars are role models for today’s generation. Please, let’s take advantage of this culture.” Shanti understood both views: the budget constraints and the need to juggle the allocation of funds effectively. So she suggested a compromise. “Let’s all consider how we might find alternative funds for the concert and use the Global Fund for a larger national programme.”

Running Shanti gave the matter some serious thought over the next few days. Finally, she came up with what she believed was a good idea, and looked forward to sharing her thoughts with the rest of the team at the next meeting. This time the team had gathered at the Ministry of Health in the imposing blue and gold conference room. It was a far cry from the team’s usual cramped offices. Now they were seated at a teakwood table surrounded with cushions that harmonised exquisitely with the blue curtains and gold tassles. Coming into this room after a chilling blizzard on on her journey had helped to calm Shanti’s nerves. The deputy minister chaired the meeting this time. “We must respect all views and opinions,” he began, “but may I remind you that we should look at prioritising value for money. The education programme is likely to have a profound effect on young people over a longer period, whereas the concert, while it would attract a larger audience for that evening, might have less impact and for a short while only.”

The deputy minister chaired the meeting this time. “We must respect all views and opinions,” he began, “but may I remind you that we should look at prioritising value for money.”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Shanti told him that the team members fully supported his view, but that formal life skills education in school could be supplemented by a rock concert funded mainly from other sources. She and her colleagues had contacts in the corporate sector, she promised, who might be willing to sponsor it. As Shanti glanced out of the window, her eyes fell upon a huge billboard advertising Coca Cola.

Shanti left the country soon afterwards. As she travelled to the airport, she cast a final glance at the billboards that had inspired her to identify alternative funds for HIV awareness in the country that had been her home for the last five years. Now Global Fund monies would be used effectively, and the private sector and the arts would contribute together to prevent HIV. And best of all, the annoying billboards would be put to good use.

Mr Konstantin’s eyes lit up, “That’s great. Why didn’t I think of that? You have some time to plan this so keep me informed. How much do you think you can raise?” Shanti looked over to Alexander, hoping her idea would appease him. “Can the budget be reduced if we can get some, if not all, of the artists to perform for a low fee or even no fee?” she asked. She dearly hoped the artists could be persuaded to make their contribution to this important cause. Alexander was relieved that his idea had not been discarded entirely. Although not entirely happy, he agreed to work out a revised budget. Shanti, in turn, would plan with her colleagues to contact representatives from the corporate sector and persuade them that a concert that drew huge crowds of young people would be an ideal platform to promote products such as shoes, designer wear and soft drinks. So the arguments had been settled for now. At the end of the day, all of them – the deputy minister, the Principal Recipient, the donors and Shanti herself – had the best interests of the country at heart. All were united in their common aim to reduce rates of HIV infection.

GRINDING THE SEEDS

GO FOR GREEN CARLOS L CALICA

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

When Juan hears the outcome of the grant evaluation, memories flash into his mind of the sex workers at the project site, eagerly showing off the new health initiatives. What will happen to them now? Juan’s consultancy skills are tested to the full as he delicately negotiates for reconsideration of the project’s non-compliance with Global Fund reporting requirements.

Yellow: stop or go? Juan, a public health expert from the one of the Pacific Islands, was enjoying his breakfast of fried dried beef and two sunny-side-up eggs in a homely old boutique hotel near the Mekong river. Although the morning was beautiful, with the sun’s rays projecting shadow patterns on the hotel’s façade, Juan was anxious. He was waiting to meet the person coordinating the HIV Global Fund grant for a country in the Mekong region. “Hi Juan, it’s nice to see you again,” Juan turned towards the cheerful voice and was surprised to see Guy, a fellow medical doctor who he had met in his home country three years ago. Guy had been part of a visiting group of public health practitioners that Juan had helped to host. “What a small world, Guy,” exclaimed Juan, with a huge grin, as he shook hands with the athletic-bodied 50-year-old. Juan breathed a quiet sigh of relief as he realised that his cheerful old acquaintance was the ‘Guyena’ repeatedly mentioned in his work documents. They were going to work closely with each other during this assignment. “Our Global Fund grant,” Guy began, eager to brief Juan on the work he was about to take on with his team, “is aimed at improving STI prevention and care, reducing STIs among sex workers and maintaining reduced prevalence through comprehensive intervention, including PPT.” “PPT?” queried Juan, eager to hear more but amused at how colleagues everywhere slip so easily into abbreviations, acronyms and jargon. The abbreviation for sexually transmitted infection, STI, was known almost everywhere, but PPT was new to him.

“Oh, my apologies,” Guy chuckled, realising what he had just done. “Periodic Presumptive Treatment is both a strategy and an intervention, providing STI treatment for all the service women by providing antibiotics covering both gonorrhea and chlamydial infections. Information materials on STIs and HIV, plus condoms, are also provided, of course. But PPT is used to rapidly reduce STI rates, thus reducing vulnerability to HIV.” “Service women?” asked the visiting doctor, with a sense of foreboding about where this issue might take them. He had witnessed a similar discourse in his own country. “Yes, service women,” repeated Guy energetically. “They are women who work at entertainment establishments, such as clubs, beer houses and drink shops. They act as waitresses and sometimes go out with customers. Sometimes they are called sex workers,” he added. “Ah, so why do you call them service women and not sex workers?” questioned Juan further. “Defining and identifying women who sell sex for money can be difficult. For instance, women working in bars or nightclubs may engage in commercial sex transactions, but their employment in these venues doesn’t necessarily make them sex workers,” continued Guy. “Besides, using the term ‘sex worker’ is not accepted in this country,” he added. “But it has already been accepted by the rest of the world, including my own conservative country,” thought Juan, making a mental note to tackle this issue with Guy and his team. “I wonder if this was articulated in their grant

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proposal?” he mused further, noting that Guy had used the term ‘sex worker’ when he described the project goals. “Who provides the PPT and where do you usually conduct it?” Juan continued, guiding the discussion back into the programme interventions. “PPT is done in the assigned entertainment venue and is conducted by trained health workers and volunteers,” responded Guy. While the kind doctor continued their informal briefing, they set out on the short drive to his office. Juan couldn’t help admiring the view from their utility vehicle. Guy, who was at the driver’s wheel, had taken them along one of the capital’s main roads, a stunning tree-lined avenue that ran parallel to the Mekong. Soon they were entering the driveway of a compound framed by old French colonial buildings washed in faded yellows. “Here we are,” Guy exclaimed. “Welcome to the home of the HIV, AIDS and STI Centre.” As they entered the offices of HAS, as the centre was known, Juan couldn’t help noticing the eclectic mix of old wooden tables and modern modular work stations, and cement walls decked with posters and old calendars featuring local celebrities holding out condom packets. “The project is nearing the end of the Phase 1 implementation and HAS will soon be applying for Phase 2,” continued Guy, as he beckoned Juan to take the guest black leatherette swivel chair positioned on the other side of his desk. “Of course, our grant renewal will depend on how we perform in our current phase,” he added.

Flickering yellow, red and green The lush greenery of the countryside, with its tall trees and fresh breeze scented with lemongrass, welcomed Juan as he travelled with the team to visit the project site. He fell in love immediately with the breathtaking beauty of Pradanh, the popular tourist town that was their destination. Perched on a peninsula formed by the Mekong, and ringed by limestone hills, its beautiful temples and ancient sites spectacularly showcased the region’s cultural heritage. As the car came to a slow halt, Guy explained, “This is a big club and can accommodate more than 50 people. We started work at this site about a year ago.” They were greeted by a cheerful-looking woman in her late thirties. “You can interview my women here in the club,” offered the voluptuous Mamasan Fa, waving her heavily bangled arm towards all the women seated at the club’s tables. “I also got the antibiotics and condoms myself during PPT outreach,” she offered enthusiastically. “I am now nursing my six-month-old son.” She proudly led Juan and the team towards one of the tables. “I have at least three to five clients each week and go out with them if asked to,” began Suphantong, a petite lady in her early twenties. “Most of my clients are businessmen and government workers,” she explained. Like most of the women in the club, Suphantong was not from Pradanh. “Thank you for providing us with the antibiotics for the PPT, which I’ve had twice already,” Suphantong added.

“You can interview my women here in the club,” offered the voluptuous Mamasan Fa, waving her heavily bangled arm towards all the women seated at the club’s tables.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Next the team visited a small, cozy drink shop, taking them a little further from the centre of town. Two young women in their early twenties, Kim and Ou, came up to the team. “Yes, I received the antibiotics and condoms that the outreach team gave out during the PPT,” Kim confirmed, having undergone one round of PPT. “I’ve also received antibiotics and condoms, even though I haven’t gone out with anyone,” Ou added.

Pushing green: a mentoring journey The clanking of the car engine seemed unusually loud as the team began the ride back to the capital city. Slowly they wove through the busy streets near the market, passing by the club they had visited the previous night. “I need to do a report on my observations of the PPT intervention. I should include my questions on service women receiving PPT even though they are pregnant or nursing a baby,” thought Juan. “How will these antibiotics affect a mother’s breast-feeding?” he wondered. Then, attempting to comfort himself, he added, “Of course, at this stage the tetracycline group is not part of the regimen.” The clinician in him had jumped eagerly into the internal debate. “Is it general practice here that all service women working in entertainment venues, even those not actively selling or practising sex, should take antibiotics?” Juan thought aloud, addressing Guy but knowing his question was really rhetorical.

Taking in his medical counterpart’s affirming nod, he added, “Obviously, providing PPT among service women rapidly reduces STIs. However I do have reservations about women who are not sexually active and nursing mothers receiving PPT. I suggest we address this concern in our questionnaires when we implement the next round of PPT.” “I agree with your concerns. Yes, let’s discuss your recommendations at the next round,” Guy responded positively. After a good night’s sleep and a couple of hours writing at the hotel’s café – accompanied by a large glass of the strongest Mekong coffee, soaked in a generous pile of crushed ice with thick condensed milk – Juan returned to HAS and one of their small meeting rooms. As he handed his report to Guy he remarked, “I’ve included here some of the observations we’ve already discussed informally. I’ve also included my recommendations. But let’s discuss this further with the project management team, shall we?” Guy immediately started scanning through the document. One specific section caught his eye: ‘Project implementation is properly carried out but there have been problems in supplying the correct number of antibiotics to service women during PPT. Some have received one dose while others received two doses.’ “That was because the antibiotics, which were procured through an international organisation, didn’t arrive on time,” Guy hurriedly responded.

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“Why don’t we look at your procurement system to check where the bottleneck is?” suggested Juan. Guy picked up a folder from the piles of documents on his desk and said, “Here’s the procurement plan,” handing the four-page plan to Juan. Juan quickly scanned the document. “The procurement plan says the products will be delivered within six months after payment. It has been nine months since you sent the payment, but you haven’t received the drugs yet. Will an emergency procurement be acceptable to the Principal Recipient?” he added, leaning forward while waiting for Guy’s response. Guy looked at him blankly, so Juan continued, “Let’s discuss the options with the management team. First, we need to check with the procurement agent how soon they can ship drugs in – we don’t want to send service women away because of stock-outs. The other option is to study the inventory of the STI drugs and explore the possibility of moving stocks between sites that are near to each other. We need to make sure that facilities can continue to provide the complete treatment regimen while we’re waiting for the arrival of the stocks we ordered. We’ve done this successfully in my country, despite the fact that some sites show slow movements in their inventory. If we carefully study the inventory, we can even minimise expiration of drugs,” he explained. “That’s really helpful, we’ll pursue all those action points. I am really grateful for your help so far,” enthused Guy.

“My pleasure,” Juan smiled.

Red: no go Juan scanned the now-familiar scenery during the short trip from the airport to the city centre. Refreshed by the smooth traffic flow, his mind drifted back to the phone call he had received back home just a week before. “Juan, is that you?” came the familiar jovial voice of Guy, the phone line surprisingly clear despite the torrential rain hammering down on Juan’s rooftop. “Yes, it’s me,” answered Juan, genuinely pleased to hear from Guy. “I‘m happy to tell you that the management team has endorsed your recommendations and we’ve already incorporated action steps during this quarter. We would like to ask you to come to help us out in developing the proposal for Phase 2 of this Global Fund grant,” Guy said. “With great pleasure,” Juan responded. “Good, I’m looking forward to working with you again, then.” There was a noticeable shift in Guy’s tone as he added, “Our Phase 1 grant evaluation is currently underway and we are a bit worried. They have asked us so many questions. It has all been helpful, though, because it has made us examine our programmes.” “Yes, that’s the best way to look at it. There’s so much we can all learn from an evaluation

“Will an emergency procurement be acceptable to the Principal Recipient?” he added, leaning forward while waiting for Guy’s response.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

process,” Juan replied, in a gentle, reassuring voice. “Well, wish us luck, Juan. I will email your terms of reference after this call. Really looking forward to your return.” “I’m certainly wishing you the very best of luck, Guy. Do let me know if there’s any way I can support you before my next visit. Otherwise, see you soon.” The chill of the Siberian winds welcomed Juan as he arrived for his second consulting visit. He was looking forward with a mixture of excitement and apprehension to hearing the result of the final evaluation of the grant’s Phase 1 implementation. “So, Guy, what happened to the grant evaluation?” asked Juan energetically, as he hung his heavy brown jacket on the back of the swivel chair. There was a moment of awkward silence from the usually cheerful Guy. He cleared his throat, “I’m sorry to inform you, Dr Juan, we are facing a significant problem here. We received a no-go notice for our request for funding of Phase 2,” said Guy, his voice low and throaty. “What seemed to be the problem?” asked Juan, concerned. His own voice lowered in sympathy, shoulders a little sunk in disappointment. But then he quickly picked himself up. “One of the main reasons for this no-go extension is our perceived non-compliance with

reporting requirements, such as the use of term ‘service women’ as opposed ‘to sex workers’,” continued Guy. Juan fell silent. Flashing through his mind were pictures of Mamasan Fa nursing her sixmonth-old baby, her face filled with eagerness to show off her support for the health initiatives being piloted in her club. He thought of Suphanthong, her beautiful face sometimes worried, but lifting with assurance when she spoke of health services she had been able to access. And he thought of Ou, her energy still fuelled with the optimism of youth. “What will happen to these women if this project suddenly ends?” was the question that ran through the visiting doctor’s mind.

Green: conditional go “Let me review your previous reports,” Juan requested, as he extended his hand out to Guy. After scanning the rather brief annual report, he observed, “This report did not capture your achievements in the field, and you kept insisting on using the term ‘service women’ when the indicator in the grant used ‘sex worker’. Can we ask for consideration from the Global Fund by responding immediately to these issues?” Juan phrased this as a question, but really it was more of a command. “I don’t know if we can still do that at this stage,” said Guy reluctantly. “And as you know, formal, brothel-based sex work is rare in this country, and prostitution is illegal.”

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GO FOR GREEN CARLOS L CALICA

Juan sighed, “I know the sensitivities around using the term ‘sex worker’ in your country, but there’s no harm in trying to explain where you are coming from. Other countries are using the term ‘sex work’ already, and it’s deemed best practice to give what you call ‘service women’ the dignity of acknowledging their ‘work’ as work. I can help you draft a letter of appeal, but more importantly, let’s convene a meeting among the management team, other sub-recipients and your key stakeholders to help resolve these issues.” “Yes, let’s go for it,” Guy responded positively. Juan sighed once more. “What would happen if they weren’t given another chance? Would the country be able to sustain the programmes it had already begun implementing?” he asked himself silently. Looking around, he noticed how quiet the HAS staff were today. Each of them had their heads down, intently studying their documents or typing away on their computer keyboards. Even the weather had taken a turn for the worse, and Juan reached out for his thick jacket, suddenly needing to wrap himself in its warmth. It was raining hard on the Friday morning as stakeholders began to trickle in to the HAS conference room, abandoning their colourful umbrellas to drip on the landing. Their chatter was drowning out the sound of the rain outside. “Good morning everyone, and thank you for coming despite the rain,” began Guy, in his usual jolly way. “We have invited you here to share updates on our Global Fund grant and to discuss the issues that have been raised during our Phase 1 evaluation. We also want to consult with all of you on possible action steps.”

