By Radhika Chandiramani
TARSHI (Talking About Reproductive and Sexual Health Issues) is a telephone "helpline" based in New Delhi, India, that offers information, counseling and referrals on reproductive and sexual health issues. It is an effort to enable women and men to enjoy lives of dignity and freedom from fear, infection, and reproductive and sexual health problems by providing them with choices in their sexual and reproductive lives — choices about health services, contraception, and their sexual behavior. The program reaches people of all classes, communities, ages, and sexual preferences, over 60% of whom are between the ages of 15 and 25.
The Theoretical Basis
TARSHI believes that reproductive choices cannot be isolated from sexuality, and that sexual and reproductive behaviors emerge from and have an impact upon life contexts. Therefore, TARSHI wanted to create a program that could be gender-sensitive; provide simple and accurate reproductive and sexual health information in an interactive, non-threatening manner; provide people information relevant to their particular life-spaces; explore the pros and cons of particular choices, while never taking away the right of choice; refer people for particular services; and be easily approached and effectively used by individuals.
Additionally, we were concerned that the program be affordable, accessible, confidential, simple and user-friendly. TARSHI decided that a telephone helpline offering information, counseling and referral to appropriate agencies for sexual and reproductive health needs was the most effective program strategy to meet these criteria.
TARSHI’s Program
The helpline began in February 1996 and is operated by a team of six full-time trained counselors under the supervision of a qualified clinical psychologist. The helpline is publicized through radio advertisements, posters, press articles, and word of mouth. Both men and women call the helpline, and it has so far received more than 25,000 calls. While the age range of callers is 10 to 70 years, over 60% are between 15 and 25 years of age. We are popular with youth because we listen to their concerns and confusion with respect, and — unlike many other adults in their lives — we are open with them about sexuality. Though originally designed for women, 80% of TARSHI’s callers are men. TARSHI has attempted to increase the number of women callers through radio advertisements, recorded messages on the phone, press articles in women’s magazines, and posters and fliers stating that the helpline is meant especially for women. TARSHI also encourages its male callers to pass the numbers on to their female partners and friends.
Approximately one-third of TARSHI’s callers call more than once; continuity of service is ensured by giving them a code number that protects their anonymity, but allows counselors to reference their case number. All calls are documented in writing in registers and index cards. The main details of the calls are documented to provide continuity to the caller and also to keep track of the nature of calls and concerns. Youth call mainly for basic information about things such as contraception and HIV/AIDS, and to discuss sexual concerns like premature ejaculation, masturbation, body image, sexual urges, conception, abortion, relationship problems, and sexual abuse. If they require medical or other professional services, they are referred to appropriate agencies. Because of TARSHI’s policy honoring callers’ anonymity, it has no reliable means of checking how many referrals are successful.
The success of the helpline lies in its guaranteeing confidentiality and anonymity, and providing a non-judgmental and ‘safe’ space to its callers. Information is provided in a simple manner, so as to facilitate comprehension and applicability. All callers are treated with respect and encouraged to find their own solutions to their problems. The number of callers who call back and new callers who say they have been referred to TARSHI by their friends indicates that TARSHI has been able to provide a service that young people find useful. On subsequent calls, callers ask questions that become increasingly ‘sophisticated’ and report decisions they have made after having spoken to TARSHI on an earlier occasion. For example, young men report delaying penetrative sex, masturbating instead of visiting a commercial sex worker, and adopting other less risky sexual practices. Independent evaluations conducted annually over the last three years have found that we are a rich source of information and are providing a much-needed service in our community.
In addition to the helpline, TARSHI distributes and displays written reproductive and sexual health material during public events such as fairs and bazaars. It also distributes materials to schools and other organizations, and acts as a resource for members of the press when they write about sexuality. The press has approached TARSHI and quoted it on a range of topics including sexuality education, child sexual abuse, lesbian and gay issues, and adolescent sexuality. TARSHI also documents all calls to the helpline (main details of the calls are documented), and presents its findings locally, nationally, and internationally to contribute to the body of knowledge and advocacy on sexuality issues. For example, the data from the helpline have gone towards influencing journalists to write responsible articles on sexuality, which in turn feeds public opinion.
One of the problems that TARSHI faces is being careful that its public messages are not misconstrued. In this age of sexlines and chatlines, TARSHI finds that people mistake it for an undercover "sex service." TARSHI’s public messages state that it offers information, counseling and referrals on reproductive and sexual health issues, and the message on the phone machine also states that TARSHI is not a sexline. However, crank and abusive callers are a common occupational hazard. TARSHI has developed ways of keeping their numbers down to 10%; callers are dealt with firmly and professionally, but never rudely, as TARSHI believes in keeping doors open for people who might need help. This strategy has paid off, as TARSHI has had callers apologizing for a crank call made earlier and, once "converted," they act as allies of the program by dissuading their friends from making crank calls.
Lessons Learned
- Young adults, like anyone else, need to be heard and treated with dignity. Often they experiment with risky sexual behaviors in order to get information that no one else in their surroundings seems willing to share with them;
- Those working on sexuality issues cannot afford to be judgmental or moralistic if they wish to truly empower individuals;
- Documentation of real individuals’ experiences, perceptions, fears and expectations is important for advocacy and understanding;
- Proper training, security, safety, comfort with sexuality issues, and understanding of ethical issues prevents staff burnout and helps the program function more smoothly and effectively;
- Keeping tabs on events occurring in society and the media is helpful as it helps staff understand what informs public perception;
- Conventional mechanisms to publicize the helpline are complemented by grateful callers who pass on the helpline numbers to others; and
- A telephone helpline can address the needs of many types of people—irrespective of gender, sexual preference, class, caste, and age.
Contact Information:
Radhika Chandiramani
TARSHI
49 Golf Links, 2nd Floor
New Delhi 110003
INDIA
Helpline: 011-462-2221, 011-462-4441
Office: 011-461-0711
Fax: 011-461-0711
Email: radhi@unv.ernet.in
