How much we take our healthcare for granted - A report from the Slums

Healthcare – How much we take it for Granted for Ourselves?

A Report of Healthcare in the Slums

After struggling for months in the field of health, we are finally learning the malady of the people living in the slums. The surprising thing is that the malady is not money; it is un-education, attitude and a deep sense of fatalism prevailing in the people who have internalized the fact that meaning of life is survival from one day to the next.

Because of un-education they do not take the simplest of precautions in the form of hygiene. Because of their attitude of living life in the moment, they do not make a visit to the doctor till they are on the verge of dying. And when they do decide to get medical attention, they go to seedy doctors who are actually compounders or Rural Medical Practitioners, without any MBBS degree, (but flaunting spurious medical degrees). These doctors then prescribe a huge array of tests, x-rays, costly medicines for even the most common ailments, cashing on the slum people’s psychology that, costlier the treatment, the better it is. We know how these people are treated in government hospitals. We, after all our education and civilized upbringing measure the worth of a person by the amount of money he has or the position he holds in society. What value can we give to a person in rags, who sells iron scrap?

Mongli, is a fifteen year old in Rambasti. One day Suman was just taking a round, when he noticed this girl lying on the bed with a huge swelling in her leg, writhing with pain. Her father was drunk and was wailing that her daughter is going to die. They had showed Mongli to some medical shopkeeper who suggested them to do an x-ray, though Mongli had no history of any fall or accident and had prescribed some medicines which were mere pain-killers. He had borrowed two thousand rupees for this entire exercise. Obviously, her condition only deteriorated. Suman took the girl to a known doctor in the evening, who did a minor operation during which huge amounts of puss oozed out from her leg. Had the puss been there longer, her leg would have required amputation. The entire operation took barely two hundred rupees. The next day itself, after this operation, Mongli was seen running behind her father’s bicycle to get her dressing done. Meanwhile her father helped himself to another bout of liquor that evening – because his daughter was now going to live.

Our war is with attitudes. Our work is to start a long and tedious journey of making the urban poor change their attitude to health and life.

The mortality rate of the urban poor is startling. In the last three months, we have seen the death of three youths, all of whom could have been saved with basic health care services. Unfortunately because of our own lack of experience and resources, we couldn’t save these lives. With all our resolve, it seems death finds its way.

An inroad was made into the murky situation of health when one of the doctors, Dr. Ajay who himself completed his MBBS degree under situations of poverty came forward to help us by coming once a month to check all patients of the basti, free of cost. He conducted the first free medical check –up on 5^th January, 2008. This will at least ensure that now the slum people can get an honest diagnosis and at the onset of a problem so that we can take preventive action. For the time being we have hit on the following three tier strategy to prevent death from stalking more people.

• Spread Awareness about hygiene and commonly occurring Diseases
• Early and reliable diagnosis of diseases and ailments through a doctor visiting the Basti once a month
• Forming a network with doctors and medical shopkeepers

FW: The melee of a mela - NEEV Herbal Soaps

I grew up hating crowds, yearning for less people, more trees and more natural landscape but a mela is a different place. I think the world will be friendlier if there are a lot more melas. The last time we put up a stall, it was a new experience, somewhat torturing – convincing customers to buy our soaps and I must share it took a lot out of my middle class, urbane sophisticated sensibility to sell a bar of soap across the counter.

We have put up our stall the second time in Jamshedpur at the large Gopal Maidan and this time, I enjoyed it for I have long erased my history of a cool middle class professional and have embraced the melee and the chaos of the mela. I enjoy the visceral feel of jostling in the crowds, snooping on people’s conversations. There is more than just selling that happens across the counter. In many cases the bar of soap is just the starting point for a dialogue which can range from the colour of the skin to the state of the world. There are people who will actually eat your head out and not spend a single paisa, but in due course you learn to enjoy these encounters.

Minu (in yellow salwar kameej) and Shikha (in brown jacket)

There are three stalls of soap in the mela, ostentatiously decorated with screaming banners. Ours is humble and this gives me the opportunity to stand by a corner and watch what draws people to the stall. One customer came to us, who happened to be a chairman of an NGO. He said he was drawn to the stall by the aura of Shikha and Minu. I saw one child dragging his reluctant father to our stall because he was fascinated by the word ‘handmade’ in NEEV Herbal Handmade Soaps. I realized that mostly people who came to the stall were drawn by something beyond the material essence of the product, which I would leave to your imagination, as to what it could actually be.