Guy continued, scanning around the room that was now filled with quiet tension, “As most of you already know, we have received a no-go notice from the Global Fund on our request for funding of Phase 2 of our programmes.” Hands were raised immediately. As Guy took on their questions to help clarify the issues, his voice seemed to float above a quiet buzz of thoughts and occasional hushed comments. “I suggest we send an explanation to the Global Fund on why we appeared to be inconsistent with the reporting – that technically, we were addressing the same targets as in our performance framework. We need to make them understand our country context better,” the monitoring and evaluation officer responded, as Guy steered the discussion towards resolutions. He then called on Juan, who was waiting to speak for the first time. “We also need to say that we have learnt from this experience,” Juan added to his attentive audience, “and that in our reporting system we will consistently use the term ‘sex worker’ from now on, as defined in the proposal we had submitted. We must all understand that we are involved in implementing a performance-based fund. It means that the continuation of our grant relies on how we deliver our work, and the way that is communicated back to the funder is through our reports.” Guy followed through with a summary of the issues they had discussed, and asked the attendees for their final approval of the suggestion to send a letter of explanation to the Fund and a request for reconsideration. “Yes,”

“Sometimes the most rewarding moments are beyond the terms of reference,” he thought, images of the printed pages of his terms of reference flashing through his mind. “And it is a continuing journey.”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

cried everyone in unison, heads collectively nodding approval. “Can we request Dr Juan to help us draft this letter of reconsideration?” asked Guy, looking in Juan’s direction. “Definitely. Happy to assist you in this,” Juan replied amiably. “Allow me to further suggest, though, that we dialogue with the Global Fund portfolio manager to make sure he understands where we are all coming from. He can then endorse the letter and help us negotiate with the secretariat. He’s arriving next week, yes?” “Yes, he is. I will email him to schedule that dialogue. Let’s make that the first item on our agenda,” Guy concluded. The following days were a buzz of activity at the HAS offices. Drafts were passed back and forth, and the letter was read in its final form at the coordinating body’s meeting. It got everyone’s approval, and was finally signed by its Chair, the minister of health.

Go for green “Cheers, Juan! It is a conditional ‘go’,” chimed Guy’s familiar voice on the phone. “That’s really good news, Guy. Thanks for letting me know,” Juan replied happily. After the phone call was finished he remained almost motionless in his own black swivel chair. It had contoured itself to his form from the countless hours spent at his home workstation. Although the sounds of the street children were typical of a summer afternoon

in his neighborhood – a clear reminder that he was back home – his thoughts were far away in that charming city by the grand Mekong. “So this is what consulting life is like,” he mused. In his mind he was seeing their relieved faces: the project managers; Fa and the other women at the club; the HAS staff among their eclectic mix of furniture; and Guy, driving through the organised streets of the small city. “Sometimes the most rewarding moments are beyond the terms of reference,” he thought, images of the printed pages of his terms of reference flashing through his mind. “And it is a continuing journey.” He liked that thought. “What next?” he wondered. The bouncing blue icon at the bottom of his computer screen brought him back to the present. The street noises burst in, an orchestra of sound from a passing ice cream vendor, with his signature music-box melody playing full blast. As Juan clicked on the icon, he noticed the message that had just come in. “Hello, are you online? Can you help us respond to a few clarifications being asked by the Global Fund?” It was Guy, his profile photo never failing to make Juan smile – a glass of Mekong iced coffee, thick white milk settled at the bottom, waiting to be stirred among the crushed ice. “By all means,” Juan began to type on the chat screen.

FINDING THE RIGHT FIT

Sisters (and brothers) doing it for themselves â&#x20AC;&#x201C; with a little help from their friends

Kevin Nicholas Baker

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

The Principal Recipient has given Khairul’s team just one day to train 30 lively transgenders and men who have sex with men on strategic planning. Are they crazy? Most of the groups don’t even have an office let alone an action plan. So the team asks for a little help from Alliance friends – and soon it doesn’t even feel like work.

“Bugger!” muttered Khairul, the ISEAN Hivos programme manager in Malaysia. “How the hell do they expect us to achieve this quarter’s objective?” Khairul was alone in his office in the red light district of Kuala Lumpur. It was late at night and he was waiting for his small team to arrive to help him tackle their objective of supporting community-based organisations (CBOs) to develop strategic plans. “We don’t even have four fully formed CBOs in Malaysia working on men who have sex with men and transgender issues. And now they expect us to deliver strategic plans by providing a one-day training,” he fretted. Khairul, a resourceful, plain-talking thirtysomething, had only been working on the programme for eight months. But he had worked with the men who have sex with men (MSM) and transgender (TG) populations in Malaysia for many years and knew his audience. So he had called his team together to their office in a rundown building in Chow Kit to brainstorm how best to hit the programme deliverables. This was the Global Fund, after all, and the organisation needed to deliver. One by one his team made their way down the dark lane to their cosy office. Being a relatively new implementer in a new-ish programme, they knew there was little or no room for failure. But they also knew that most of the groups they worked with didn’t even have offices or computers, least of all missions, visions and structured action plans.

Predictably, Naza was the first to speak. “One day for us to train ten CBOs on strategic planning! Are you crazy?” was the first comment from the consistently vocal training manager. Khairul had expected this reaction and smiled as he encouraged the whole team to air their concerns. The monitoring and evaluation officer, Dhan, added a typically measured comment, “Our partners aren’t ready or able to support this activity, and I doubt we have the capacity either. This is all so new.” Naza broke in again, this time more constructively, “We’ll have to bribe them with a really nice hotel otherwise they’ll be too scared to come!” All good comments, thought Khairul, and ones they would use to help them achieve this challenging objective. “Thanks guys, all great points,” he smiled. “Now let’s think about some solutions.” Khairul scrutinised his team, confident that they were beginning to rise to the challenge. “We need to do some further work with the CBOs to allow us to select the organisations and groups who would most benefit from this activity,” he decided. “I agree with Dhan. None of our partner organisations know anything about strategic planning, much less can write one in a day.”

FINDING THE RIGHT FIT

Sisters (and brothers) doing it for themselves – with a little help from their friends KEVIN NICHOLAS BAKER

Naza had already begun to type. “I’m creating a shortlist of the ten organisations I think will be up to the challenge and could commit to what we require of them,” he said briskly. “Great!” said Khairul quickly. He had hoped that his training manager would offer. Naza knew the CBOs best, having working with MSM and TG organisations for many years. “I’d better make sure the ones we select still exist. Half of them have been closed down by the funding cuts this year,” explained Naza. “Yes,” added the ever forward-thinking Dhan, “and check on their availability too. We don’t want to book the hotel and none of them show up.” “To save time we’ll have to do the training in English. So can you check on their language skills as well?” added Khairul. Once Naza had done this, the team advised on the selection, adding in extra information based on their personal experience of the CBOs on previous projects. Once the final list of CBOs had been agreed, they were prioritised based on the likelihood of success. But Naza knew that this was not enough. “OK we know who they are but I’m still worried about their capabilities. We’re asking a lot of them.” He played nervously with his large pearl earrings. Naza liked to brighten up the team’s dynamics with striking combinations of larger-than-life jewellery. Khairul agreed. “I know this is a pain in the butt, but each of us are going to have to adopt these organisations and support them through this.”

Naza echoed Khairul’s thoughts. “We all know that a one- or two-day training rarely achieves more than increased knowledge levels. To ensure they are actually committed to developing and implementing realistic strategic plans is a long-term project. And everyone in these organisations is super-busy. They have lots of roles and no time for navel gazing about what they want to achieve five years from now.” After the team had finished groaning at the thought of all the additional hours of work, they agreed to the final CBO selection by the usual if unorthodox method – spin the bottle. Dhan then suggested that the team could kickstart the technical assistance to each of their CBOs with an initial meet-and-greet session. “I’ll develop a process document on how we should do this,” he added, “and hopefully this will guide us. At the meeting we can update the CBOs on the programme and invite them to the training. We can also use the opportunity to find out more about their strategic planning needs and discuss the types of support they would like.” Everyone agreed that one type of technical assistance alone would not be appropriate for all of the organisations as they each had different needs. Indeed, as the team met up with their selected organisations, these differing needs became only too clear. But by the time the team had got together again for the next weekly meeting, the work was well underway and they were all rushing to complete their outstanding tasks. “Thanks for this report on the meetings with the CBOs,” Khairul said as Dhan handed him the document, “it’s really useful for planning what we want to do next.”

“We all know that a oneor two-day training rarely achieves more than increased knowledge levels. To ensure they are actually committed to developing and implementing realistic strategic plans is a long-term project.”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

“Help! What’s the difference between a vision and a mission,” called Jane, leader of a newly formed TG Facebook group, and Sue from a more established TG CBO in northern Malaysia. They asked Khairul for pre-training for their staff to guide them in developing draft plans that they could then refine and perfect at the training itself. Khairul and Dhan went over to their office. Over nasi lemak (coconut rice) and coffee they explained some of the basics such as mission, vision and goals. After that the women felt much more comfortable attending the training.

the workplan from the Principal Recipient it was assumed that the training would be provided from internal resources. But everyone agreed with Naza that given the short timelines and the need for community-focused training, it would be better to use an external consultant with the relevant expertise.

Predictably, the team’s objective had met with an incredulous response from the CBOs. “Are you crazy? We need way more time to discuss something this big. Can you help us?” begged Pang from one of the larger MSM organisations based in Kuala Lumpur. Despite being around for many years they had never developed a plan. So they asked Naza to organise a retreat for 30 of their volunteers and organisers. The retreat allowed them to work through their vision, mission and goals before the training. Naza managed to rope in a friendly consultant to support him to run the workshop for free and formulate a draft in a mere two days.

Straightaway he got on the phone. “Hey Greg, how’s life in Phnom Penh?” asked Khairul. “Look, I need your help. We‘ve got to deliver a oneday training on strategic planning to our CBO partners here in Malaysia and we need some expert assistance. Time is short so we really need someone who can achieve the impossible. Who would you suggest?”

“We can’t do it alone,” pleaded Ivan from another newly formed volunteer-led MSM organisation in the Eastern Borneo state of Sabah. He asked one of his core volunteers to work with Khairul to develop a draft for discussion among their board members in preparation for completion at the training. Once this was done they felt happier about attending the training. “So who can we get to help us deliver the training?” Naza asked in his usual direct style. In

“Let me call Greg at the Alliance technical support hub,” Khairul offered. “I’m sure they’ll be able to help us somehow, even though we’re just a sub-recipient.”

Greg was silent for a while and seemed to be typing at the other end of the line. “Of course we’re happy to help sub-recipients as well as Principal Recipients,” he said finally. “I just checked on Maria’s availability and she’s free. What do you think? She has all the relevant experience, having worked with the MSM and TG communities in South East Asia for 15 years. I’m sure she’d be able to support your needs well.” “Excellent! What a perfect choice for the job,” enthused Khairul. “I know Maria well. You’re a life-saver Greg. We owe you one.” Khairul immediately Skyped the consultant. “Maria, I hope you know what you’re getting yourself into here? One day to train and develop

FINDING THE RIGHT FIT

Sisters (and brothers) doing it for themselves – with a little help from their friends KEVIN NICHOLAS BAKER

strategic plans for these CBOs is a tall order. But together we can do it – we hope!” “We’ll make it fun and then it won’t feel like work,” promised Maria. They agreed for her to arrive in Kuala Lumpur two days before the training to work with the team on developing the fun, communityfriendly training schedule and syllabus. Khairul breathed a sigh of relief. The plan was finally coming together. Naza insisted on meeting Maria the minute she arrived in Kuala Lumpur, and was sitting waiting in the lobby when she got in from her long flight. Maria would have preferred some sleep, but knowing Naza she thought it better hear him out sooner rather than later. “I know the original materials were developed by representatives from sub-recipients in the various countries covered by the programme – Indonesia, Malaysia, Philippines and Timor Leste,” Naza explained to Maria. “But CBOs in these countries are more developed and advanced than ours. These materials are just not suitable for the education and experience levels of the Malaysian participants. They will be completely lost.” Naza looked at her with some desperation. “We did a run-through with a focus group of 12 participants from CBOs in Kuala Lumpur last week and my fears were confirmed. We received feedback from the participants like, ‘I felt lost from the beginning’ and ‘I didn’t understand any of the words used’.” Maria nodded. It looked like they would have to go back to basics. So together with Khairul and Naza she developed a more suitable syllabus for their

community audience using simple language, with lots of interactive sessions. The workshop would start with a session on ‘What headline do you want to see in your local newspaper in ten years’ time’ to demonstrate what was meant by a vision. And they would work hard to make it fun, with little or no jargon and few technical terms. “We know they can do it. They all have the experience. We just have to help them get there,” was what Maria kept affirming as they put the training together. “Thanks Maria, it’s really great to have you here,” confided Naza. “We needed someone with your experience to give us the confidence to do this.” Finally they were ready, and by the day of the workshop they were all excited to be running the session. Meanwhile Naza had worked his magic and managed to negotiate an amazing rate from one of the best hotels in Kuala Lumpur – a tropical oasis in the middle of the city, close to all the best nightspots. “No one is going to turn down an opportunity to spend a few nights at the centre of all the action,” thought Khairul as he sent out the formal invitations. And true enough, a one hundred percent positive response meant that the training was finally held with 30 people on one busy and much-anticipated day in June. The hotel had never before seen such a colourful group of participants, with MSM and transgenders in all their rainbow fabulousness attending. Maria was excellent, and despite the group being very diverse – 30 transgenders and MSM from all over Malaysia made it a very lively session – the team managed to hold it all together. During the day everything was discussed, from developing missions and visions

The hotel had never before seen such a colourful group of participants, with MSM and transgenders in all their rainbow fabulousness attending.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

to the future of the communities in Malaysia. This made the sessions really valuable and engaging for the participants. All the participants agreed that one day was too short, but their feedback was excellent – ‘The best training ever’ and ‘I never though I would be able to develop a plan for my organisation’ were some of the comments. Naza was most pleased by an aside from a veteran transgender activist as she was leaving, “I didn’t even feel like we were doing work and by the end we had a plan – like magic!” Holding in his hand all the documents produced that day, even Naza had to agree that the training had achieved more than they could ever have expected. “I never thought I would see ten CBOs with written-down strategic plans in Malaysia,” he enthused, as he played with a particularly large diamante chandelier earring. “I’m almost looking forward to helping them implement them.” Dhan was equally excited. “We‘ve overachieved our target by 210%!” “Typical monitoring and evaluation comment,” thought Naza as he headed for the bar. “Bugger!” muttered Khairul, just before dozing off to sleep that night. “I never thought we could do it but we did – with just a little help from our friends.”

FINDING THE RIGHT FIT

Transcending boxes: Unity and uniformity in defining trans diversity

Zaki ArzmI

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

“Who are we?” flashes the projector, as Zaza relies on consultancy experience and freshly applied lip gloss to settle the age-old question “transsexual or transgender?” The likely outcome of the meeting is a bloodbath, until someone suggests that standardising language promotes unity but at the expense of diversity. Girlfriend knows what she’s talking about!

PART ONE ZAZA There will be blood! “There will be blood!” assured Zaza’s tiny but overbearing inner voice, as she painstakingly reapplied a generous layer of last season’s M·A·C lip gloss to her chapped lips in front of the bathroom mirror. “Your gorgeous little head is on the chopping board, girlfriend! You must have been out of your mind to think you’d be able to facilitate a meeting in a room full of transgenders, their inflated egos matching their gaudy accessories, least of all discuss and agree on a definition that would best describe them. Oh, it’s going to be one hell of a bloodbath, believe you me. There will be blood!” the catty mental discourse continued. “You’ve done this a million times before,” Zaza calmed her own nerves, searching her cluttered cerebral compartments for the elusive crisis mitigation switch. “Let’s run through the facts of this meeting once again,” she thought, as she pictured herself unfolding the hotel paper on which she had scribbled the facilitation notes (more legible and organised than the real thing, naturally).

