During my Primary Health Care course, I had the opportunity to visit a non-government organization called HANDS (Health and Nutrition Development Society) in Malir (a town in Karachi). Since 1979, HANDs has been promoting health, education and the alleviation of poverty in marginalized communities in Pakistan. This includes, 9.0 million people living in nearly 7000 villages in 15 districts of Sindh and one district of Balochistan. HANDS is certified by USAID.

We visited this particular organization because our course objective was to gain practical and theoretical knowledge about primary health care set up in an area serving marginalized populations. This experience also gave us an idea how both private and non-private organizations can work together in partnership as well as how communities can be mobilized and empowered to take care of their own health and well-being.

Some of the services provided by HANDs include: education programs (for midwives, educators, nurses, community doctors, and volunters), Early Childhood Development, primary school education, micro-credit loans and other financial services, programs aimed at establishing clean and safe drinking water, vocational training, medical services (OBGYN, Lab, OR, EMONC, radiology, vaccination, family planning, etc..)

A distinctive feature about this organization is that it works hand-in-hand with the communities and the people it serves. The communities were consulted before the services and clinics were set up. The people were asked as to what problems and issues they are facing and what type of services they would like in their communities. This concept of community mobilization and participation is of the utmost importance to any health care system in any part of the world. In fact, community participation is one of the principles of the Primary Health Care. It's the community that decides (or should decide) what it needs and how to best solve their problems. Organization can provide technical support to communities but should not force their will. Only this creates sustainable and committed communities.

As part of HANDS, young women are given training in handicraft and sewing, free of charge. We were given the opportunity to see the textile workshop set up by HANDS. So many young women were working on various different designs on various different fabrics taught by their instructor. I talked with a couple of these wonderful ladies because I wanted to see what they thought about this program and what are they personally benefiting (if they were) from this program. One lady said that it is a 3 month training program for women living in marginalized communities across Sindh. This same lady also mentioned that when she is done with the program she will go back to her community and with the skills she has gained, she will open up her own shop and sell her designs. I had asked, "Why are you doing this? What motivates you to do this?" She said, "Because this is my passion. This is what I like to do." Every women in that women said the same thing. So I asked, "What about your family? Do they support this?" Another women answered, "My father encourages me. They want me to do this." I also found out that all the supplies (sewing machine, fabrics, scissors, etc) are all provided free of charge. How wonderful is it that women are empowered to pursue what they love instead of being forced to settle with something they have no interest or passion for. This is community participation.