As for our Herbal Soaps business we don’t make huge profits, we are breaking even. We dream of procuring a moped for Minu some day so that she can become a soldier for our business and our profits can increase and we can employ more women like her. Our humble NEEV soaps has finished one year, it is still ON SALE, sustained by its vision of a socially responsible business and the love of people.

Love,
Anurag

Making of SHG hut - A Story of Self-Relaince, Community Effort and Democratic Leadership

Making of the SHG Hut

A Story of Self-Reliance, Community Effort and Democratic Leadership

We needed a space for our activities. Constantly in our meetings I could here rumblings about a community centre that needs to be built. Like it happens in all works of such nature, many ideas were mooted – contacting the Local MLA, contacting rich businessmen…etc. etc. But somehow these ideas were not woven form the yarn of NEEV’s dreams.

Things of the spirit have a way of happening. First of all they are not linear. They erupt suddenly and break out into a form. All our meetings, our discussions seep into the unconscious of all our team members. We consider our meeting sacred and our true strength. Out in the field, each one carries the fire of the sacred meetings – at the given time and at the given moment the form emerges. It’s quite unlike business meetings where everything is slotted, planned and executed (literally). Today modern physics also recognizes that chaos is a high form of order. At NEEV we believe in discovering the order of organized chaos.

In one of the women’s SHG meeting, the idea came up with urgency that the women need a place to have their tailoring classes. Shikha and Sangita, two atoms which have the power of nuclear fusion when they combine set out on the task. Many people in Rambasti were contacted for a place and ultimately Upendra, a resident of Rambasti volunteered to lend a room. The room was a thatched structure, made of bricks and cemented with mud. There was no floor as well. How would we do the repair?

Second day Suman and Sangita went out with a resolution, they would do it on their own. They asked for help from the residents – nobody volunteered. Undaunted they went out alone with a spade and a bucket to dig mud from a nearby land. As always, the children were the first to spot them and get enthused by something that involved digging, mud and water. Soon a young army gathered around Suman and Sangita – giggling, digging and sweating.

Next day, Shikha not wanting to miss out on the fun, joined the party. And so did the women and the youth of nearby basti. The youth toiled with the spades, the women started plastering the hut and the children, the path breakers continued with the same spirit.

Now we needed a door. Fagun, another resident of the basti, a srap metal dealer volunteered to give a tin sheet to make the door. Now, we just needed the wooden frame to make the door’s frame. I had just about sanctioned Rs. 600 for that when I received the news that, that too would be provided by Upendra as a gift to the community. I don’t deny a spark of self interest in Upendra and his family but overall what emerged was a generosity of spirit, a wish to see the community develop.

The hut required three layers of plastering with mud and flooring along with a thin coating of cow dung. The hut was completed in a week’s time. No money was spent. What went in was the collective effort, sweat, smile and spirit of all the members.

A few days later, I went to the basti and was admiring our own version of the Taj Mahal, when a young girl slowly emerged from around the corner of the hut. When she saw me looking at the hut, her eyes sparkled and her face widened into a glorious smile.

“We made the hut”, she said.

Another few days later we had a visitor from London, Saikat Mitra, a friend of NEEV – fashion designer – he was all smiles.

Another Light Extinguished

Rukhmani in Hospital – Her Last Picture before Death

Dead, Jan 6, 2008 – Age, 18 – Killer, TB which transformed into Meningitis due to neglect – Another light extinguished

I still remember her eyes, the way they looked at me when we used to visit her. It’s as if they were trying to communicate something that I could not understand.

On whom to vent my angst, on the system which does not care for people in the slums, on the neglect of the hospital doctors, on myself for not having taken her TB gland seriously, for hesitating to get her FNAC test done because I wanted to be cautious of the way we spent our funds – when we still had a chance to save her, or on her family which did not take her disease seriously because of uneducated ness and neglect.

For the two weeks she was there in hospital, her husband served her by mortgaging all the things of his house. After all they had had a love marriage.

We could not save her despite all our efforts; we were late – once again!! I can give excuses, it is Shikha who forced Rukhmani to be admitted to the Govt. hospital. Shikha, Sangita, Suman and Uday went there everyday chasing all doctors to get her treated, Suman ran all around Jamshepur to get the injections, Shikha read the internet to know more about the disease, consulted private doctors – but we lost!! Rukhmani died just minutes after Uday left the hospital after giving her a bottle of Horlicks. I know we cannot play God but I also know that Rukhmani could have lived as we all live with our spouses whom we love, had she been in an educated family with adequate health care.

