Bridging Access to Care

This article examines the humanitarian aid and development sector through a postcolonial lens, tracing its historical roots to colonial power structures and the modernisation theory that underpins mainstream practices. It explores current transformations – including shifting donor priorities, the rise of neoliberal management, and increasing calls for locally-led and decolonised approaches – as signs of both sectoral unravelling and potential renewal. Drawing on the case of Timor-Leste, the paper argues that the sector’s persistent failure to engage with postcolonial realities results in unsustainable outcomes and marginalised local voices. It calls for a fundamental shift in how aid and development are conceived and implemented: from top-down interventions toward respectful, adaptive co-creation with communities. The paper proposes that instead of retreating, practitioners should step in with humility to build equitable relationships that allow communities to define development on their own terms.

Incarceration is a significant public health issue that disproportionately impacts transgender (trans) women, particularly those of color. The cycle of incarceration interacts with high levels of substance use, mental illness, and HIV to produce a high disease burden among trans women, but, to date, there are no published studies of trans-specific reentry support interventions. Informed by the Model of Gender Affirmation, we systematically adapted and pilot tested the evidence-based Project START intervention to create Girlfriends Connect (GC), a reentry support intervention for trans women incarcerated in a county jail. Qualitative interviews with trans women (10 prerelease and 6 postrelease) and community social service providers and jail staff (n = 7) who serve justice-involved transgender women, as well as input from a community advisory board, informed our adaptation. We then conducted a pilot randomized controlled trial (n = 14) and a service implementation project (n = 16) of GC to examine its feasibility and acceptability. Lessons learned include the importance of peer facilitators, facilitated referral to gender-affirming community resources, and obtaining programmatic buy-in from jail staff and administration. Results indicate that GC is feasible and acceptable, and holds promise in improving the health of transgender women reentering the community after a period of incarceration.