Sharan began work in the Gautamnagar Basti near the All India Institute of Medical Sciences with a community of outcastes who came from the Rae Bareilly area of Uttar Pradesh in 1981. We were a group of young professionals and artists and church people who wanted an Indian expression of a response to the waves of rural poor moving to cities.
The common ground we then had was the swarm of poverty around us, and to rise to the humongous challenge of reducing and transforming it through first measures of the “poverty line or calorie intake essentials”, and subsequently to a QoL measure that included access to food, clothing, shelter, health and education, and as would constantly add, access to work.
Community modelling and inclusiveness was a hallmark of Sharan’s modus operandi from day 1, and solutions to women and child health a bench marked priority, as with men’s groups for employment at community level, including as health educators and teachers.
One of our most significant learning was that health expenditure for the very poorest created substantive debt, which was easily available at high risk loan shark rates of 20% per month, and that families would experience extreme exploitation at the hands of private practitioners including private medical facilities as they were abused in hospital settings, and health services did not really reach this population.
Sharan split into two organizations under one roof, one developing into Saadhan and Saahsee that focussed on loans and community banking, and the other retaining the name Sharan, but working in close coordination with Sahara House, where we addressed challenges of drug use and alcohol challenges for the very poorest, and generally employed and cherry picked the best guys in the rehab that were ready to work for us. We had grown out of the same alternate christian community, but were also preferring to function as scientific and state of the art for the vast responsibility of treatment and care and support we were burdened with.
Our growth had put us into national and international spectand been appreciated by international and national agencies, but we were constantly burning out. We decided to formally split in 2003, where community savings and banking would function entirely independently of the organization now providing specialized services for HIV and Drug Use in the context of extreme poverty.
What else did we do?
Sharan operates two community based care and support programs. One, supported by Community REACH program, started in 2002. The project focuses on creating access to health care services and employment for people who are living with HIV and creating access to health care services and employment for them. It revolves around the strengthening of support groups and the inclusion of their members in a variety of activities, which affect their lives. This includes negotiating with health care providers, monitoring and supporting people’s access to a continuum of care, and taking a greater role in the design and delivery of services.
The other is as an implementing partner with MAMTA as the lead partner that started in 2003 are closely associated with drug users, homeless people and women who live in slums. This project operated a DOTS sub-center in collaboration with the ministry of health. The project aims to sensitize health care service providers to the treatment needs of people who are living with HIV, while improving the understanding and treatment outcomes of these people.
The Asian Harm Reduction Network (AHRN) collaborated with Sharan in a four-country research in 2003 to promote initiatives and policies that reduce drug related harm. Sharan has continued this into the tradition of the Indian Harm Reduction Network, set up under joint auspice of the DFID ‘Project Network’ and Forum, that had brought grassroots drug treatment service in Asia together. We have successfully challenged many unjust and discriminatory laws and practices in India through collaboration of rights based services and access to health, inclusive of some landmark rulings with the Lawyers Collective, with who we work closely. ‘P
What we do now?
At the national level, Sharan was managing and implementing – Project Network – A Scale up of IDU interventions across 9 states in India, all supported by the State AIDS Control Societies. Substitution with Buprenorphine for IDUs is a major component of the intervention and with support of SACS these at the end of the project life cycle were successfully transitioned to the national targeted intervention program of the National AIDS Control Program, Government of India. Sharan continues to manage 3 targeted interventions covering more than 3000 drug injectors in Delhi that were associated with its earliest interventions, and now funded by the Delhi Govt., our current mainstay for finance.
To ensure universal standards of service are followed and practiced by partners across the states, guidelines for protocols on NSEP, BST, wound management, general health and M&E have been disseminated to all partners for implementation through the Technical Support Unit, a pool of resource consultants, each an expert in the above mentioned areas to provide support to partners, established and managed by Sharan. These consultants are now part of Sharan’s Managing Committee and supervise research and operational diagnostics as required, including work done for UNAIDS, RST Asia and India Country office and our regional partner, Response Beyond Borders
We are also currently providing services for children of the streets in Delhi, and more recently, for children of people who use drugs, supported by CRS ( Catholic Relief Services) and Wings of Support ( KLM Crew Foundation).
Sharan Targeted Interventions: 3 targeted interventions under the auspice of the Delhi State AIDS Control Program as part of the National AIDS Control Program
TI 1: Project Manager Shabab Alam
This TI is situated in Jamuna Bazaar and encompasses areas like Kashmiri Gate, Inter State Bus Terminal, NigambodhGhat (Cremation Ground), Hanuman Mandir, Jama Masjid, Red Fort and Meena Bazaar. The project has been the site of Sharan interventions since 1998 and is currently supported solely under TI budgets.
The baseline conditions and mental health of clients in JamunaGhat have been well recorded since inception, and these reports have been game changers for local, national and international injecting drug use and related harm, where street based services for drug injectors are involved.
The program is currently covering services for 950 PWID in areas of Needle Exchange, OST, outreach and counselling in Tier 1, and linkages with DOTS, ART, ICTC, CCC, RCH and Detox and Rehab referrals, and related support groups.
Contracted till March 2017.
TI 2: Project Manager Alok Mohan Agarwal
This TI is situated in Jehangirpuriand covering areas such as Mahendra Park, SabziMandi and Adarsh Nagar. Sharan has run this intervention since 2007 and has worked in close co-operation with the Sahara program there. It is also supported by DSACS and NACP.
Jehangirpuri comprises of slum rehabilitation housing, consequentially there are more spouses and children in social units.
Border proximity to Haryana and UP also make for “crime zones” and the DIC is situated in the middle of one.
There are 24 “hotspots identified in Jehangirpuri that are covered under the outreach services.
The program is currently covering services for 800 PWID under two tiers structured similarly to TI 1.
Contracted till March 2017.
TI 3: Project Manager David Thapa
This TI is situated in Nabi Karim and covering areas such as New Delhi Railway Station, Brucharkhana,Qutub Road, GB Road (Red Light area), and Asaf Ali Road. Sharan has run the intervention since 2008 and so it forms the newest of Sharan TI sites.
The Paharganj Area has been the star on the drug tourist route, but the TI covers local rickshaw puller/driver populations, and their sex partners, spouses and children.
The program is currently running services for 600 PWID under tow tiers structured similar to TIs 1 and 2.
The TI at NabiKarim is additionally supporting 100 children of PUD, a women’s group and a crèche service under KLM/Wings of Support.
Contracted till March 2017