God knows how many more lives I will see extinguished like this. But we have to work. Friends, first Mausam and then Rukhmani, the burden of their memory shall be our guiding light - to work with more diligence, more compassion or else this system is going to take its toll with mathematical precision. Let us come together to address the suffering in this world.

After Suman and Sangita got Rukhmani’s dead body discharged from the hospital and arranged for an ambulance, we gathered in the basti where her body was kept.

I kept looking at Rukhmani’s face for a long time. It was so serene and her serenity gave me the strength to accept death. Rajender, her husband who had nursed his beloved till the last sat beside her silently. I could feel his silent grief - the strange, pure and final silence of death.

A Day in My Daughter's Life - 2nd Oct, 2007

Like me, I presume this day would have passed uneventfully for all of you. You must have read in the headlines that Sonia Gandhi is going to give a speech on World Peace Day, a day in honour of a bald, bespectacled man. If your newspaper shares the same sense of irony which mine does (and I bet it does) you should not be surprised to find a colour photo of Shakira giving a rock concert just behind the page where there is a black and white photo of Mr. M.K Gandhi – Father of our Nation. The photo of this old world figure might most likely be followed by a caption lamenting Gandhian values are fast fading in the world.

I was in the din of the marketplace, as I began my ritual of reading the newspaper. I had brought along with me merely Rs.10 for purchasing two papers which carried news about the health camp we conducted yesterday. As I was scanning through, my daughter asked me for some money. She must have read the questioning look in my eyes for she promptly said that she wanted to give some money to a poor lady. The poor lady, in question was a destitute woman who has been sitting in a particular corner of the market place as long as I can remember. My six year old daughter has had a special corner of concern for this lady, for even in the past she has asked me to give that lady some money. I fished out two Rs.2 coins from my pocket, hesitated for a moment, bemoaning the fact that I did not have a Re. 1 coin and gave a 2Rs. coin to my daughter. She instantly disappeared with the coin and I burrowed myself in to the newspaper again. She appeared back within a second, tugged at me and insisted that I come and take a look at the old lady. I knew the haggard state of the old lady so I tried to avoid the encounter. Yet my daughter persisted and I gave in. The old lady was dozing, possibly due to the effect of liquor. It was a little disappointing for Harshal that the old lady had not seen her doing the act of charity and understandably it deprived Harshal of some satisfaction.

As we headed back to our soap stall, the following conversation took place.

Harshal: Papa why was the old lady sitting like that?

Me: I don’t know baby, most probably she was sleeping.

Harshal (giggling to her self): Is this the place to sleep?

Me: But Harshal , she does not have a home.

Harshal(a bit concerned this time): Does she have food to eat?

Me (haltingly): Most probably no, Harshal.

Harshal: Papa are you not someone who always helps the poor?

Me (at this stage a mixture of emotions – pride, guilt, feeling small and yet concerned): Yes Harshal, but there are too many poor in the world, I cannot help all of them.

Harshal (after some silence): You had ten rupees with you didn’t you?

Me: Yes, I did! Harshi

Harshal (almost seizing my words): So why did you not give it to the old lady. At least she could eat something for today.

I did not reply to her after that. We kept walking silently amidst the din of the traffic. For a while all the noise faded in my mind as it retraced its steps back to see the crouching figure of the old lady again. Where will she spend her night? What does she look forward to, for the next day? What could I have done for her? What can I do for all these poor? I am already trying, but is this enough?

Dear friends, wish you all a Happy Gandhi Jayanti ……………………..whatever it means!!

Love,
Anurag

The Story of Radha

This is the story of Radha, no she is not the mythical Radha, the beloved of Krishna who prances in the moonlit Vrindavan. She is the Radha who sweeps our house, washes our clothes and lives in the basti. She is 33 years old, her face has a glow of serenity and a smile that is golden pure. This evening, by chance, I happened to observe the way she was vigorously scrubbing a stubborn stain on one of Harshi’s socks. “You wash the clothes with a lot of care”, I told her. “What to do, children make their clothes so dirty, we have to scrub them hard to clean them”. You could have easily mistaken that she is talking about her own children. I silently saluted at the spirit of this woman. Money can never compensate such feelings but suddenly I felt small in front of this woman whom we pay Rs.350 per month.

Did I say that Radha had a serene face and a golden smile? No! No! That’s deceptive. Because I came to know from Shikha, this very evening that Radha cries all night. She cries when her children have gone off to sleep so that they don’t see her.