Global Fund Round X Community systems strengthening project in country Y for men who have sex with men and transgender people ‘Extraordinary’ meeting for the transgender community Objective: to find an agreement upon a standardised use of terminology and definition to describe ‘transgender’/’transsexuals’ for HIV service delivery of the above project Technical assistance requested: facilitation of meeting Methodology: focus group discussion centred on ‘lived experiences’ of participants

“Shoot!” she cried under her breath. She had accidentally missed with the lip gloss, a visible sign of a short circuit in the crisis mitigation switch. Evidently she was a little concerned that her three-year consultancy experience in HIV

and gender (and her medical school training, for that matter) might not have prepared her mentally for what could happen in the conference room next door. She deftly fixed her lip gloss and readjusted her signature bun, all the while drowning out her annoying inner voice with a mental airplay of Madonna’s seminal yogainspired late 90’s hit, ‘Ray of Light’. Then she hoisted up her well-worn fishnet stockings (another signature Zaza look) to hide that ostensibly questionable rip (she refused to explain its origin), and to also hide any unsightly curves that would give away her assigned-atbirth sex. Just as Madonna (in her head) was about to crescendo into the infamous frenzied chorus chant, “And I feeeeeellll…!”, she stole one final glance in the mirror at her now improved put-together self and proclaimed with a renewed (semi) self-confidence, “Ladies, here I come!”

TASHA It will be good for business Tasha had received a call a week ago from one of the outreach workers at the city’s most prominent community-based organisation working on HIV and transgender issues. It was an invitation to a meeting that would gather together a diverse group of trans people, both male and female, to put to rest the age-old question, “transsexual or transgender?” She wouldn’t normally attend such gatherings (“What’s the point? We’ll end up bickering and biting each other’s heads off!”), but there was an inexplicably positive ring to the outreach worker’s voice that convinced her. Maybe this time things would be different and she could meaningfully contribute to the process – plus, it would be good for business, she thought. The meeting would present her with the perfect opportunity to network among her fellow trans sisters with the goal of expanding the clientele of her highly successful beauty salon.

FINDING THE RIGHT FIT

TRANSCENDING BOXES: UNITY AND UNIFORMITY IN DEFINING TRANS DIVERSITY ZAKI ARZMI

The flush of the next-door toilet travelled audibly through the paper-thin wall of the bathroom stall, abruptly killing the memory of the week-old phone call. “Look at the time,” she panicked, realising that the meeting was about to convene. She too gave the toilet a good flush before stepping outside the bathroom stall. Tasha decided to give herself a final once-over in the bathroom mirror before her grand entrance. Hair – silky, dress – tight, makeup – flawless, breasts – perky: she was running a mental checklist of her appearance as she admired her own reflection. Then she noticed the bespectacled woman standing next to her in a white shirt, black high-waisted pencil skirt ensemble, giving her the vicious trans once-over (she presumed). Tasha darted a dirty look at her and smirked at the fishnet stockings she was sporting. The woman, in retaliation, offered, “Lip gloss?”

NINA I’ve seen it all “I’ve seen it all.” Nina, a post-operative transwoman in her late forties, had indeed seen and gone through it all: countless heartaches and rejections (by her own family and a bevy of insatiable lovers); and sex work on the side to support her sex reassignment surgery and her penchant for silk sarees imported from Mumbai. She had even dabbled in trans activism back in the day, but withdrew herself from the scene soon after she realised that her mouth could land her in trouble more than it should. Recognising her controversial standing in the trans community, it was as much a surprise to Nina as everyone else when she received a text from one of her community-based organisation contacts inviting her to a meeting of trans sisters. It was a rather brief and unsatisfactory message, she thought, but that only triggered her curiosity all the more to find out what it was all about. Today, she was in her glitziest crimson silk saree (she had actually saved it for a friend’s wedding

that, alas, had not happened), complemented by elbow-length golden bangles and fresh jasmines planted in her neatly tied bun. She needed to be sure that her intricate getup was in order, so she made her way to the ladies’ restroom adjacent to the meeting venue. As she was about to step into the washroom, she found a bespectacled woman in a white shirt over a black high-waisted pencil skirt ensemble holding the door for her. They exchanged smiles.

PART TWO ZAZA Today’s extraordinary meeting “Who are we?” flashed the projector as Zaza, the meeting facilitator, corrected her posture (the undesired effect of prolonged wearing of fiveinch stilettos) in front of an audience of over 30 trans men and women alike. “Heeeyyy!” Zaza’s signature salutation opened the meeting – a salutation that had gained both recognition and notoriety in the HIV community for its effervescent and exaggerated qualities. “Today’s extraordinary meeting,” she continued, “elevates the meaning of ‘extraordinary’ to a whole new level. It is extraordinary in the simple fact that it has brought together the diverse sections of our community – the transgender community – in one room for a meaningful engagement that will hopefully unite us under an inclusive term and definition, allowing us to address our concerns more effectively.” Silence. Undeterred, she elaborated, “Our community, for as long as I can remember, has been bombarded with names and labels – some good but mostly bad – and we have fought tirelessly to define and defend ourselves.”

“I’m not interested in technical textbook definitions,” she assured her audience. “I only care about what you think – your stories. And don’t we all have stories to tell?”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Again, silence. (“And is that woman in the back row sleeping?”)

of the facilitator “to pass this trying time, more like” (a mental snipe at Zaza).

“Now, it is more important than ever that we are united by a language that is accepted by most, if not all, in these trying times,” alluding to the recent spate of negative media portrayal of the country’s LGBT community, “and at this critical juncture where we are presented with the opportunity to strengthen our community through the programme supported by Global Fund to turn the tide around and better our community’s response to HIV.”

Indeed, a considerable amount of “trying time” had passed (“I felt like I was being possessed by the spirit of the pencil”) before she realised that the in-room discussion had shifted from personal accounts of living the ‘transgendered life’ to (re-)constructing definitions and concepts of sex and gender.

More silence. But like the well-manicured warrior that she was fated to be, Zaza soldiered on with her facilitation. “So today is your opportunity for your voice to be heard.” (If life were accompanied by uplifting soundtracks, this would be the moment where Vangelis’s ‘Chariots of Fire’ would play, she thought.) “Going back to the business of the day,” she segued, “definitions are only valid if they are informed by stories and experiences that are real and honest. I’m not interested in technical textbook definitions,” she assured her audience. “I only care about what you think – your stories. And don’t we all have stories to tell?” The sleeping woman in the back row, who she noticed was wearing the oddest-looking kneelength beaded caftan top paired with sandblasted jeans, had now woken up. “Now, who would like to start?”

TASHA Aren’t we all ‘transgenders’? She was mindlessly fiddling with the hotel pencil and paper laid out on the table as the facilitator’s opening tirade continued (“with no end in sight,” she thought). By some power of magic, she had miraculously found herself sketching a rather serious-looking and fiercely androgynous portrait

“If we look at how gender is commonly described in textbooks worldwide,” she heard the facilitator say, before reading the following from a PowerPoint slide flashed onto the projection screen: Gender is a social construct that defines the roles, rights, responsibilities and obligations of men and women in a given culture, location, society and time.

Squinting at the blinding projection, she searched within herself to discover what ‘gender’ meant for someone who had been defying norms, expectations and conformities all her life. At lightning speed, she raised her hand to offer her opinion. “So, if ‘trans’ means a ‘crossing’,” she started off, “and ‘gender’ is a social construct of masculine and feminine roles, then aren’t we all transgenders on some level? Exactly what gender line are we crossing here?” “Interesting,” Zaza the facilitator responded. “Would you care to elaborate on what you mean by ‘we are all transgenders’?” “Well, aren’t we all, transgender or not, made up of both male and female qualities? For example, people say that I’m caring and motherly, but at the same time, to manage my business well, there are moments when I have to be heartless and tough in order to make unpopular decisions, just like a male boss would. I’m sure the same can be said about every human being. So does that not make all of us transgenders?”

FINDING THE RIGHT FIT

TRANSCENDING BOXES: UNITY AND UNIFORMITY IN DEFINING TRANS DIVERSITY ZAKI ARZMI

The entire room nodded in agreement (even the woman who was sleeping in the back row). “That is why,” she continued, “I find the term ‘transgender’ problematic.”

NINA Respect must be earned “All I want in life is to find myself a nice girl, take her home to meet my parents, and make her my wife,” Joe, a transman in his early thirties, concluded his personal story. The room burst into a thunderous round of applause, as if to welcome the new hero in town, in appreciation of Joe’s honest confession of what his gender meant to him.

She paused, quite uncharacteristically for someone who was known for her unrivaled skills in articulating criticisms. “Have any of you stopped to wonder whether, perhaps, the reason why society has a hard time accepting us is because we don’t take ourselves seriously?” Tension had built up so remorselessly it became palpable. “How do you expect society to accept us when some of you continue to make yourselves a laughing stock by behaving inappropriately around men in public?” She paused again – this time for dramatic effect.

A raspy voice, indicative of a long history of smoking and alcohol consumption, suddenly interrupted the cheer, “I have something to say.”

“I know what many of you think of me. The names I’ve been called – they were not kind. But you must remember where I came from.”

Everyone knew whom the voice belonged to. Drop-dead silence seemed the only fitting reaction to such a grand scale of fear and ferocity.

Another strategic pause (“Are those tears in her eyes?” Zaza noticed).

“Yes, Nina. Please say what’s on your mind,” the facilitator invited her, motioning towards the stand. “Joe’s story is indeed heart-warming, but I think we’re forgetting one important point about our meeting today. Madam facilitator,” her voice had begun to take on a more condescending tone by now, “did you not say that one of the aims of this meeting was to address our concerns as a community?” “Um, yes…” Zaza momentarily hesitated over her affirmative response, which stemmed from her own disbelief that the very thing she had been warned about was in fact coming true. “I have been observing our community for as long as I can remember, and through the years we’ve been talking about society’s negative perception of us.”

“I came from a place where respect must be earned, rather than be a privilege we were entitled to. We must carry ourselves with dignity if we want to be respected.” Silence continued to permeate the freezing airconditioned room. Unprompted, the woman sleeping in the back row stood up, walked up to Nina and offered her the tightest sisterly hug.

PART THREE ZAZA Girlfriend sure knows what she’s talking about “So, Maya,” referring to the woman sleeping in the back row, “it seems that you’re the only one who is in favour of the term ‘transgender’.” Zaza

A raspy voice, indicative of a long history of smoking and alcohol Consumption, suddenly interrupted the cheer, “I have something to say.”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

re-announced the clear-cut results of the poll (by show of hands), so as to avoid any inaccuracies.

she turned to social media to post her thoughts about the meeting on the group’s wall.

“Yes,” affirmed Maya, who was now more than ever wide awake.

Never walk in anyone’s shadows. Your life is your own unique experience. Live it! Thank you to all my sisters for teaching me this valuable lesson today at the meeting. Keep fighting the good fight. Tasha x

“Just out of curiosity, may we know why?” asked Zaza, exuding authority as the momentary matriarch of the community – an overbearing one, some would say. “I have no particular preference, to be honest with you. My vote was simply out of convenience. ‘Transgender’ has been the preferred or widely accepted terminology all along in Global Fund and other international documents, and I figured that maintaining that consistency was just as important.” “So you wouldn’t be averse to the term ‘transsexual’ instead, then?” Zaza’s overbearing manner had properly reared its ugly head by now. “What’s more important is that we don’t lose sight of why we’re doing this exercise today and the implications it has for our community. Definitions and standardising the language do promote unity but usually at the expense of alienating the ones living on the margins. We must acknowledge that our community is just as diverse as any other. I mean, take a look around you right now. Transgenders of every colour and creed… transgenders who use drugs, who sell sex, who are living with HIV… We must not allow diversity to drive us apart; we must celebrate it.” “For someone with zero fashion sense,” Zaza’s evil inner voice resurfaced, “girlfriend sure knows what she’s talking about.”

TASHA Keep fighting the good fight Tasha was also an active contributor to the transgender (now transsexual) online community network on Facebook. As any respectable famemongering child of the cyber universe would,

The post was accompanied by a photographed sketch of a rather serious-looking and fiercely androgynous portrait of the facilitator.

NINA Sorry if I got too emotional “Thank you for coming,” Zaza extended to Nina her obligatory post-meeting appreciation before giving her a hug. “Sorry if I got too emotional in the room just now,” said Nina as she withdrew her body from Zaza. “I genuinely found the sharing of the personal stories moving and useful for the discussion. You’re right – the ‘lived experience’ method you used to elicit our opinions really helped us to define and understand ourselves better.” Flummoxed by Nina’s uncharacteristically glowing assessment of her facilitation, “Thank you” was the best response Zaza could muster. “I guess I can count on seeing you and your fabulous silk saree at another one of these gatherings in the future?” she found eventually. As if she too was flummoxed by Zaza’s invitation, a crooked smile was the best response Nina could muster. “Nina! Nina!” a shrill voice echoed from behind them just as they were about to go their separate ways. It belonged to one of the participants from the meeting. “Can my friends and I have a photo with you?”

FINDING THE RIGHT FIT

YOU’RE A LEADER! Harjyot Khosa

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Can that vocal transgender leader demanding respect from a petrified hotel manager really be Rani? What a different picture to the forlorn figure Asha encountered three years ago at the back of the training room. It’s a moment of intense pride for Asha as she sees what the programme is doing for the empowerment of the transgender community.

In a warm hotel room in Hyderabad, Asha snuggled into her cosy bed. She was exhausted from travelling, and needed a good night’s rest before the long week ahead. But the sharp ringing of the hotel phone beside her bed cut through the midnight silence and jolted her from her thoughts. Rubbing tired eyes, she flopped across the bed to lift the handset. “We want the hotel to be vacated now. Right now!” yelled the voice. Gripping harder on the handset that she’d almost dropped, Asha asked in astonishment, “Why?” “Come down to reception and see for yourself,” snapped the man, before banging down the phone. Asha jumped out of bed, frantically searching for her shoes before racing downstairs to the reception area. There was an unusual sight at the front desk of the hotel. More than a dozen cross-dressed people, most of whom were participants of the training that was to begin the next day, had crowded into the lobby, clapping deafeningly in front of a bewildered manager. The poor man stood firmly behind his desk, masking his agitation with a forced arrogance. Asha snaked through to the front of the mob and to her surprise saw Rani banging her fist on the hotel manager’s table, squawking at the top of her voice. At first Asha could barely make our what Rani was saying; something about “defending the rights of a fellow transgender,” and “ill-treated by hotel staff for cross-dressing”. Then she said more clearly and firmly, “I will settle for no less than my share of respect.” Asha was flabbergasted. When did Rani learn to talk like this? She had turned into a fiery leader. “What a totally different picture from the Rani I met three years ago,” she thought to herself. Asha had met Rani during one of her training sessions. She was one of the participants, but

had spoken little throughout the day. She had been shy and timid, with low self-esteem. All that seemed to have changed. Taking control of the situation and pacifying the protesters, Asha led aside the petrified hotel manager and Rani to a small meeting room to try to sort out the problem. After almost an hour of explanations from both sides, the hotel manager backed down and apologised. He tried to explain that he and his team really were sensitive to the lifestyle and culture of transgenders and hijras – a transgender sub-group with strict community and religious norms. But they had all felt overwhelmed by the group of cross-dressed training participants and had overreacted. The mortified manager returned to the front desk and promptly apologised to the grumbling participants. Asha turned to Rani and gave her a disbelieving look. Rani, a free-spirited, empowered, supportive and vocal community leader? “Is this your rebirth?” Asha asked. “I have my pehchan now,” Rani proudly replied. Pehchan was a local term that meant ‘identity’, and Rani was now wearing her identity with pride. It was a moment of pride for Asha too as she realised what the programme had done for the empowerment of the community. “It has given them a new life, a new spirit and strength to fight for their rights,” she exclaimed.

Perplexity: the beginning of knowledge Hurriedly tracing the long, silent corridor back to her room, Asha finally curled up in her bed with a sigh of relief. As she started to relax and feel the drowsiness overtake her, thoughts of the beginnings of this journey of hers drifted into her mind. It was only three years ago, but it felt like yesterday.

