Connecting local responses around the world
NGOs often undertake various community based awareness, peer education activities and home visits as part of ongoing care and support effort for people living with HIV.
I wondered if home visits worked. I had no experience of doing home visits for community engagement and mobilization. The thought of turning up at someone's front door unannounced or for the matter someone even at my door did not go well with me. There were other things to fuel my anxiety like the uncertainty of what you're going to find on the other side of the door.
I got an insight into home visits when I was part of the Glocon Team with Ian and Alison in India (Mizoram and West Bengal) in February this year. The plan was that we would divide into 3-4 teams and go to different homes. After the visit, the team congregated at a common place in the village, sometimes joined by local community members, we would reflect on our home visits.
A key lesson was that you don’t just drop in someone’s home. Home visit is done by invitation and time suitable to the family members. I found that we were usually welcomed by the family and even offered drinks and refreshments. Also we always had a person known to the family in our team. Alison Campbell underlines the most important factor “I think the key is in the way home visits are done. SALT approach is key. Lots of home visits are done in a different attitude, more provider or teacher than alongside.”
Local Salvation Army team, CHAN in Mizoram has set a fine example of home visits. CHAN has fostered positive relationships with local community members through home visits. Realizing that the community is too huge to be covered by the Salvation Army team, it has encouraged formation of volunteer youth groups within the community which do regular home visits. Over last six years, local neighborhoodsin Dinthar have determined their own response to HIV through home visits, community-led change and youth response.
“ Willingness to meet is developed by the home visits, because people share more openly and privately at home. The concerns are gradually shared, until the community is ready to meet together.” – Alison . What happens in home settings is through community conversation a personal connection is build with the family. This is community counseling in nature where community members reflect on theirsituations and see the issue in their own context. Home visits also act as stimulation for the visiting SALT team and growth of dignity for those visited. ''Accompaniment in the home and neighborhood environment a source of self confidence development” observes Onesmus, an experienced facilitator from Kenya.
Another critical lesson I learned about home visits was from Nagaland. To focus on selected homes can be stigmatizing. Therefore, selecting a group of homes in the neighbourhood is done. I recall a peer educator working on PPTCT project in Nagaland shared with me . “I used to go for home visits alone under PPTCT programme…people used to shun me away as I visited only homes of potential clients…Now after SALT programme I go with village youth teams and visit homes in the neighbourhood without targeting any particular house. We have moved away from information providers to facilitating conversation about HIV in the family. Referrals to the hospital for HIV testing have shot up. Now women come to me to take them for testing”
In the context of HIV and associated risk factors such as injecting drug use, the experience of personal stigma within local neighborhoods grows. Ian Campbell shares how home visits can lead to acceptance and openness.”The expansion of HIV related community response is noticed through home care with one person and relatives, that 'infects' neighbours with a realisation of shared concern, and the possibility of reaching for a better future” .To illustrate, here is a stoey from village leader in Dinthar, “I myself did a home visit to the home of a positive person who had passed away. I am the one who prepared his body for funeral and by touching his body demonstrated that HIV cannot be transmitted by touching”.
Ian during Glocon Kenya found the communities continue to respond to their issues without external stimulation or support for nearly two decades. Moreover this has been transferred to several other communities. “We see accumulated effect – it is alive, because neighborhood groups take ownership. Ownership is facilitated by home visits, don’t forget. Both home and group/neighborhood processes are needed. The team is still working because it is beyond the boundaries of any one institution. Always think beyond institutions, to the Spirit of God, and the human connection. " comments Ian.
The question is how many NGOs are exposed to the concept of home and neighbourhood life. Experience shows that rather than being limited to delivery of services as response to HIV, organizations can explore learning based in local experience and action. It must also be kept in mind that mindset with which home visit is done can be a determining factor in its success.