Radha’s husband is 40 years old and he is suffering from lung failure. One of his lungs has failed entirely and the other is partly functioning. The doctors have given three months time within which if nothing is done, it would fail too. No Radha’s husband did not smoke or drink.The operation has to be done in Vellore and it would cost atleast Rs. 60,000. Even after the operation, the doctors are unsure how long would these lungs perform. Radha’s son who studies in the polytechnic is planning to leave his studies so that he can earn money. Radha’s brother was going to get married and he has stalled his marriage so that he can contribute something to Radha.

Friends, these are the stories of the lesser India. These are also stories of the India where the economy is registering a 9% growth rate for the third consecutive year. You might say these things are part of life. I am not willing to believe these are part of life. Bini Besra lives today. His survival is equally part of life.

The question is what can we do? Can we do something? I feel we can. We are people having the talent, the education, the opportunities and the contacts. Together we can do something if each one of us tries to pool in our bit.

I welcome all your thoughts and suggestions in this regard. More than that, perhaps I require your will and support.

NEEV - Charity, Reform, Revolution and Evolution

A few days back, Deepak Goel my friend and college mate called up from California. We had a conversation which lasted for about two hours. The conversation sparked a certain chain of thought in me and has been the inspiration for writing this article. Thank you Deepak for providing the spark and I hope we gradually nurture this spark into a fire.

Friends, NEEV has been in existence for a little longer than a year. It has proliferated and grown – in structure, thought, intention and impact. In the past one year we have established NEEV Public School, a registered charitable trust NEEV, a herbal handmade soap business called NEEV Herbal Handmade soaps and a growing community on the web NEEV Google groups. It’s been a whirlwind of activity for me, Shikha and my team. If anyone of you would come down to Jamshedpur, the projects might appear to be small in size but for us they have been microcosms to explore all the questions and aspirations that NEEV had set out to answer and achieve. It’s been a huge struggle to find the resources both in terms of capital and people to get the ships afloat on the ocean. With all your help they are finally afloat and now we require the resources and the crew to help them reach their destination.

Those who have been part of the journey from the beginning know that NEEV is a vision, not to be confused with the structures it creates to accomplish the vision. As far as the vision goes, even the name NEEV does not matter. The name is the vehicle for the vision but what is more important is the vision of life itself. So NEEV cannot be straitjacketed into particular forms or structures. In all my correspondences with NEEV google group members, I have been as bothered with sharing the spirit of this vision as I have been reporting about my activities. My intention always has been to find more people for the journey.

When a movement of such width begins, it is like a seed – small and undifferentiated. Within it, lies the potential to grow into a huge tree with myriads branches, trees and flowers. You might notice in nature that the growth of any living structure is marked by increase in organizational complexity. The organizing principle remains undifferentiated but to meet its multiple needs, it develops new structures.

NEEV can be considered one such living movement. It is not an NGO or a School or a Business. These are structures which have sprouted as an increase in organizational complexity. In future many more structures will grow. At this point, I felt the need to define the structures and the organizing principle of these structures. Because if I don’t do this there is a danger that people might mistake the complexity for disorder. A garden might look more orderly than a forest, yet it is the forest that hides in its apparent disorder an amazingly delicate and complex web of life. A forest is living and breathing – self sustaining unlike a garden which needs to be tended and manicured. I visualize NEEV as a forest, not as a garden. After talking to Deepak, I felt the need to probe into this forest and bring to light the underlying order, in the hope that it enriches all our wisdom.

Social work is a vast field – as encompassing as life itself. Over the years I have been able the following components of social work

• CHARITY
• REFORM
• EVOLUTION
• REVOLUTION

Most organizations are unable to encompass all these movements in their fold and so they pick either one or two of these processes as their organizing principle and leave the rest. Doing so lends them efficiency and even the comfort of not having to deal with vexing contradictions inherent in these movements all the time. The degree, to which the organizations encompass these movements, is the degree to which they can be called living. If you see life, living is always a process of continuous resolution of contradictions on higher and higher planes. To give an example – our body is continuously navigating the opposite poles of living and dying. If death is not part of our body’s regimen it will not live either. Every day parts of our body – cells, tissues etc. die to give birth to new ones. Similarly if our human organizations do not understand the play of polarities they become sick and diseased. This has what happened with the industrialized world.

It is my own contention that a living and holistic social work organization has to be modeled on all the four principles that I have mentioned above if it has to be vital, living and healthy. I am venturing with this proposition and am experimenting with it. Let me define the four processes as I view them.

