Chinese NGOs can be both innovative and business savvy – Over the course of the three-year Initiative, we saw that although the Chinese-led NGOs were relatively young, they were professionally run and adaptive. Reports were thorough and on time, and senior staff were familiar with sector best practices. Innovations included using text messaging to provide follow-up HIV and health information to hard-to-reach migrant workers and providing rural villagers with cameras so that they could capture everyday life, and then use those photos to discuss behaviours that affect health, including HIV risk.
Foreign-led NGOs still play an important role in China’s nascent civil society – Two of the three foreign-led NGOs in this programme were modelling new approaches that we hope local NGOs will eventually emulate (one working in red light districts, the other offering alternatives to institutional care for HIV orphans). In a country with an immature non-governmental sector, these replicable models can help shape the development of the sector.
Support and cooperation of local government is critical – In 2008, many of the partners mentioned that the limited cooperation with government agencies and representatives was a challenge. By the end of 2010, most reflected that developing good working relations with government departments over time was critical to their achievements. Fu Hua, one of the partners, commented: “The most fundamental success we had was a good working relationship with the county health bureau. Because of this success, the rest of the work became not only possible, but also smooth.”
Stigma attached to HIV and high-risk groups – Working with IV drug users, CSWs, and migrant workers has its challenges: high turnover among peer educators, recidivism for both IV drug users and CSWs, lack of time for prevention education activities (construction workers), and constantly mobile populations. As HIV/AIDS has been largely ignored in China until recent years, there is still considerable stigma associated with the disease, which is itself a challenge to overcome. Similarly, as many beneficiaries stated when interviewed, stigma and prejudice attached to all high-risk groups means there is very little public support for the work of these pioneering organisations.
Political instability in border regions – Many of the project’s locations were along the Yunnan-Myanmar border. As Health Unlimited reports, “Political instability remains a critical constraint to carrying out activities in the project area, specifically relating to travel to local ceasefire group and central government jointly controlled areas.”
Identifying and retaining staff – Many of these projects are in remote parts of Yunnan. Pay is lower than in other parts of China, and living conditions can be much more basic. These factors can make finding and retaining qualified staff more challenging.