***

FINDING THE RIGHT FIT

YOU’RE A LEADER! HARJYOT KHOSA

Asha stepped out of her boss’ room apprehensively. Her bare feet chafed on the floor, seeking relief from the grip of leather sandals. And as her hands nervously fidgeted at her workstation, she cast a pouting glance at the pictures pinned on the office wall. On the green noticeboard, which was hung right in the centre, were colourful pictures of transgender and hijra, all smiling and posing eagerly for the camera. She wondered whether she would ever be able to work effectively with them, thinking of the enormous challenges these communities faced – not least the stigma and discrimination they encountered on a daily basis. “Do you really think I can do this?” she asked Kumar, biting her nails. Kumar, himself a confident example of community leadership, stood up from his desk and walked the few steps towards her workstation. “You will be fantastic,” he urged, in a rasping voice filled with assurance. Looking straight into Asha’s eyes, he added with a slight frown, “But you really do have to fast-track the capacity-building and training component.” Asha looked back at her tall, handsome boss, drawing confidence from his strength, yet also feeling a hint of apprehension. “I understand,” she murmured. “Let’s not forget you need to strengthen a pool of master trainers too,” Kumar added, his eyes dilating as he grinned. “Asha, you should be thrilled to be working with the largest single country Global Fund programme supporting men who have sex with men, transgender and hijra programmes in 17 Indian states. We aim to build the capacity of 200 community-based organisations so they can become effective partners in the government’s HIV prevention strategy. And the target is to reach almost half a million men who have sex with men, transgenders and hijras by 2015,” Kumar added dramatically. Having finished his small speech, he promptly turned and sashayed back to his workstation, leaving Asha to gather her scattered thoughts.

“This must be my focus now,” Asha declared, mainly to herself. “My aim will be to streamline the training modules effectively and facilitate their implementation to the highest possible standard.” Pronouncing her goal with growing conviction, she continued to highlight phrases with a neon yellow marker as they jumped off the page from the project document she was reviewing.

Unity is strength However, as Asha sat at her workstation she could sense a growing burden on her sloping shoulders. Then Kumar’s loud voice broke in, “The modules were initially developed by engaging men having sex with men, transgender and hijra communities in the process of developing them. This was good because it enhanced ownership by the community of the training process. Technical experts further developed the modules based on feedback from the community.” Kumar was impinging not only on Asha’s quiet moments of introspection, but probably on everyone else’s in the office too. Amused, Asha egged on her enthusiastic colleague. “Yes, I agree the process really helped in fine-tuning the overall training model and the strategy for scaling up the programme,” she said. But wretchedly piling up bundles of printed modules to free up space on her table top, Asha sat back as the top layer collapsed into her computer keyboard. And banging her head on a thick document in front of her, she reprimanded herself, “Really we need to have simplified modules that the community can understand and relate to.” Some time later, seated in one of the smart meeting rooms at her workplace, Asha declared in despair to the team of consultants, “The modules are very lengthy, technically heavy and way too detailed.” She added, “We need all the modules to be consistent and fluid in terms of knowledge, technical inputs and relevance to the programme.” As she thought of preparing her team of consultants for the mammoth task of

“If community leaders take ownership of the programme, it will be our first step towards community preparedness,” Asha continued, as she drew a rough capacitybuilding flowchart on tissue paper plucked out of a floral box on the meeting table.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

streamlining all of the 18 modules, Asha was apprehensive. “The training modules were developed as a response to the capacity needs of the community. That’s what we should always bear in mind as we review and revise these materials,” Asha emphasised, tapping on the voluminous drafts in front of her. Running her fingers through her lustrous black hair, she leaned back in her chair and shot Kumar a glance, “Kumar, you were involved in the community consultations and capacity assessments, weren’t you?” Kumar nodded, then added, “During one of the sessions, a transgender spoke up to say that she always knew she was transgender. But she had never framed her experience around issues of sexuality, gender or identity. She also didn’t see how all of that could have impact on HIV prevention. But she knew about stigma and discrimination. She experienced that in more ways than one, in almost every aspect of her life. Every single day.” “Yes, it’s not easy to make others relate to the experience and challenges of transgender and hijra communities, especially in the context of Indian society and culture,” one of the consultants reflected aloud. As the meeting continued, Asha swung back and forth between feeliing overwhelmed by the task to feeling more confident that between them they could make the programme work. They simply had to. ”There should also be some focus on examining family issues from the perspectives of men who have sex with men, trangenders and hijras. We should add some tools that would help them identify support strategies – recognise the support mechanisms that already exist, and the opportunities they already have or can create for themselves,” Asha suggested emphatically, as the whole team went through one of the modules. And this triggered another round of discussions on possible approaches and tools. Asha smiled to herself, pleased at the eager exchange of ideas among her team.

“I want leaders,” exclaimed Asha, cutting short a particularly long-drawn-out exchange on one of the modules. Kumar raised an enquiring eyebrow, not entirely sure where Asha’s sudden statement was coming from. “I want community leaders to be our master trainers,” Asha blinked, seeing images in her mind of men who have sex with men, transgenders and hijras facilitating trainings for their own communities. “Yes, that’s definitely the right approach,” one of the consultants replied, as the others nodded in agreement. “If community leaders take ownership of the programme, it will be our first step towards community preparedness,” Asha continued, as she drew a rough capacity-building flowchart on tissue paper plucked out of a floral box on the meeting table. Then she added, “Community leaders are the role models. Our modules will be delivered directly from the horses’ mouth. Other members of their community will be inspired by their leadership skills and will be similarly motivated to build their own skills.” Continuing with the upward arrows and boxes in her tissue-framed flowchart, Asha concluded, “We will work intensely on strengthening leadership and governance issues, and this, in turn, will facilitate the process of organisational development. Moreover, it will help achieve the goal of sustainability for the community-based organisations.” After many hours of discussion and several rounds of steaming hot coffee, Asha called the meeting to an end. Her steps lighter now, she walked back to her workstation with Kumar trailing behind her. “Now I’m convinced that the training modules have the potential to be liberating and empowering for the community,” Asha chirped, stopping abruptly to look back at Kumar and causing him almost to fall backwards. Oblivious to what she had done, Asha added, without skipping a beat, “We have to review further the modules on leadership and

FINDING THE RIGHT FIT

YOU’RE A LEADER! HARJYOT KHOSA

governance. And we also have to strengthen our sessions on legal rights. Oh, and on issues of violence and trauma, we have to strike a good balance between participative approaches and bringing out peoples’ experiences, but also provide inputs and a framework for looking at these issues.”

motionless, at the back of the room. “Why she is looking so lost?” she asked Kumar, motioning towards the quiet one.

Kumar replied, amused that the nervousness of his colleague had turned into a seemingly uncontainable energy, “Our trainings can act as a catalyst and leaders will emerge from the community.” Kumar was both hopeful and reassuring.

“Let’s see how she reacts over the course of the day,” Asha replied with an encouraging smile, determined to remain optimistic.

“I really want community leaders to be the torchbearers in the programmes,” replied Asha.

Coming together Fired up with the spirit of the programme and her own team’s enthusiasm, Asha walked into the training venue. Today, the long-awaited training of trainers would begin. “This room is full of potential leaders,” she thought to herself, taking in the dazzling spectrum of bright colours. “Like a collective rainbow flag,” she added. Some of the participants were dressed in magnificent kanjevarams (silk saris), glittering gold jewellery and had beautifully executed and unsullied mehndi (henna) on their palms. It was also a room full of voices! “They are the future pehchan of our programme,” she whispered to Kumar, breathless with excitement. “Yes, indeed,” said Kumar, calmly sipping his coffee. This was his community too. “Yes, indeed,” he repeated. It was time to begin the training of trainers. Asha took out her printed copy of the five-day agenda, aiming to have a quick glance at it before formally opening the sesion. A burst of laughter from one group of participants made her look up. She smiled at their animated gestures. And then something caught her eye. One participant was standing quietly, almost

“Oh,” sighed Kumar, immediately recognising who Asha was referring to. “She’s Rani. She’s just shy. She just needs to open up more.”

Throughout the day Asha kept an eye out for Rani. During the afternoon tea break she found Rani sitting forlornly, flipping through the pages of the printed module. “Which module are you reading?” she asked. Startled, Rani replied, “Leadership and…” Flipping back a page to check on the module title, “Governance,” she added. “Why are you reading this specific module?” enquired Asha, noting that the topic had not yet been covered but was obviously of interest to Rani. After a few seconds of hesitation, Rani slowly uttered in her low voice, ”I want to be a leader and do something for my community.” “So who’s stopping you?” Asha asked teasingly, giving Rani a gentle and reassuring smile. Kumar handed Rani a mug of hot coffee and joined in. As the two smiled at each other, Asha saw Rani visibly relaxing. Then the three of them remained silent for a moment as Rani timidly took a sip of her coffee. “I also want my people to listen to me,” Rani began. “They should value my thoughts too. We transgenders are so discriminated against.” “Confidence and knowledge can be your ammunition, Rani. You need to bring out the leader in you. Participate and share as much as you can in this training. It’s a platform for you to gain your confidence,” Asha replied. She

“Confidence and knowledge can be your ammunition, Rani. You need to bring out the leader in you. Participate and share as much as you can in this training. It’s a platform for you to gain your confidence.”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

was glad to see a spark in this seemingly shy and quiet leader. “Yes, she can be a leader,” she silently thought.

“You are our leader!” someone shouted from the side of the hall. She was a hijra and had stood up, pointing and smiling at Rani.

“Now, let’s go back inside and resume the training session,” Asha said, waving the printed agenda towards the direction of the meeting room. As they watched Rani move towards the doors, Asha whispered to Kumar, “What did you put in that coffee mug? She was suddenly on fire!”

“You are our leader!” came two more voices, and then it became a chant, echoing and engulfing the entire training hall. “Yes, let it rage. Like a storm,” thought Asha. Her eyes glued to Rani, she watched as her face turned from disbelief to embarassed giggles to radiant smiles.

Kumar laughed.

You are a leader! “Do you think we all are leaders?” Asha tried to look at each participant as she let her question sink in. Some avoided her glance, their eyes darting to the papers in front of them or to other parts of the room. Others just stared back blankly, unsure how to react. There was a deathly silence and Asha thought, “Now what?” “But leaders are born, not made.” It was Rani, breaking the room’s momentary silence with her quivering voice. Asha exchanged a quick triumphant glance with Kumar. “I am standing here. Do you think I am your leader?” Asha prodded, looking straight at Rani and raising her eyebrows in anticipation. As Rani pondered, Asha pushed on, “Can I explain your issues? Do you think I will be able to provide solutions to your problems?” Rani stared back at her with increased defiance. “No,” she blurted out, “I know best about me.” Her hennaed palm rolled into a fist and jabbed her own chest. Then after a pause, Rani added, “But I feel that I cannot be a perfect representative of my community.” Asha walked to the middle of the training hall, heading towards Rani’s end of the room. Not about to let up, she threw Rani’s own words back at her, “You know best about your issues. You can be the best representative of your community.”

*** Back to beginnings Asha jolted awake to the harsh sound of the hotel’s alarm clock. She had slept soundly but not quite enough. Drowsily, she looked at the time and groaned, “Five o’clock. Why, oh why, oh why?” Dragging herself out of bed, she jumped into the shower and her mind promptly woke up with the shock of water over her head. “Did that really happen?” she found herself chuckling out loud. Rani and the crossdressed protesters in the hotel lobby, the petrified manager’s face – she suddenly remembered the events before bedtime. “And Rani, what a transformation!” As she dressed and prepared for her day, Asha’s thoughts settled on Rani and how eloquently she’d spoken on behalf of the group. She shook her head in disbelief. How much a person can transform! What a pleasure to witness it. It was almost time for her breakfast meeting with the training team. She was here on a mentoring visit for their community trainers. The phone rang and Asha picked up the call. “Good morning, Asha. I hope you slept well? My co-trainers and I are now waiting for you in the breakfast hall,” Rani said, her voice confident and upbeat. Asha smiled.

SMOOTHING THE SILK

Expect the unexpected Dechen Wangmo

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

With the future of the country’s major disease programmes at stake, Sonam finally gets the green light for the revamp assignment. But reforming the Country Coordinating Mechanism governance will be a delicate task. And first on the agenda is to convince the Chair and other members that the Global Fund requires them to be elected.

The October sun was dazzling, reflecting back the golden tones of the harvest in the fields around the eighteenth-century fortress. It was a spectacular autumn day as the health consultant drove to her usual place of work, the Ministry of Health. The brightly painted building was perched on a hill overlooking a valley of rice fields. It was decorated with a blend of exquisite classical motifs and contemporary design – a perfect juxtaposition of tradition and modernity. Sonam la, as she was commonly known, had just got back from an assessment of the sanitation services in five rural villages around the country. Two weeks in the field showed on her tanned face and unruly dark brown hair. Usually knotted into a neat bun, it was now tumbling wildly over her shoulders. She cherished these trips out into the beautiful countryside, but she was equally pleased to be back. As Sonam walked up the glossy white marble stairs of the ministry, carrying her Starbucks latte in a burnished blue commuter mug, the conversation with her colleagues flowed from the exceptional autumn weather to a more serious discussion about the Global Fund application they were all developing, and concluded with the worrying gap in funding for the national HIV programme. At the top of the stairs, just by the revolving glass door on the second floor, the director of the Health Ministry’s communicable disease programme, Mr Pema, was waiting for her. “Good to see you, Sonam,” he exclaimed hurridly. “I wanted to ask if you are available to work for the assignments on the Global Fund eligibility criteria.” But before Sonam could reply, Mr Pema was whisked away for a high-level meeting in the opposite room and that was the last she heard about the possible assignment for a month. It was not until the final Monday of October, as Sonam was editing a report on her home computer one evening, that an email appeared from a consultancy

firm she had worked for before. It contained the terms of reference for the Country Coordinating Mechanism (CCM) revamp assignment. The CCM is a governing body responsible for overseeing the country’s Global Fund grant, with representatives from various sectors and development partners. The terms of reference were labelled ‘Task Order #138-CT CCM’ and they were designated high priority. As she scanned through them, she noted the objective ‘To provide technical support to the CCM to strengthen its capacity to carry out the full range of functions of a CCM’. “Wow,” she thought, “this task is enormous!” Sonam had worked with the CCM before so she recognised some of the challenges that lay ahead. She let out a long sigh and moved gently away from her computer, as if haunted by the magnitude of the task. From the garden she could hear her dog, Dawa, barking for his usual walk around the neighbourhood. Up until the moment when she signed the contract, Sonam continued to argue with herself about whether to accept the assignment, given that a successful outcome depended heavily on the responses from CCM members. Apart from technical knowledge of the grant eligibility criteria and architecture, the assignment required soft skills to delicately weave and tighten the loose ends of the current CCM governances. And as she ran through the processes required, she began to doubt her own skills. After all, this was going to be her first CCM assignment specific to governance. Finally, still with reservations, she signed the crisp paper with her favorite lucky blue pen that had been given to her by her grandfather. Two weeks later, Sonam and the two other members of the small team that had been put together for the assignment were immersed in laying out the masterplan for the revamp

SMOOTHING THE SILK

EXPECT THE UNEXPECTED DECHEN WANGMO

process, and identifying the weak areas of the current CCM functioning. The view from the ministry’s small meeting room adjacent to the library was breathtaking. A fresh, thin blanket of white snow covered every inch of the ground, and glistening snowflakes hung on the barren branches of well-manicured hibiscus hedges around the car park.

various correspondences and reports. On the fourth day, for a change of scene, they set out for a long discussion in a small cafe outside the ministry. The smell of freshly brewed coffee mingled deliciously with the aroma of baked goods displayed on the clear glass shelves. Sonam had to use all her will power to resist the temptation.

The meeting room floor was covered with wallto-wall grey carpeting that gave off a faint whiff of mould. Piles of documents and old books were scattered on the floor, waiting to be shelved in the library. Just as Sonam was starting to feel desperate for fresh air, her daydreaming was gently interrupted by Mr Navin’s tapping of his Mont Blanc fountain pen, followed by a polite request, “Could I have the minutes of the last CCM meeting, please?”

By the end of the afternoon they had come up with an action plan for the assignment. They still had some reservations about how it would be received by the Chair and other CCM members. First and most important point on the agenda was to convince the Chair of the governance reforms ahead.