CHARITY – For many professionals, especially those working in corporate circles and even NGOs this has become a bad word. Yet I have not been able to dispense with this value. Charity is a spontaneous act of kindness embedded into our human consciousness. Its decay is marked by the rise of capitalism which puts self achievement as the highest goal. Many times, you meet people in acute distress, who require immediate attention. At that time what can help them is an act of charity. We do it in the time of disasters but this value is slowly fading from the fabric of present day social life. I remain an adherent to its therapeutic effects on society and completely endorse it. It will not cause a reform or a revolution but it will save lives – and that counts. It might save the life of your near and dear one day.

NEEV Trust does Charity.

REFORM - It’s a hot word in the social sector and political circles today. Reforms imply that a particular structure is good intentioned but is not working properly. Take the example of the PDS or the Public distribution System of the government through which it gives ration to the poor. A reform in the PDS implies that there is no corruption in the system, that the vendors of ration shops are supplying the ration to the poor at the government prescribed rates and quotas and siphoning of the material to the private market. Needless to share with you all, this is far from true. A reform here would imply that aware citizens mobilize the poor to fight for the rights which the government has provided them. RTI or the Rights to Information Act is a potent way to seek reforms in the system.

A reform implies that the system is good, the structure is correct – what is required are some reforms in the way it is functioning. Most NGOs prescribe to this philosophy. They have to because they are registered by the government and if they don’t their registration will be cancelled – their funds will dry up. The governments give an illusion of space to the NGOs but in a hidden way they control the NGOs through the funding. You cannot go against the government and still carry on with all the expenses of your NGO.

And that is why reform is a bad word for the revolutionaries. For revolutionaries the PDS system is giving alms to beggars – reducing the poor to beggars. From the revolutionary angle, it is the system’s fault that there are rich and poor. PDS is a means of giving medicine to the sick but it is not attending to the root cause, the diseased system itself. It maintains rigidly the concept of the ruling class and the working class.

Acknowledging the limitations NEEV Trust and NEEV Herbal Handmade Soaps are involved in reforms. A revolution takes time to happen. Till then there is the question of feeding the poor, healing the diseased, educating the poor and cleaning the environment..

EVOLUTION – Evolution is a gradual process. It is about designing systems, maintaining them, sustaining them and improving them. It is about acquiring knowledge and wisdom, learning through experimentation, thinking and failures. It is about creativity and striving for the ultimate object of consciousness. Most of us are perhaps most familiar with this process. We are quite familiar with this process because it has held man’s attention ever since there was the birth of a scientific mind in man. Unfortunately our theories of evolution have been incomplete because of which man has waged a war on the earth itself. Evolution again has its trenchant supporters primarily in the realm of science.

Personally I have been very entranced by the connections between evolution and revolution. A surface analysis says that evolution is a slow non-violent process and revolution is about sudden and violent changes leading to formation of new structures. But when I think deeply, I find it difficult to separate an evolution from a revolution. Does an evolution brings about a revolution or an evolution brings about a revolution? As of yet I am led to think that revolution and evolution are same processes but revolution is referred to that event in which the structure shows a transformation whereas evolution describes that state of structure which is undergoing change.

I think NEEV Public School best represents the structure which deals with evolutionary growth.

REVOLUTION – A revolution is a transformation of the very system. For most it is threatening so it is only the few who lead revolutions. A revolutionary is out of the system and most of us depend on the system for our self worth and sustenance. When Gandhi led the freedom movement, it was not the freedom movement that was the revolution. The revolution he created was that he gave birth to a concept of freedom for a people that were slinking into accepting the dominion of the British, not only politically and economically but culturally and spiritually. Intellectuals of India had started singing paeans to the British, propagating how Indians are better off with British as our masters. The revolution that Gandhi created was that we are in no way culturally and spiritually inferior and that no power has the right to infringe on our freedom. We have the right to be free – this was the revolution. To make people believe that they can and should be free.

Today we are so called free citizens living in democratic countries. But is this complete democracy, is there complete freedom. In the era of globalization (read global imperialism) when multinationals have gained control of all natural resources for loot and plunder and throwing some bones to the middle class to maintain their organizations – are we free?! Are we leading the lives we want to lead or are we being unconsciously led to make choices which the multinationals want us to make – the food we eat, the dresses we wear, the entertainments we choose, the technology we use, the news we read, the aims we have for our lives.

Certain things cannot change without a revolution. Unfortunately those things which cannot change without a revolution are the ones on which the future of the human race depends – like climate change and global warming. We need a revolution to develop a new way of living on this earth – the principles which are enshrined in the philosophy of NEEV.

NEEV google group is presently the structure which most effectively deals with revolution – so far?!! But this is not enough; more structures need to be developed.