Plans for Healing

In Hindi, the word humsafar means a companion on a journey. The Humsafar Trust, an advocacy group for sexual minorities based in Mumbai, India, has found such a companion in Robert Daly, a fourth-year MD–MBA student who has used his interests in business and healthcare to help the organization expand its reach.

The Humsafar Trust was founded in 1994 to advocate for equal rights for sexual minorities throughout India. The program conducts research and provides a variety of outreach services for its constituents, including HIV/AIDS counseling and testing in Mumbai.

Daly got involved in 2006 as a first-year medical student. “I wanted a project that would use the business acumen I gained in my first year of business school but that was focused on healthcare delivery for disenfranchised populations,” said Daly. Through his mentor, Harvey Makadon, HMS clinical professor of medicine at Beth Israel Deaconess Medical Center, and Harvard Medical International (now part of Partners HealthCare), Daly was introduced to Humsafar, which needed help crafting a strategic plan to better focus its efforts and secure funding.

Daly devoted many hours, in both Mumbai and Boston, to leading the development of the five-year strategic plan. The 55-page document outlines the problems faced by sexual minorities in Mumbai, the Humsafar Trust’s mission and purpose, and the program’s plans for the future. He also helped develop a budget and tools to help the group track its outcomes.

The plan was implemented in 2007, and a little more than two years later, the Humsafar Trust has already received funding from major organizations like the Gates Foundation and USAID. Since the plan was put in place, the trust has reached more than 60,000 clients (a figure that was not tracked until the strategic plan helped develop tools to do so) with its education and prevention programs. In addition, Humsafar doubled the amount of HIV tests provided per month, from 250 to 500. The plan has since been used as a model for other non-governmental organizations in India.

In 2008, Daly turned his attention to the hijra community, considered the third gender in India. Though hijras do not have an exact equivalent in Western culture, they are similar to male-to-female transgendered people. Hijras have traditionally occupied a cultural and ceremonial role in Indian society, but as that role has eroded over time, many of them have faced endemic discrimination and are unable to find employment, said Daly.

Left with few other options, many hijras work in the sex trade, and condom use is low. “Studies report an HIV prevalence rate of 68 percent,” said Daly.

With fellow HMS students Tyler Chernin and Matthew Oertli, Daly developed a business plan for the Hijra Health Van, a mobile health clinic that collaborates with the Humsafar Trust to bring treatment and prevention for sexually transmitted infections directly to the community. The three students, advised by Makadon and Vivek Anand, CEO of the Humsafar Trust, entered their business plan in a Harvard Business School competition, where it was selected as one of four finalists from over 50 entrants. Though it did not win the top prize, which would have provided $20,000 in funding, Daly and his collaborators were invited to present the plan at the Harvard Social Enterprise Conference, ranked by Forbes magazine as one of the world’s top twelve executive gatherings, generating much needed awareness of the hijras’ struggle.

In recognition of his work with the Humsafar Trust, Daly was recently honored with the Dean’s Community Service Award from the Office for Diversity and Community Partnership. As he closes in on his MD, he is preparing for a residency in internal medicine, with a career focused on training hospital leadership to emphasize the safe delivery of care. Though he will be working domestically, he said he was inspired by his time with Humsafar. “What started me on this path was the hijras’ lack of healthcare access,” said Daly, “and the lack of quality of care that these disenfranchised communities were receiving. I am interested in learning more about what can be done to improve the delivery system, and I have been lucky thus far to have as guides along this journey Dr. Makadon and Vivek Anand and my HMS colleagues.”

Readers may contact Robert Daly at robert_daly@hms.harvard.edu for more information on getting involved with the Humsafar Trust.