“Of course,” replied Sonam quickly, and passed the aged manila folder containing the background documents for the assignment to her colleague. Mr Navin flicked through the pages with his reading glasses perched on the end of his nose, and methodically ticked off one document after the other on the list. Mr Navin was a management consultant in his mid-fifties and the team leader for this assignment. He and Sonam had been colleagues in the past and were well acquainted with each other’s working style. Sonam enjoyed working with Mr Navin. He was well organised: a man of process and detail, and always prepared for plan A, B and sometimes even C – rather similar to Sonam’s own style, in fact. “I’m lucky to be working with Mr Navin,” she thought. The dynamic between team members was so important for the success of an assignment. Sonam and Mr Navin spent three days dutifully going through minutes of CCM meetings, previous Global Fund proposals, copies of

The nuts and bolts of the issue One week later, armed with a finalised action plan, Sonam and Mr Navin sat waiting for the CCM Chair on a shiny leather sofa outside his office in the Ministry of Health. They were half an hour early but were happy to wait as his secretary had offered them some refreshing masala tea – the perfect tonic after all their hard work. “Good morning,” smiled the CCM chair eventually, as he ushered the two consultants into his well-organised office. A stack of books on community health leaned against the yellow wall opposite his beautifully carved oak coffee table. It had been imposingly placed in the middle of the room, surrounded by four splendidly upholstered brocade chairs. Mr Lekey’s office might have been destined for the cover of a magazine. After a round of handshakes and introductions, Mr Lekey addressed them. “We have decided at our most recent CCM meeting to apply for grants for all three diseases in the upcoming round of the Global Fund. Now that there are all

“Good morning,” smiled the CCM chair eventually, as he ushered the two consultants into his wellorganised office. A stack of books on community health leaned against the yellow wall opposite his beautifully carved oak coffee table.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

these new CCM eligibility criteria, we would like the team here to review the status of our CCM and guide us through whatever processes we need to go through.” Sonam was relieved to see the Chair’s receptive attitude. She knew from past experience not to expect too much interest in any reform of the CCM’s governance structure. But Mr Lekey continued, “I have always had the highest respect for the institution of CCM governance, be it at community or national level, and will continue to respect it. But sometimes, perhaps because of our human nature, we forget to accommodate change.” Mr Lekey’s statement was refreshingly honest. Since the CCM’s inception there had not been any change in its structure. Almost all the members were nominated by the Principle Recipient, without any election taking place. He cleared his throat and continued, “I am told that the reason we did not get the Round 10 proposal approved was the conflict of interest, with me being head of the Principle Recipient while also heading the CCM.” He paused while he repositioned his Ray-Bans, and in a melancholy voice added, “I can’t help feeling,” he paused again, “a certain degree of personal responsibility for this unfortunate turn of events. So now we want to try our best to meet the requirements of the Global Fund.” Sonam remembered how she had raised this issue many times in the past. In the world of donor funding, the current system had major structural issues. Next Mr Navin took to the floor and presented the strategy for the CCM revamp process. Topping the list was the election of the CCM Chair and the other members, followed by slightly less-sensitive interventions such as orienting the CCM members on the new requirements and

facilitating a consultative meeting with them to identify bottlenecks. After an hour of deliberations Mr Lekey stood up, indicating that the meeting was over. “I look forward to these changes,” he said, looking intently at Sonam. “Sonam has been working with us for a long time and she is very much aware of how we do things around here. Thank you for coming and I look forward to the presentation to our full CCM members in two weeks’ time.” With the green light from Mr Lekey, the team rolled up their sleeves and began deconstructing the strategy right down to the last detail. Every scenario was dissected and analysed with total commitment and dedication. First on the agenda was a briefing session with the Principal Recipient and the sub-recipients of the grant. This involved an intensive analysis of the CCM – what was working and not working. The analysis continued for several days, with a series of meetings and PowerPoint presentations. Each discussion began with the team stating the purpose of the review, followed by an assessment of the technical assistance needed and a formulation of the end deliverables.

The much-awaited verdict At the end of two weeks the team presented the results of the assessment to the full house of CCM members, Principal Recipients, subrecipients and observers. The air was tense with anticipation of the major changes to follow. Since its inception there had been very little restructuring or capacity-building of the CCM, so this process was new to everyone. Mr Lekey opened the meeting, and once the agenda had been adopted by the floor, the Chair addressed the meeting. “Let us all listen and

SMOOTHING THE SILK

EXPECT THE UNEXPECTED DECHEN WANGMO

deliberate,” he said, “so that the people who need the services that we expect to be funded by the Global Fund do not suffer. What we discuss here today will determine the future opportunities for the HIV, tuberculosis and malaria programmes in our country. We are happy to have the required expertise with us to guide us.” The floor fell silent as participants reflected on his statement. Mr Navin, in his customary formal black suit, stood in front of the U-shaped table in the conference hall. As a line of serious faces gazed up at the turquoise screen, he motioned to Sonam to begin the presentation. They had summarised and listed the work under four major assessment components: the structure and process, monitoring and evaluation, capacity, and human resources. With a fleeting smile, Sonam cleared her throat and began to present the processes and outcomes of the assessment. “The current institutional arrangement of the CCM needs major changes, both in terms of structure and process,” began Sonam strongly, casting a quick glance at her audience. “The CCM secretariat needs to be separated from the programme management unit of the Principal Recipient, and routine oversight activities need to be instituted.” She cleared her throat again and, avoiding looking directly at the Chair, continued, “And the Chair and all other members of the CCM must go through a transparent election process.” There was a long pause and a bewildered look on the faces of many CCM members. Then suddenly a voice from the back of the room asked, “Why all these changes now? We have been getting the grants in the past.” Sonam and Mr Navin exchanged a quick glance. Both consultants were sensing the need to change tack. Rather than continue with their presentations about election processes and oversight

mechanisms, they first needed to help members to understand the underlying principles. Back to basics! So after a quick discussion, they took a step back and began to explain the fundamentals of the Global Fund principles and mechanisms. For many in the audience, performance-based funding was an alien concept. As one member from the non-governmental organisation constituency said, “We are performing well with our grants and I don’t see where this idea of meeting the eligibility comes from?” That was the opportunity Sonam needed to introduce the institution of governance. “Yes, you are absolutely correct,” she replied, “the grant is performing well in terms of the deliverables. But the issues here are checks and balances, transparency and having representation in the governance. The Global Fund wants to know that all these are in place for effective grant implementation. This means that the implementer cannot oversee the grant. It would be a major conflict of interest.” There was a moment of silence before Mr Lekey spoke, “These are critical issues that Sonam and the team have raised. I am happy they are here to guide us through this process.” The discussion that followed turned out to be a guiding light for the entire assignment. The team was able to help CCM members understand Global Fund architecture and what is required of recipients, and to present a way forward for the CCM to meet these requirements. The team’s prompt action in recognising their audience’s knowledge gap and making immediate changes to the agenda saved the day. After four hours of explaining the fundamentals of the Global Fund and answering numerous questions, the meeting agreed to resume the

“Wow!” said Sonam, “that was quite a U-turn. We went in this morning with an assumption that they were aware of how the Global Fund works, but that was far from the reality, wasn’t it?”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

next day. They were intending to return to Mr Navin’s presentation, hopefully with a more engaged audience this time.

The light at the end of tunnel The team got together for a short post-session meeting and went briefly over tomorrow’s agenda. “Wow!” said Sonam, “that was quite a U-turn. We went in this morning with an assumption that they were aware of how the Global Fund works, but that was far from the reality, wasn’t it? I’m so happy we figured that out before we presented our way forward, because without the fundamentals it would have made no sense to them.” “With all the background information in place, they will be far more receptive to the way forward tomorrow,” agreed Mr Navin firmly. The next morning Mr Navin took to the floor and explained meticulously all the guidelines and requirements for the election of CCM members to occur in a transparent and accountable manner. Then after the meeting was closed, the two consultants met separately with the Chair to agree on the next steps. The way forward included developing a governance manual, a mitigation plan for conflict of interest, and an election process for an oversight committee, proposal development and technical working group. The Chair was genuinely pleased with their performance, and thanked the team members with a formal dinner.

SMOOTHING THE SILK

Listen to ME: itâ&#x20AC;&#x2122;s not bad to be bad Maria Cristina Vinas-Ignacio

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Deeply concerned by the sub-recipient assessment, Joy knows it will be a ‘no’ for YES Foundation in Phase 2. The Principle Recipient is just as worried – YES are very influential in his country’s HIV community. But Joy has an intriguing suggestion for the sceptical technical committee that means there may yet be a way to say ‘yes’ to YES.

The good life in the Far East

Bento boxes: an oriental treat

With a sharp crack, a bolt of brilliant white lightning forked across the sky. Joy Rivera glanced up at it anxiously as her taxi made its way through the knee-high flooded city streets. Joy, a rather fun and carefree consultant in her early thirties, had been sent to the Far East to help a Principal Recipient assess the performance of their sub-recipients. It was a challenging mission but one that she had accepted without hesitation, despite the very short notice from the technical support headquarters. Realising the need to multitask, she was already reading grant documents en route to the Good Life Foundation’s office – although somewhat distracted by the hard rain hitting the cab roof.

Undoubtedly Joy knew what she had to do. “Changes brought about by people are more meaningful than imposed ones. Facipulate (Facilitate and Manipulate).” Joy could still hear the well-modulated voice of her favourite college professor. She lifted her cup and smelled the familiar aroma of the local brew inside the already-freezing conference room.

“We do not have an assessment tool. How do we assess? Who will be part of the assessment? How soon can we finish? We need to come up with a decision before Phase 2 starts. It’s month 17 and we need to submit our Phase 2 application next month.” These were some of the problems thrown at Joy by Dr Montero, programme manager of the HIV/AIDS division. Dr Montero, an influential public health practitioner who often delegated major tasks to his subordinates to maximise his executive time, still managed to get worried by these kind of challenges surprisingly quickly. “Our sub-recipients are all over the country so we need to get your local stakeholders involved,” replied Joy. “We urgently need their help this time. Your team, even with my help, cannot do it alone.” She snapped open her laptop, swivelling around on her chair inside the small meeting room crammed full of voluminous reports. “Joy, please take over. I trust you,” asked Dr Montero firmly. Apologetically he added, “I am very sorry but I need to go as I have a very important meeting with the Ministry of Health.” Instantly he was gone, and Joy heard only the creak of the door hinges as it closed behind him.

“We can use the Global Fund Principal Recipient assessment tools,” she said, as the members of the HIV/AIDS technical committee and Principal Recipient department heads looked perplexedly at her PowerPoint presentation. It showed the functional areas examined by the Global Fund when assessing a Principal Recipient. “I think those are too complicated and rigid for a sub-recipient’s assessment,” said one department head finally. “Yes, we don’t have enough time,” agreed a technical committee member, while other participants nodded. Vince, a tall, dark-skinned government employee in his mid-forties, who could always be relied on to be supportive of his colleagues, suggested, “Why don’t we go through the tools first and check what we can use from them?” Joy looked at him with a thin smile as she waited for a response from the group. But silence had fallen over the room like a heavy blanket. “I think it’s only systematic for us to evaluate the sub-recipients in the same way as the Global Fund examines the Principal Recipient,” she said confidently. “Basically, the Global Fund Principal Recipient assessment tool looks into the institutional and programmatic, monitoring and evaluation, procurement and supply management, and financial management systems. We can use these as parameters as

SMOOTHING THE SILK

LISTEN TO ME: IT’S NOT BAD TO BE BAD Maria Cristina Vinas-Ignacio

well. Every six months you prepare the Progress Update and Disbursement Request. That means you are telling the Global Fund that you did this much, you spent this much, you planned these things for the coming months, and that is why you are requesting this much,” she explained. “And if the Global Fund finds out that we failed in terms of performance, then they will not approve the release of the funds to support our programme implementation for the succeeding period,” a department head added drily. “Absolutely,” Joy replied. “And if you don’t deliver, you can’t buy sexually transmitted infection drugs and HIV test kits, condoms and lubricants for the clinics, or information, education and communication materials for community outreach. And how about the antiretrovirals for your patients?” she added emotionally. “So you must protect the grant funds,” Joy concluded, leaving everyone in the room deep in thought as she made her way back to her seat. Glancing at a young, fair-skinned woman who had just entered the room, she added, “And you will not have a free lunch from the Global Fund!” Laughter filled the room as everyone opened the Bento boxes the staff had ordered for lunch. “An oriental treat indeed,” she thought.

A tropical storm Street children selling flowers knocked on the car window as the driver nervously stepped on the brakes. Joy lurched forward. The police officer had unexpectedly given them a ‘stop’ hand signal even though the traffic light was green. From inside the taxi Joy could hear the horns of cars trapped on the busy highway. Floodwater that had accumulated along the side streets had not yet subsided. Heavy-hearted, Joy looked out at the tail end of the tropical storm that had recently claimed lives and devastated that part of the country. Slowly the car began to move forward again, and Joy took a deep breath as she recalled the recent challenging discussions with the department heads and technical committee

members so they could come up with an assessment tool aligned with the Global Fund’s requirements. To her, the conflicting views of the stakeholders and staff were mirrored in the angry sky and fierce thunderstorms. These storms scared her so much she sometimes had to cover her face with a soft pillow. But there was no room for faintheartedness for a budding yet determined consultant. In reality, the critical discussions had only served to fuel her passion still more. “Essentially, the tools are already there, but the participatory process of development is a ‘must’ that we all have to go through,” she thought. “The storm is over. I’m no longer afraid.”

Island paradise “Vince, here are the grant performance reports and assessment tools,” Joy smiled, as she rushed to have her luggage scanned at the airport. A short while later, leaving behind the hustle and bustle of the city, they hurriedly stepped into a well-ventilated local restaurant made of bamboo and nipa, a palm whose foliage is used for thatching. Meticulously crafted ornaments of seashells and abacá were everywhere, and Joy felt her good spirits return once more as she listened to the refreshing splash of the fountain at the centre of the dining area. “What’s the house specialty?” Vince asked the fair-skinned young waitress. “Mud crab in coconut milk, barbecued pork belly and chicken, pan-fried shrimp or dried taro leaves in coconut milk, sir,” she smiled. “I want to try all of those,” said Joy quickly. She felt the warm welcome and sincerity of the beautiful waitress, who continued smiling as she wrote down their orders on a small piece of recycled brown paper. “How characteristically oriental,” Joy silently thought. Restored by the delicious flavours of the local cooking, they were soon ready to be on their way. “Where to?” asked Vince.

These storms scared her so much she sometimes had to cover her face with a soft pillow. But there was no room for faintheartedness for a budding yet determined consultant.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Joy, thrilled, opened her notebook, and read out, “YES Foundation and Dr Martinez, local health service head.”

the signal for them to start. Vince quickly nodded in return. “Did you receive the letter from the Good Life Foundation?” began Joy.

Vince grinned and picked up his backpack. Together they walked towards the tricycle (a local form of public transport consisting of a motorcycle and an attached passenger sidecar) they had rented, and he proclaimed in a fruity voice, “Dr Martinez is a straightforward and very passionate medical practitioner in this part of the country who has been working in the government for more than two decades.”

“Yes,” the officer-in-charge replied quickly. “The Good Life Foundation clearly explained the purpose of the sub-recipient assessment and how important it is to the country’s Request for Continued Funding for Phase 2.” He added curiously, “In the letter, Dr Montero said that the assessment team will examine source documents of the reports we have previously submitted to them, and also that you need to interview our finance and programme officers and community health outreach workers.”

“Wow! Such long service,” commented Joy as she stepped inside the colourful three-wheeled vehicle, a common sight in the rural areas. “Indeed,” agreed Vince. “In fact he first established his career in the medical field and has proven his worth to the local government and his patients.” The lush open fields and the roaring waves of the Pacific astonished Joy as she made her way through the countryside with Vince. She loved the cold wind that blew her magenta hair right into her eyes. “This island is truly a paradise,” she silently told herself.

YES, who? “…a community-based organisation of gay men that promotes the rights of homosexuals and provides services for the prevention of sexually transmitted infections,” Joy read while waiting for the officer-in-charge. She and Vince were standing in a bedroom that had been converted into the conference room of the semi-concrete two-storey apartment that was the YES Foundation’s office. “Good morning Vince, good morning Ms Joy,” said a thin man in his early forties, as he shook Joy’s hand. “Good morning. Rivera, Joy Rivera, monitoring and evaluation consultant,” replied Joy, smiling. She looked over to Vince and raised an eyebrow,

“Yes,” said Vince and Joy simultaneously. “All right,” replied the officer-in-charge. “I’ve already informed them about this and I think they are ready. How do you want us to proceed?” Joy was pleased. “First of all, we would like to give you a background of the sub-recipient assessment. The Good Life Foundation, with guidance from members of the technical committee, developed a tool to assess the Phase 1 performance of their sub-recipients. Key functional areas that will be examined for each sub-recipient are institutional and programmatic, monitoring and evaluation, and financial management,” she confirmed. “So, Vince will interview you for the institutional and programmatic arrangements, and I will take care of monitoring and evaluation. But I need to sit down with your staff for the interviews separately. Do you have an extra room for this?” The officer-in-charge looked worried. “I see,” he replied, stroking his chin. “You can stay here, Ms Joy, and I will ask the others to join you. Vince can join me in my room.” “Perfect,” approved Joy. “By the way, an internal audit staff member from the Good Life Foundation is coming along too.” She opened her binder to take out the printout of the assessment tools.

SMOOTHING THE SILK

LISTEN TO ME: IT’S NOT BAD TO BE BAD Maria Cristina Vinas-Ignacio

“No problem, our finance officer has gathered the documents for the review. He’s ready,” the officerin-charge confirmed. “Good. Lastly, we would like to let you know that we have also requested a meeting with the local health service head, Dr Martinez.” She paused and then continued, “Do you have any more questions before we go our separate ways?” “None for now,” the officer-in-charge replied. Vince picked up his bags and followed the officerin-charge, while Joy opened her Excel files ready for the interview.

No to YES Foundation “If you will insist that we partner with YES Foundation, then let me tell you that we do not need the HIV/AIDS project support.” Joy could still hear the foghorn-like voice of Dr Martinez responding to her question about the relationship between the YES Foundation and the health office. She sipped her coffee as she paused to think of the best way to document her findings. She clicked the toolbar to go back to the Excel table she had been working on since she got back from the countryside. Her summary tables revealed the low score of the YES Foundation, with only 59% in institutional and programmatic systems due to poor partnership and coordination. Their score in monitoring and evaluation was slightly higher, but still ranked the lowest among the sub-recipients. Joy took a deep breath and switched to the PowerPoint file she had been working on for hours. Alarmed by the lone red among the green bars in the graph she had patiently created for the technical committee meeting scheduled the next day, Joy took a reassuring sip of coffee and told herself intensely, “YES had recently moved to that apartment simply because they do not have sufficient funds to pay for the monthly rental of their previous office. Their staffs are all MSMs and therefore beneficiaries as well. In fact, their officers were spotted

as potential community leaders by previous implementers of an HIV/AIDS project in this country, and were consequently encouraged to set up an organisation for themselves. YES is the community!” Deeply concerned by the results of the subrecipient assessment, she rubbed her eyes and spoke sternly to herself in the mirror. “YES is a struggling community-based organisation who is at your mercy, Joy.” She knew that it woud be a ‘no’ for YES in Phase 2.

Listen to ME (monitoring and evaluation) “Joy, YES Foundation is very influential in the HIV/AIDS community in this country. They have been here for ages. And they’re my friends.” Dr Montero, the Principal Recipient’s programme manager sounded tremulous as he looked straight into Joy’s eyes. He had been tapping the desk incessently, which attracted Vince’s attention. “As soon as you present those findings I will be the bad person here,” he continued. “I need to maintain a good relationship with the local health partners, but I also need my sub-recipients.” “Similarly, you need to maintain a good relationship with your sub-recipients but you also need your local health partners,” Joy responded as she flashed her PowerPoint presentation onto the white screen of the makeshift conference room. Unfortunately, the Ministry of Health had also been affected by the devastating flooding. Staring blankly at the screen, Dr Montero stretched his legs and leaned back against the damaged gas lift chair. He took a deep breath. Vince edged up to the two of them and sat down, sipping his cappuccino. “Listen to me,” he said soothingly, “I don’t think you’ll have a problem when you reveal the results of the assessment. For one, you got us involved, and I’m a member of the HIV/AIDS technical committee. And although the assessment was orchestrated by the Principal Recipient, you made sure that we were involved throughout the process. That

Deeply concerned by the results of the subrecipient assessment, she rubbed her eyes and spoke sternly to herself in the mirror. “YES is a struggling communitybased organisation who is at your mercy, Joy.”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

alone offers you protection, because when we present the findings you can confidently say that we were with you from conceptualisation through to planning and even data collection.” Vince stood up and patted their shoulders reassuringly, then went back to his seat.

“Now that the technical committee has approved the findings of the sub-recipient’s assessment in this special meeting, the Principal Recipient may communicate the results to the concerned organisations”, the Chair said, referring to Dr Montero.

Yes to YES?

Still standing in front of the room, Joy smiled and glanced at Dr Montero, who smiled back. “Thank you,” he mouthed.

“The sub-recipient assessment has identified the strengths and weaknesses of each subrecipient,” began Joy. “In summary, all of the 22 sub-recipients passed the sub-recipient assessment except for one. YES Foundation failed primarily because of the extremely low score given to them by the local health service head for poor partnership and coordination. This was verified by the assessment team when we conducted interviews with YES Foundation staff, as well as with staff from the local health service.” Joy’s voice was modulated as she handed out their response. She continued, unaware that she was rubbing her hands together and crossing and uncrossing her fingers, “Actually, YES Foundation handles two project sites. And they seem to have a good relationship with the other local health service head, who expressed willingness to continue working with YES Foundation if Phase 2 is approved. Since the main challenge with YES will actually be on partnership and coordination, I recommend that they be retained for one site but ensure that the identified weaknesses be made Conditions Precedent for Phase 2. So you can remove YES from one site but give them the opportunity to prove their worth by allowing them to continue with the other site.” Joy was waiting for a reaction from the members of the technical committee who were absorbed in her presentation that had flashed onto the screen. “I move for the approval of the findings of the sub-recipients’ assessment,” said the PLHIV community representative finally. “I second the motion,” said the treatment hospital’s head.

“Whew! A ‘yes’ to YES,” she thought.

It’s not bad to be bad Joy thanked everyone and quickly packed her belongings, as the car that she rented was already waiting outside the old Ministry of Health buildings. She stretched out her hand to Vince, “Thanks a million, you’ve been very supportive. And for that I owe you one.” Vince stood up and accompanied Joy to the car park, carrying her laptop. As they approached the car, Joy took out a small pouch from the new bag she had bought from one of the provinces, and handed it to Vince. “Keep this, Vince – and thank you,” she said before climbing into the car. “International airport,” she instructed the driver. Surprised, he quickly moved back the seat that he’d reclined for a power nap while waiting for Joy. Turning the ignition on, the engine made a strange whining sound and then faltered. Joy quickly opened the window and smiled at Vince, who was waiting for the car to leave. “Please treasure that small gift of mine. You might need it next time, and you’ll definitely find its use priceless.” Joy closed the window as the worried driver finally managed to start the car, and leaned back against the faded canvas of the seat. Curious to see what she had given him, Vince opened the small pouch and carefully took out the priceless gift. “TROJAN, Shared Pleasure,” it read. Smiling at the condom packet he whispered, “Indeed, a bad girl.”

SMOOTHING THE SILK

LET THE FLOWER BLOSSOM Lasantha Kodituwakku

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

When Kanna first encounters the charismatic leader of MAGSA clothed only in a bath towel, he begins to suspect that the community organisation may not easily fit Global Fund expectations. Increasingly frustrated but ultimately inspired by their work with marginalised communities, he becomes determined to help MAGSA carry on doing what they do best.

Kanna switched on his car radio and glanced at himself in the front mirror. He felt so confident in his Bangkok clothes, bought just days before leaving the city. Humming along to his favourite local radio station, he heard the voice of his new boss, Nevil, replaying in his head.

A man, wrapped only in a bath towel, opened the door. His chest was bare and his shoulders were broad, blocking the entrance. Before Kanna could say anything, the man wrapped his arms around him. “Kanna, welcome to my kingdom,” the man exclaimed.

“Kanna, I need the final versions of MAGSA’s human resource management and financial management manuals by 10 May,” Nevil had said. “Don’t forget, they need to be signed by the Board’s chairman and secretary.” Although it was now only four days to the deadline, Kanna wasn’t concerned. “It’s just a matter of a few discussions and a bit of editing,” he thought dismissively.

“Ravi?” Kanna asked shakily, trying to avoid staring at the enormous dragon tattooed around the man’s bicep.

Kanna had been contracted by AFD, a subrecipient of a Global Fund project. He was to provide technical support to MAGSA, a community-based organisation known for its decade-long work with men who have sex with men and transgender people, and for its charismatic leader, Ravi. With Kanna’s support, MAGSA was to build its human resource and financial management systems, and become a sub-sub-recipient of the project. Kanna had spent the last week at AFD’s office with Nevil, preparing and discussing MAGSA’s existing systems. Although the manuals they had reviewed looked suspiciously similar to the examples AFD had sent to MAGSA, Kanna still wasn’t worried. He had spent the previous evening highlighting the sections that MAGSA needed to change. “It’s nothing compared to the tasks I’ve carried out in the past,” he thought to himself, admiring his new tie in the front mirror again. It was almost 9am and, parking on a quiet street, Kanna walked quickly up the path. He was used to being on time; punctuality had been required in Bangkok. As he came closer to the building he slowed a little, looking curiously at the small house in front of him. Why were all the shutters closed? Where was the office’s sign-board, or even the house number? He looked again at the address in his hand, and smiling slightly nervously now, stepped inside.

“Who else?” laughed Ravi, pulling Kanna inside. As they walked up the staircase Kanna looked around the building. The only signs of an office were one glass cupboard with a few files in it, two old computers and a few members of staff chatting in an open space on the third floor. Behind them was a round wooden dining table, dishes piled at its edges and four dogs snoozing around its legs. Could this be his desk, Kanna wondered? Sitting down, Kanna clutched his laptop bag closely to his chest as they began to discuss the work ahead. As the conversation meandered on, Kanna thought back to the picture of a beautiful swan that had hung in his shiny office in Bangkok. Had he made a mistake? “Maybe you should go home today and come back tomorrow,” Ravi announced abruptly, noticing something on the other side of the room and rising from his chair. “We’ll start at ten.” Kanna was shocked. So this was to be his first day? He had so many questions for Ravi. He wanted to discuss MAGSA’s staff recruitment and procurement process, to agree rates for per diems and accommodation for staff travelling, and to make a plan for the week. He knew he had to act quickly. “I can see you are busy,” Kanna said respectfully, “but why I don’t spend some time talking to your staff instead? I have some questions for your administrative officer. Perhaps I can meet with him today?”

SMOOTHING THE SILK

LET THE FLOWER BLOSSOM Lasantha Kodituwakku

Ravi nodded, and Kanna breathed a sigh of relief. Maybe he could get the information he needed from Ravi’s colleague instead. Driving home later, Kanna thought about his day, his mind crowded with images of MAGSA’s office. He had finished the job with the administrative officer quite easily. The man had said little, allowing Kanna to make all the changes, just saying they were fine with him. It seemed as if no one in MAGSA was really interested in developing these manuals. So why on earth did they want the funding? They must have known the Global Fund would expect systems to be in place. Or did they just want the money and didn’t think the rules and regulations would be so strict? Kanna thought back to the stories he had heard about MAGSA before he arrived: the years of work they had done with marginalised communities, the differences they had made. “It’s probably the first time they’ve had this type of funding,” he said to himself reassuringly. He knew the challenges these organisations faced in his country, and in others – the stigma, and how the legal system and society in general stacked up against them. Breathing more slowly now, he knew he had been too quick to judge. It wasn’t MAGSA’s fault if they didn’t fit in with the expectations of the Global Fund. His body started warming up again, despite the blasts of air conditioning from his car. From: Kanna To: Nevil Subject: End of day one I assumed duty with MAGSA. No real paperwork and no induction as such, but I met Ravi and had a brief discussion with him. From the administrative officer I got the information I needed to start updating the manuals. I will get approval from Ravi and get back to you tomorrow.

at plates of fruit in front of them. After polite introductions, Kanna arranged to meet each of them individually, hoping to get to know them and find out how much they knew about MAGSA’s systems. An hour later, Kanna sank back into his chair, chewing on his fingernails anxiously, as the everpresent dogs sniffed at his feet. “Nothing,” he exclaimed to himself. “No systems – or if there are, it’s only Ravi who knows about them. He’s the only one running the show here.” The staff had each made it very clear that they had joined MAGSA because of Ravi. He had helped them when they were in trouble and had rescued them from the police. They trusted him, worked for him and were loyal to him. And now at the end of each month he gave them some money. This was the power of Ravi. After lunch Ravi strolled into the office, smiling and joking, and greeting each staff member in turn. Seizing his moment, Kanna spoke quickly, describing the work he had been doing since his meetings. He understood now that MAGSA had few permanent staff, he said, and he had amended the list of procurement committee members accordingly. He had checked the government regulations, and had updated the sections on staff leave and dismissal. What did Ravi think? Were there further changes he wished to make? Did he approve? Kanna continued to chew his fingernails as Ravi glanced through the document. “Everything’s fine,” he said after a few moments, his gaze returning to the room.

Day two

Kanna let his hands drop to the table in astonishment. Was that it? Ravi was the great leader – everyone knew that. Would he simply accept the changes without question? Was he distracted and thinking of something else? Or was he disinterested because manuals, systems and paperwork meant so little to him?

More staff had arrived in the office the next morning, chatting around the table and picking

As Kanna sat dumbfounded, Nevil’s words came back to him. ‘‘I need the final versions

Waving his arms around the room, he demanded,“Why do you need old documents like that? We don’t keep those! My donors give me money to work for my community, and that’s what I do. They know we don’t have time for records.”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

of MAGSA’s human resource management and financial management manuals by 10 May,” he had said. That was only two days away now. His curiosity about Ravi’s personality would have to wait.

grant. But despite MAGSA’s experience with communities, it was still a small organisation and simply wasn’t prepared for this pressure. Would he able to persuade Ravi to cooperate and finish the manuals?

“Ravi,” Kanna said loudly, in an effort to attract his attention. Articulating his words carefully, he asked to see the budgets and financial reports from the previous year’s projects. He knew MAGSA didn’t have a financial officer, but surely some records would be there?

Kanna knew he had to make Ravi understand why the changes were needed. It was all about helping MAGSA in the long run. Surely Ravi would be able to see this? Kanna was determined to meet Ravi the next day and do his best to explain.

It was clear from Ravi’s response that he did not like the question. His voice grew stronger and deeper as he spoke, and his cheeks reddened. Waving his arms around the room, he demanded, “Why do you need old documents like that? We don’t keep those! My donors give me money to work for my community, and that’s what I do. They know we don’t have time for records.” Anger burst into the room with each of Ravi’s words. “The Global Fund may request anything and everything, but we are a small organisation,” Ravi shouted. His sleeves fell back as he spoke, revealing the dragon tattoo. “We want the money to work with our community, not to fill out forms. I am the boss here, not them. I built this organisation and it works only to my command!” Ravi stood up, scraping his chair along the floor. Turning his back to Kanna, he walked out onto the balcony with a cigar in his hand. Glancing over one shoulder, he snorted, “There was an evaluation last year. Ask admin to find it. It must be somewhere in this office. But as for the finances, we spend the money on what we know is best. That’s it.” Driving home later, Kanna’s worries continued and so he switched on the radio, trying to relax. “Let the flower blossom, don’t force it to blossom,” a shrill voice sang, the lilting music filling the car and forcing the hairs to stand up on Kanna’s neck. Was this what was happening with MAGSA? It made sense that the Global Fund wanted these systems to be in place before awarding the

From: Kanna To: Nevil Subject: Day two update Things are becoming clearer but they have been tense at times. I have revised more portions of the manuals and got Ravi’s approval, but I’m not sure how interested he really is. I will discuss more with him tomorrow.

Day three It was Kanna’s birthday. Waking up, his body ached. “Getting old,” he muttered to himself, rolling onto his pillow and wishing he could stay at home. But instantly he remembered what had happened the day before and he knew he had to go back to the office to complete the task. He must persuade Ravi that all the efforts were worthwhile. Walking up to MAGSA an hour later, Kanna bumped into Ravi rushing out of the door. Standing up straight, Kanna tried to tell Ravi that he had something important to discuss. But Ravi continued on down the front path, calling behind him, “We’ll talk later, Kanna. Go ahead and share what you have done with my staff. I’ll make any decisions separately this afternoon.” Kanna felt his shoulders slump. All the way to the office he had been preparing himself for this morning. No listening to the radio, no adjusting his tie today; just going over and

SMOOTHING THE SILK

LET THE FLOWER BLOSSOM Lasantha Kodituwakku

over what he wanted to say to Ravi. And now he wouldn’t even meet him. Kanna groaned and walked into the office. The members of staff were seated around the table again, whispering. They fell silent as Kanna approached. Remembering Ravi’s request, Kanna took a seat at the end of the table, pulled out his laptop and began to speak. He finished his presentation 30 minutes later, after describing the changes he had made to the manuals. He talked through MAGSA’s new organogram and salary structure, and the procedures for taking leave and recruiting new staff. Along the way, he tried to explain why this was important, how this would help MAGSA and its staff. But although the staff nodded occasionally, friendly and polite as always, he received no comments, questions or requests for clarification. Really, he had received no response at all. Ravi had been right. He would be making any decisions separately this afternoon. A few hours later Kanna was still seated at the table, half-heartedly eating his lunch, when he heard Ravi coming up the stairs. Taking a deep breath, he tried to prepare himself for the conversation again. “Happy birthday to you! Happy birthday dear Kanna!” Ravi and his staff burst into the room, bearing a cake covered in icing and candles. One by one they hugged Kanna, placing gifts in his hands and flowers around his neck. Kanna sat in shock. He had worked for more than 20 years but had never been surprised by his office. He could feel tears come to his eyes. Laughing, he was pulled up by his shoulders and told to blow out his candles. Later, still buzzing from the celebrations and the sugar in the cake, Ravi and Kanna sat in conversation. It seemed easier now, and they were able to discuss the work Kanna had done on the manuals and the sections that remained.

Ravi spoke openly about his views, making it clear what he did and did not want. He was forceful in a way Kanna had never experienced before. He insisted that he be the person who signed and authorised cheques. And he argued vigorously for higher per diem rates for his staff, only surrendering when Kanna said there was no way Nevil would agree. Among all the negotiations over policies and processes, Ravi also spoke about MAGSA and what it meant to him. He had founded it when he was 18 years old, desperate to do something for his community. He talked of its staff, how he had met them, supported them and brought them to MAGSA. He told stories of the work it did, the differences it had made when no one else had bothered. He described the challenges MAGSA faced: the laws and attitudes ranged against them, the stigma, the continuing struggle for funding. And he emphasised his determination to continue. As Ravi spoke, Kanna could feel tears prickling again. He could see it now: MAGSA was a family and Ravi its father. No wonder he had been defensive at times. The conversation slowed. Seizing his moment, Kanna exclaimed, “We’re almost there, Ravi. I can make the final touches. Then the manuals just need to be signed by MAGSA’s chairman and secretary.” He hesitated before continuing, “How can we arrange this?” “Leave it to me,” said Ravi, his eyes darting around the room. He was becoming distracted again. “Leave me the hard copies and I’ll have the signatures for you tomorrow.” To: Nevil From: Kanna Subject: Almost there After some interesting conversations the manuals are almost done – just waiting for signatures. There’s much to discuss. More tomorrow.

As Ravi spoke, Kanna could feel tears prickling again. He could see it now: MAGSA was a family and Ravi its father. No wonder he had been defensive at times.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Day four Kanna practically jumped into his car the next morning to get to the office and finish his assignment. Switching on his radio, “Let the flowers blossom” played again. He started to whistle. Walking up the stairs to the third floor, the rooms were quiet. “No one’s in the office today, Kanna,” the administrative officer said, feet perched on the round table. Even the dogs were out today. “Ravi left a message and two books for you,” the officer said, pushing the papers towards him. Kanna could feel his heart beating as he opened the note. “Dear Kanna,” the note began, “the chairman and secretary are both out of town, so we have signed on their behalf. They will sign later. Please send the documents to Nevil and arrange for the first installment of funds as early as possible. Lovingly yours, Ravi.”

Board hadn’t been involved, and neither really had the staff. It had all come from Ravi. What would happen next, if the grant were awarded? Would Ravi stick to the systems developed? Or would something go wrong? Would all the rules and regulations, and processes just become too much? And if that happened, what would become of MAGSA and, more importantly, the work they did? Kanna walked out on to the balcony, desperate for fresh air. He glanced down at a group of children playing cricket in the road and wished he could join in. Sighing, he turned back inside. Sitting down at his desk, he switched on his laptop and started another email to Nevil.

From: Kanna To: Nevil Subject: Completed manuals Please see attached for the signed and completed manuals. As you can see, the signatures are not as requested. If you need any clarifications, please get back to me.

That evening, Kanna lay on his bed. He knew he should have written more to Nevil, but what could he say? Despite his confidence at the beginning, he knew he hadn’t really been ready. All his discussions with Nevil, all the books and guidelines he had referred to before he arrived; none of them had prepared him for working with an organisation like MAGSA. His conversations with Ravi had shown the importance of MAGSA’s vision, how committed they were to working with their communities. Kanna had done what he could, and the manuals were complete. But was that enough? The

counting the chillies

GREEN LIGHT Ritu Kumar Mishra

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Prasad’s carefully planned training on the Global Fund’s monitoring and evaluation tool is about to fly out the window. The sub-recipient seems to struggle to understand the basics. And when Prasad switches to a participatory approach, the participants want to know why they’ve been asked to do all the talking. But then the impossible begins to be possible.

As Prasad travelled from Kathmandu airport to his hotel, he noticed to his dismay the lack of traffic on the road and the boarded-up shops. The streets were deserted except for a few heavy military vehicles. “Maoists,” confirmed the taxi driver in a tired voice. “Whenever they are protesting the whole country closes down.” “Why is this happening to me?” Prasad sighed. “I‘ve already had to postpone my trip once, and now when I’ve finally made it I may not be able to conduct the training after all. I’d better call Sunita and check what she wants to do.” Sunita was the Golden Pearl Foundation’s programme manager. The community-based organisation he had come to work with was dedicated to preventing HIV and sexually transmitted infections among men who have sex with men and male sex workers. And it was run by people from the community themselves. The Golden Pearl Foundation had recently become a Global Fund sub-recipient (SR). The Principal Recipient (PR) had been concerned about the quality of reporting from the SR, and had requested technical support from the Alliance technical support hub to build their capacity in monitoring and evaluation. “Hello Prasad, how are you?” called Sunita from the other end of the line. “Welcome to Kathmandu!” Sunita reassured Prasad that the road closure was for one day only and that they would be able to conduct the training without any problem. And as the training venue and Prasad’s hotel were in the diplomatic area, which was highly secure, they would also have no problem getting to the training venue. Prasad relaxed back into his seat and looked out at the buildings as his car flew past. He remembered his school trip to this same place 16 years ago. It didn’t look like much had changed since those days: same bad roads, same dilapidated buildings. “I guess it’s not easy with so much political instability,” he thought.

As Prasad entered the hotel lobby he was greeted with a smile by Rajesh, the Golden Pearl Foundation’s tall, fair monitoring and evaluation officer. After Prasad had checked into the hotel, he asked Rajesh to join him for a coffee. Although Prasad had read about the Golden Pearl Foundation, he wanted to learn more from Rajesh before meeting all the staff the next day. Rajesh explained that the organisation distributed condoms, ran sexually transmitted infection clinics for men who have sex with men, and disseminated information and communication material about sexually transmitted infections and HIV. They had been carrying out these activities for the last ten years, with funding from various donors and larger non-governmental organisations, but they had never had any training on monitoring and evaluation. “It’s only now that we’re getting Global Fund money that we’re being asked difficult questions about monitoring and evaluation, and what capacity we have in that area,” confided Rajesh worriedly. “They seem to be a bit stricter on these issues than other donors.” Prasad took a sip of his coffee. “Yes, the Global Fund is pretty strict about the monitoring and evaluation system of organisations that receive money from them. They’re keen to make sure that the grant recipients are capable of reporting correctly and on time.” Rajesh was curious about the process Prasad was going to use during the training. “How will you conduct this type of training when there are such different levels of knowledge among participants?” he asked. “It’s a very structured process,” replied Prasad. “I had to spend a great deal of time and effort planning the training, keeping in view the objectives of the training and the needs of the participants. But often the needs are not clear to me until I arrive at the training venue and meet the participants.”

COUNTING THE CHILLIES

GREEN LIGHT RITU KUMAR MISHRA

After agreeing that Rajesh would come to pick him up the next morning, Prasad went for a quick swim in the pool at the back of the hotel and then opted to have an early night.

Red light The next morning Rajesh rang up from the hotel lobby and Prasad joined him in the car for the ten-minute drive to the training venue. To Prasad’s delight the participants were already in the room – twenty-two young men and three young women. They were sitting in small groups around tables covered with white cloth in the crowded conference room. “Punctual, that’s the way I like it,” Prasad thought optimistically. “Most of the time I have to wait for half an hour for everyone to arrive before I can start. This looks promising.” Prasad kicked off in the usual way with introductions, asking everyone to explain their role and responsibilities. He then went on to explain that the purpose of the workshop was to orient the participants on the Global Fund’s Monitoring and Evaluation Systems Strengthening Tool – or MESS tool, as it is known. “Excuse me,” said Rajesh, “what is the … mess tool?” The other participants looked equally perplexed. “Don’t worry, I’ll explain it to you. It’s a tool that analyses how strong your monitoring and evaluation system is. It’s a requirement by the Global Fund that the PR completes this tool to get the Global Fund grant. As an SR, it’s useful for you to fill in the tool as well, because the PR depends on the SRs’ capacity to monitor and evaluate, and report on their activities.” Prasad went on to ask everyone in the room to say what they expected from the training. “I want to learn what all the things in the reporting formats we get from the PR actually mean,” said a

man at the back of the room. “We’re asked to fill in all these sections, but I don’t understand what information they’re asking for.” “And I want to know the difference between monitoring and evaluation,” asked another shyly. “Look,” said Sunita, “we’ve never had any training on monitoring and evaluation before. You’re going to have to explain things slowly and in simple language.” Prasad felt the anxiety rising in him as his carefully planned agenda swiftly went out the window. “These guys don’t know the basics of monitoring and evaluation. How am I going to make them understand the technicalities of the Global Fund performance framework and the MESS tool? I’m going to have to start from scratch. Thank God at least I speak the local language,” he said to himself. “If the technical support hub had sent an international consultant who didn’t speak Nepali, they would be in a tough spot. Half of the people here don’t really speak any English.” As Prasad was having dinner at the hotel restaurant that evening, he started to replan the training. With only three days remaining he wouldn’t have time to go through all the details of monitoring and evaluation and train them on the entire Global Fund reporting framework. “I will have to choose the key things,” he thought, “and the participants are the ones who will have to guide me to what is important. I’ll need to make the training more participatory and leave out some of the lectures.”

Orange light “Ha ha! What are you here for then if you’re asking us to do all the talking?” The participants were puzzled by Prasad’s suggestion the next day. He had proposed that during the training the push–pull ratio should be 1:2 – meaning that they, the participants, should speak twice

“Look,” said Sunita, “we’ve never had any training on monitoring and evaluation before. You’re going to have to explain things slowly and in simple language.”

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

as much as Prasad himself. He would do some pushing, meaning teaching them concepts and terms, but they would have to ask questions to guide him in what to cover during the training. “That’s what we call a participatory approach,” Prasad said. “When you, the participants, take an active approach in the training instead of just listening to the trainer, then there’s a much greater chance that you will learn the things you want and need to learn than if I’m just guessing what you want.” Rajesh bravely asked the first question. “I know I’m the monitoring and evaluation officer here, but I’m not sure I really know what the difference is between monitoring and evaluation.” “Monitoring and evaluation are activities that help an organisation to know how well they are doing,” replied Prasad. “They tell them if they are on the right track, if they are meeting the needs of the people they serve, and how well they are delivering their service. Let me make it simple for you by using an example from your daily lives,” he added. “You all eat food, right? And there are actually a whole lot of activities around making sure you and your families get the food you need. So, in this example, monitoring is like checking that you have what is needed at home for cooking the food. This is something you have to check on a regular basis. If someone doesn’t check this, then no one will know what needs to be bought from the shop, and the family members won’t get food.” “So if all this is monitoring,” broke in Rajesh, “what is evaluation, then?” “Evaluation is, for example, to analyse the annual household budget to see how much you have spent on food over the year. It is also to review, together with your family members, how the quality of food was and whether all family members got enough food,” explained Prasad. “In order to collect the right information about the food supply, you decide beforehand what your

indicators will be. One indicator could be, for example, the number of bags of rice you need for one month. Another could be the amount of money needed to buy the rice, and yet another one the number of people needed to ensure that there is enough food in the cupboard for the whole month. The number of bags of rice, the money required and the number of people needed to buy the food are all input indicators. Tracking how much food is needed and who consumes how much are output indicators. If we check the quality of food that the family is eating, or the health condition of the family members after eating the food, we use outcome indicators. If we look at the health condition of the family members after, say, five or ten years of consuming this food on regular basis, we use impact indicators. “How will we decide what to measure and what not to measure?” asked Sunita with a concerned look. “I can see so many possible indicators in the work we do.” “That’s right,” said Prasad, “you cannot measure everything in a project. You will need to decide what the priority indicators are together with the project’s stakeholders.” “Who are the stakeholders?” asked Rajesh. “Stakeholders are the groups or people who are directly or indirectly associated with the project,” explained Prasad. “For example, the primary stakeholders are the beneficiaries in the community, while the secondary stakeholders are the other partners in the project, such as donors or the government. In the example of the household, it’s the family members who are the primary stakeholders.” Prasad wanted to explain more about indicators, and to do it in a participatory way. He distributed papers and pens to the participants and asked them to write down indicators they thought were appropriate for their activities. When they were

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GREEN LIGHT RITU KUMAR MISHRA

finished, the participants were asked to stick the papers on the wall. Several indicators duly appeared, but most of them were incomplete. “Well done,” said Prasad, impressed with their efforts. “These are good examples of indicators of your projects. However, some of them are incomplete. In order to make the indicators complete they need to explain who, what, where, how much and when.” It took the participants some time to learn how to create a complete indicator. But after a while some of them got the knack and started helping the others. “This is great,” thought Prasad, “they’re really learning as a group here. It’s funny, I’ve done so many trainings, but until now I’ve never made my training as participatory as this. It looks like it’s working.” When they had finished creating the indicators, Prasad asked the participants to identify the category to which they belonged – were they input, output, outcome or impact indicators? He was impressed to see that most of the participants placed the indicators in the correct categories. When there was uncertainty, they discussed among themselves and sorted it out, while Prasad was observing them. Again, he was impressed. “It’s hard to believe that this is the same group of people who said they don’t know anything about monitoring and evaluation,” he thought. “Now they can not only define indicators but also categorise them properly.” Prasad realised how important it was to give enough space and time for the participants to learn and try out for themselves all the new things they had been taught. And it was equally important to listen to what they wanted and how they wanted to do things. Prasad had even asked the participants to come up with energisers themselves, and in the process he’d learnt a few new ones he’d make use of in future trainings.

Yellow light On the third day, Prasad introduced the MESS tool. He saw clear signs of stress on the participants’ faces when the projector flashed the Excel spreadsheet on the wall. “Don’t worry,” he said in a light tone, “I felt nervous the first time I saw this tool as well. But really it’s not as complex as it looks.” Prasad started to explain. “As I mentioned on the first day,” he began, “this tool basically measures whether the organisation has sufficient data reporting capacity or not to comply with the Global Fund’s requirements. The Global Fund wants to check whether an adequate monitoring and evaluation system is in place and, if there are any weaknesses, what measures the organisation is taking to strengthen these areas.” Prasad handed out paper copies of the three Excel spreadsheets to the participants. He went on to explain the purpose of each sheet – the monitoring and evaluation plan, data management capacities and data reporting system – and asked them to start filling in the required information. “I’ll do it with you, but first I’d like you to have a go at filling it out yourself,” he said. “And just so you know for the future, all the instructions and guidelines you need to fill in the document are available on the Global Fund website.” Prasad then went on to help the participants navigate through the colour codes in the system. Basically, the different colours indicate whether the organisation filling in the tool has sufficient capacity in a certain area or not. If it does, it’s green; if it doesn’t, it’s red. And if it’s something in between, it’s yellow or orange. “Hey Prasad,” said Rajesh, “it’s like traffic lights, isn’t it?”

“It’s hard to believe that this is the same group of people who said they don’t know anything about monitoring and evaluation,” he thought.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

“Exactly,” said Prasad, pleased that Rajesh had grasped what was a fairly complicated system. Although the participants took some time to complete the forms, Sunita spoke for them all when she said, with a sense of satisfaction, “At least we now know what needs to be done to strengthen our monitoring and evaluation system. This is a really useful tool.”

training to understand properly how to measure what they are doing,” he thought. “If this kind of capacity-building could be provided, the organisations could use the implementation data they already have for more effective programme development.”

“I’m glad you think so,” said Prasad. “And even if we haven’t got it all right, we can improve the system using the guidance of this tool.”

Green light On the evening of the final day, Sunita and Prasad met over a cup of tea. “Congratulations,” said Sunita, “you look satisfied with the training. But how can you be sure that the participants have understood everything you have imparted over these last few days?” Prasad told her that along with the technical support hub he had developed a format to assess the knowledge of the participants before and after the training. Indeed, on returning to his hotel room Prasad did an analysis of the ‘before’ and ‘after’ assessment of the training. It was with some relief that he concluded, “Wow, what a drastic change! Thanks to the participatory approach I was able to adopt, the impossible became possible. It was an important lesson that as a trainer I need to be flexible enough to respond adequately to the needs of the audience. This is something I’ll always remember, and I hope that I can share this learning with other trainers and facilitators.” The following day, as Prasad looked out the window of the plane taking him back to Delhi, he reflected on the past week. “There are so many small community-based organisations doing such great work but they never receive any

counting the chillies

A PERFECT SMILE? Anindita Biswas

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

As Anu stares at the disorganised papers strewn across the desk, she knows why Disha is finding it hard to report accurately. How many other community organisations are struggling like Disha, she wonders? And how can she hold up a mirror so each can see where they need technical support – or whether they have a perfect smile?

“See you later,” Anu called to Kunal, her manager, as she rushed excitedly out of the office. “Oh right, you’re off to Kolkata. All set?” Kunal called back from inside Hope, the glass-walled meeting room where they had been sitting. Anu laughed as she turned around and saw his belly peeking out from behind the door. “Don’t worry, everything will be fine,” she reassured him. “Don’t you remember how well our training went last month? I’m sure everything’s going smoothly.” “Just keep me posted,” Kunal responded, his voice bouncing across Hope’s walls. A few hours later Anu stepped out of the car, smoothing her long hair in the sunshine. She looked up at the gated building and blue skies in front of her. She was back home. It had been only four months since she had taken the biggest decision of her life – to move to Delhi, to be away from home for the first time. And just think what had happened since then. She was working in a national non-governmental organisation, a Principal Recipient of the Global Fund. She and Kunal made up the monitoring and evaluation team, providing technical support to a project working with men who have sex with men, and transgender and hijra communities. Over the last four months they had been running trainings and developing guidelines for the project’s subrecipients, together with community organisations in 17 states. They were doing everything they could to ensure that the organisations had the skills and systems they needed to report on their projects’ activities and results, and to monitor and evaluate their work. “Just a quick visit,” she thought to herself, standing at the gate of the sub-recipient’s office in Kolkata.

Reality check A young man in his early twenties, looking serious in his rimless glasses, walked towards her. This was Amit, the sub-recipient’s monitoring and evaluation officer, and one of the star participants of last month’s training. Like his equivalents at other sub-recipients, he was responsible for working with a group of community organisations to make sure they were reporting their activities correctly. Together, they entered the building and climbed the winding stairs to the office on the second floor. “So, how is everything going?” Anu asked, as they sat down in his cream-coloured cubicle. “I was hoping to discuss some things that have come up since the training,” Amit replied slowly. His voice sound anxious but hopeful that he would get some answers at last. He continued, his worries tumbling out more quickly now, “I keep getting stuck. I received the targets you sent for the first quarter, but now I have to figure these out for the next three months. They’re so complicated, and all the calculations make me nervous. Like, I know one of our targets is to reach 100 people. But we work with seven community organisations, so how do I divide that target between them? I just don’t know how to do that calculation.” Amit wiped his forehead with his handkerchief as he spoke. “Recently, some of the community organisations have started sending their progress reports for the first quarter,” he continued. “And some are sending reports that are only half-finished or with numbers that I just know aren’t right. I’ve been emailing and calling them for weeks to make sure the reports are good, but it’s not working. I don’t know what else I can do.” The drops of sweat on Amit’s forehead had become more pronounced.

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A PERFECT SMILE? ANINDITA BISWAS

Anu thought back to the reassurances she had offered Kunal the day before. “I’m sure everything’s going smoothly,” she had said then. Now Amit’s worries had brought her back down to earth with a bump. How could she have thought things would be so easy? And if this was what Amit was facing, what was going on for all the other organisations in the other states? She wavered for a moment, worried about what to do. Then she stood up determinedly, wrapping her dupatta around her waist and, taking a marker, strode over to the neglected whiteboard hanging on the office wall. Drawing lines of numbers and formulas on the board felt like leading a mathematics tuition class. Amit, her ever-obedient student, asked question after question, looking at the tiny details of every tricky calculation and target until he got the answers he needed. Sliding back into her chair, relieved, Anu caught her breath before moving on to Amit’s next problem. “Now,” she began, “you are having issues with the reports from the community organisations. Is that with all of them or just one or two?” Amit hesitated before consulting the files on his computer, and then returning. “No,” he confirmed, “it’s not all – it’s just three out of seven. But each one feels like a throbbing pain in my head. You wouldn’t believe how much time it took trying to get the right numbers.” Anu looked at his serious face and asked, “So what are your thoughts? What do you think the issues are?” After a moment’s silence he responded, “I’ve told them what to do, and they’ve been given all the documents, and yet they don’t remember what I say, even when I write it down.” Amit paused and took off his glasses, holding them in his hand. “Or maybe it’s that they just don’t understand? I don’t know. They just don’t seem to get it. Maybe it’s a capacity issue?” he volunteered eventually.

“So you answered your own question,” Anu smiled encouragingly. “And doesn’t this feel similar to what you have been facing yourself?” “Oh my God, you’re right, and I was blaming them,” exclaimed Amit. “They need more support from me, just like you have given me today. They need time to sit and talk things through. I can see what to do now. Thanks, Anu.”

Another broken spell A month later, back in Delhi, Anu was running through Amit’s latest report. Her brown eyes were fixed to the computer screen and she was barely blinking. Suddenly, her spell was broken by the sound of dogs barking from her mobile phone, as the whole office turned to her. Embarrassed by her ringtone, she answered quickly and was surprised to hear Amit’s voice. “Hi Anu, I need to talk. Are you free or should I call after lunch? It’s urgent.” Moving into Hope so as not to disturb her colleagues again, Anu listened to Amit closely. He sounded frantic. “Things have been better since you came, and I managed to send you the latest report. But there’s one organisation I’m still struggling with. I keep working with them but it doesn’t seem to be enough, and I’m not sure what’s going wrong. I need your support. Can you come down?” A few days later Anu landed in Kolkata again. After Amit’s call she had talked to Kunal. The concern in Amit’s voice and the challenges he described had persuaded them both that she should visit. That’s why, together with Amit, she was driving now towards Disha, the community organisation he was worried about. Turning up a small, potholed lane surrounded by trees, they stopped the car and walked towards the house. Ducking under the arched entrance, they saw a long hallway lined with flipchart paper and groups of people gossiping. At the end of the

Drawing lines of numbers and formulas on the board felt like leading a mathematics tuition class. Amit, her everobedient student, asked question after question, looking at the tiny details of every tricky calculation and target until he got the answers he needed.

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

hallway there was another small room, with new chairs, tables and a computer. A printed sign stuck to the door said, ‘Project director’.

Moving beyond the jargon A tall figure in a beautiful sari, face covered with makeup and a bindi placed prominently on her forehead, came to meet them. “Welcome to Disha. I am Lakshmi, the project director. Hi, Amit. Please come this way.” Amit and Anu followed, with some of Lakshmi’s staff trailing behind. After introductions and some polite conversation, Anu eventually asked to see Disha’s registers. The registers were used to keep track of the numbers and types of services they were providing to their clients. Rifling through the cabinets and drawers, Lakshmi pulled out heaps of papers, adding to the clutter already on her desk. Picking up one of the papers scribbled with numbers, Amit glanced from it to Anu. “Was this really the result of all the support he had been providing?” he thought worriedly. “Why hadn’t it been working? And what would Anu think?” Anu saw the concern on Amit’s face and reached for the papers on the table. She then pulled Amit’s report out of her bag and compared the two. “Lakshmi,” she began, “can you show me where the numbers in the report came from? From which registers?” Lakshmi responded quickly, “My monitoring and evaluation officer and I are responsible for the report. Other members of staff help to fill in the registers. It’s all there.” Anu tried to remain calm. “Yes, I see that there are papers,” she said patiently, “but let’s be honest, they aren’t really complete, are they? We don’t know where the different numbers are coming from.” Anu showed Lakshmi the differences between the numbers in Amit’s report and the crumpled papers that lay in front of her.

“They are a little disorganised,” Lakshmi conceded, “but these are the correct numbers. I just can’t find them all right now in these heaps,” she continued, defensively. Amit broke in, his voice full of frustration, “But I shared the guidelines for registers and reporting. Didn’t you look into them at all? I called you as well, and you promised that you would go through them with your staff.” “But they’re all in English,” exclaimed Lakshmi. “My staff can’t understand them, so why should I bother?” Looking directly at Anu she retorted, “It’s so much work, madam. I told Amit that too: so many registers to fill in, so many things to read and write. How can we finish?” She frowned, tapping her fingers on the table in annoyance. Anu wavered again. How should she respond? Should she use her authority and force Lakshmi to get things done? Should she be angry at the indifference being shown to the work? Or was Lakshmi right after all, and things that were easy for Amit’s and Anu’s organisations weren’t so simple for Disha? Once again Anu stood up, determinedly adjusting her dupatta. “OK, I understand, language is a problem and filling in so many registers is also a problem. So let’s see what we can do.” She spoke quietly with Amit for a few moments, her forehead wrinkled, and then Amit and Anu beckoned Lakshmi and her staff towards the hallway. Sitting on the floor in a circle with the staff, Anu watched Amit begin. First, he talked to each member of staff about their role. As they described what they did, Amit took notes in one column on a piece of flipchart paper. Then in the second column he wrote a list of each of the registers that needed to be completed. Finally, they agreed together which staff member was responsible for keeping each register up to

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A PERFECT SMILE? ANINDITA BISWAS

date. In just a few minutes they had identified all the registers and responsibilities. This was the information that had been in the guidelines Amit had sent to Lakshmi all those months ago, which she had ignored. Looking at Amit’s flipchart, Lakshmi seemed surprised. “Maybe it doesn’t seem so much work now. Barely three registers for each of my staff! That doesn’t seem so bad.” Anu smiled proudly. Amit had solved his first problem. The second problem was soon overcome too. Working with Lakshmi, Amit translated the key pages from the reporting guidelines into the local language, and talked them through with the staff until he could be sure everyone understood. Afterwards, the translations were written up on flipcharts, before being hung up on the walls, hiding their cracks. Dropping Anu off at the airport later, Amit said, “You remember when we were driving there and we bounced over all those holes in the road? It felt like we were going to fall out of the car. When Lakshmi brought out that mess of papers I felt the same way. My heart almost leapt out of my chest!” Anu laughed, “It’s fine, these things happen in every project.” Then she added thoughtfully, “I’m sure we can work through most problems, we just need to be patient. Don’t give up!”

Returning to Hope? The next day Anu was back in Delhi, waiting in Hope for her weekly meeting with Kunal. Sighing, she slid her back down her swivel chair. Despite her reassurances to Amit, she just couldn’t keep calm this morning. A lot had been achieved, building up and supporting the sub-recipients and community organisations. Problems had

been solved. She knew that. But something still bothered her. “In Hope I feel hopeless,” she smiled grimly to herself. As she sat waiting, thoughts, questions and worries ran through her mind. It was such a huge and complex programme, and over the next few months more and more community organisations would be joining. Sub-recipients visit their community organisations every quarter. Principal Recipients provide support to the sub-recipients and visit them regularly too. But despite all these efforts, could they be certain that every organisation was performing well? Were there others like Lakshmi’s that they didn’t know about? “Working with community organisations is challenging, and we can’t always expect them to be monitoring and evaluation experts,” thought Anu. “But what else can we do to support them? How can we keep responding to their needs and the requirements of the programme?” She frowned, and then her thoughts raced off on the opposite tack, persuading her that things were just fine and she was over-reacting. The debate in her head continued until she was startled by the squeak of the doorknob.

Finding the beauty Kunal barged into the room. “Did you hear we got our first rating from the Global Fund? It’s A1! Isn’t that great? Congratulations for all the work we’ve done. Our monitoring and evaluation support is really showing results.” But his excited face dropped when he saw Anu. “Hey, what’s up with you? Anything serious?” Anu shared her concerns. “The rating’s great, of course, but we’re only at the end of the first six months. How can we keep it going, particularly with more community organisations joining the project?”

They were committed to ensuring that all the subrecipients and community organisations were performing well. But every organisation was different – how could they know what support was needed?

Of Spices and Silk: sharing stories of technical support to Global Fund grants in Asia

Kunal sat down, his excitement fading as he listened to her speak. “You’re right,” he said eventually. “We’re going to need to keep providing support and be prepared for more difficulties ahead. So what can we do?” Fuelled by fresh cups of coffee, Anu and Kunal talked through the challenges. If they were to keep their A1 rating they would have to continue to make sure they had high-quality data. They were committed to ensuring that all the subrecipients and community organisations were performing well. But every organisation was different – how could they know what support was needed? Eventually, Kunal interjected, “We have some savings in our budget. Is there any way we could use this?” Anu didn’t look convinced. “If we want to be certain, we need to visit them all. But we can’t go everywhere. It takes so much time – we’d never be able to finish!” She paused, “We could engage consultants to do the visits for us, but they wouldn’t know the programme.” Kunal’s face lit up, “Yes, that’s it! We could hire an audit agency. They could do a data audit, just like people do financial audits. Let’s ask the finance team, they might know someone.” His excitement had returned. Anu interrupted, still apprehensive, “But audits freak people out. How will it help anyone? They’ll just be worried that we’ll stop their funds if the audit finds anything wrong. Our programme is about building community organisations’ capacity. We’ve worked so hard on that and we’re making progress. We can’t jeopardize it now.”

Anu nodded, unsure where the conversation was going. “Your question is whether this will help anyone. My answer is yes; yes it will. The reasons are simple. This is just another way of making sure we can provide the right kinds of technical support to meet their needs, and ours, before it’s too late. The auditor would do an objective assessment of the sub-recipients and the community organisations. We would then work with the sub-recipients and they would work with the community organisations to address the gaps and build on the strengths identified.” Anu still looked unconvinced, so Kunal tried again. “Anu, when you leave for a party you look in a mirror first, don’t you? You do your hair and put on makeup – maybe just some lipstick – to look even more beautiful. Am I right?” Anu nodded. “This is the same. The audit would be like holding up a mirror so each organisation can see itself – see where to put the finishing touches and whether they need extra support. Who knows, many organisations might just see a perfect smile and say, ‘I look great!’” Kunal laughed. As he talked, the thoughts, questions and worries in Anu’s mind started to clear. She glanced at her reflection in Hope’s glass walls. And reaching into her bag, she pulled out her lipstick.

Kunal intervened, “The idea is to keep providing technical support, so we can be sure everyone carries on improving. You said that yourself, didn’t you?”

For more information please contact tshubs@aidsalliance.org Regional Technical Support Hubs provide south-to-south support to Alliance Linking Organisations and other civil society organisations to strengthen their leadership and capacity.

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