Whose Breaking News is it Anyway?

Breakfast time 'Breaking News' and Sunday afternoon 'Shocking Statistics'. 
Children dying of completely preventable causes; women being ill-treated and traumatized; horrendous health; poverty, illiteracy, unemployment, out-of-control crime and corruption, and overall abysmal levels of human existence, let alone development. 
Do any of these constitute a 'breaking news' or a 'shocking story' anymore? Is surprise even the right word for the 'we've seen it all' feeling which emerges when you hear of many children dying to the ineffectiveness of the health system, or when a new mega crore scam emerges? 


Isn't it all very much a part of your and my day, to have the morning cuppa tea with the so called eminent leaders fighting like wild animals (who may be a tad better!) to select a ceremonial head who in all probability would only increase the tax-payers' burden by taking his/her extended family on many 'foren' trips, without adding anything substantial to people's lives? 


Doesn't this then give way to the headlines of the afternoon which are dominated by rape, murder, child abuse, political mud-slinging, preventable-deaths due to health facilities being over-burdened and thus inaccessible, and the same routine of probes, commissions, inquiries, and investigations? In fact one sometimes wonders where the results of ALL these efforts vanish! I in my mind imagine a huge warehouse. Dark, stinky, with that musty smell associated with storing files and folders for a long time. A tap dripping in an unknown corner, and something scurrying in the darkness, trying to nibble and 'make disappear', the result of one more investigation, the testimony of one more witness. 


Of course the evening and the night bring nothing new. More news, more undercover stories. Stories of 'human interest'. BUT who said anything about being human? We are a nation of walking, talking, zombies. Immune and insensitive to anything happening around us. 


A  nation, did I say? Oh sorry! We are a collection of 'regional groups', who care only if the occasional bomb blast is in our city (or state, depending upon allegiance). Otherwise we tweet about it and put it as our facebook status on the 'anniversary' of the blast. We also religiously watch the 'shocking' show that shows us 'shocking' stories of women's abuse, just as the women of our family get berated, everyday, around us. We shed tears when a woman speaks of how she is rejected by society due to her caste which is expected to carry out manual scavenging and yet, when we hate somebody, we say, "Oh, he is such a Bhangi, Choora, Chamar!". We want the health services to improve and be equitable, however, we only want the attention of the BEST super-specialist in town, that too without any wait, when somebody in our family is sick. We abhor female foeticide and the ill-treatment meted out to girls, but still think that our family should have a son to take the family name forward or to light our funeral pyre when we are gone. We are absolutely against regionalism, but still say, 'Chinki' and think loose, or easy. 


We are actually amazing, aren't we. 


We agree that the environment needs to be saved, urgently, but pride ourselves on never having stepped into public transport, and how it is only meant for the mazdoors (laborers) now. We also think it is our right to throw rubbish anywhere, and mark all our travel routes with our piss and our spit. We crib that the law and order situation in the country is rotten, but never turn up to vote, or even dream of taking the administration of this country in our own hands, be it the bureaucracy or politics. In fact, most of us, take immense pride in saying that, 'I maintain my distance from politics'. Well then, you have no right to crib. Because those who do participate in the game, are obviously setting its rules. Just too bad. 


Sitting in our comfortable air-conditioned room, in front of our direct-to-home service connected LCD, we practice, 'the gloved-hand, armchair concern'. An evolved form of social concern, it causes neither dirty-hands, nor worn-out shoes, and is very effective in today's time where stepping out might involve considerable danger. Is it any wonder that we have reached the place where we are today? We deserve to be here, because society is what we make of it. You and me. Together. 


It is an emergency. We need to get our hands dirty. Practice what we preach. NO we do not need to become 'social workers', and NO social concern is not about traveling to rural India and working in the so called, 'God-forsaken' places. Start where you are. Our cities and towns need help too. They need your time and your talent. Your passion and your genuine interest. Your ability to care, and to 'give a damn', even about things that might not affect you directly.

Droplets of Happiness or Tears of Sorrow?

It started off with a loud prologue. 
Like the drums that precede the 'Baraat' or the procession accompanying the groom in an Indian wedding. Almost like a light and sound show as well, with lightning and thunder setting the stage perfectly, for the first few hesitant drops. 
The barrage followed. And just like that, it was the first rain. 
The Earth responded eagerly with that heady aroma of its quenched thirst, and the birds sang with joy. Trees and leaves, heads and tails, all enjoying and dancing in the drops of happiness pouring forth from the skies. 


And yet, there are many, dreading the onset of the monsoon in this arid part of Central India. 
The reason, when explored, links up to the lack of proper sanitation facilities in the area. Disorganized or rather, 'confused' semi-urbanized settlements like the town of Babina, and other, small, more-village, less-town, settlements in the area, combine the disadvantages of both villages and cities; and lacking the facility of clean, wet toilets (toilets which have a provision for the flushing of the excreta), they still continue with the ancient tradition of 'dry-toilets' which need manual scavenging to clean them. 


This perpetuates discrimination against certain castes, who are the only ones carrying out the 'refuse' of humanity in this part of the world. 


The impact is particularly critical on women. 


They are 'unemployable' in any other role, even as domestic help, in their own words, as the first thing people ask them is their caste, and knowing their so-called 'identity', refuse to let them enter their house for anything other than, 'cleaning their toilets'. 
Meet any woman of the 'Valmiki' caste and she will tell you how her family is called 'Bhangi', a term used to address people of the castes which are expected to carry out manual scavenging including cleaning latrines and handling dead bod es (both human and animal). 


Discriminated against, and abused for literally cleaning our, 'shit', these women silently go about their work to earn the mere, two-rotis (flatbread) a day, or the fifty rupees they are paid for an entire month of insanely difficult work. 


Made illegal in 1993, employing of manual scavengers, and construction of dry latrines, still continue across the country, and can be witnessed easily enough if one wishes to do so.

The United Nations Commission on Human Rights (UN-HRC), at a 2002 meeting of the Working Group on Contemporary Forms of Slavery, said, “Public latrines – some with as many as 400 seats – are cleaned on a daily basis by female workers using a broom and a tin plate. The excrement is piled into baskets which are carried on the head to a location which can be up to four kilometers away from the latrine. At all times, and especially during the rainy season, the contents of the basket will drip onto a scavenger’s hair, clothes and body.......they are thus exposed to the most virulent forms of viral and bacterial infections which affect their skin, eyes, limbs, respiratory and gastrointestinal systems. TB (tuberculosis) is rife among the community."

Thus the pitter-patter of happiness for some of us, might be the sound of sorrow for many. 

While you enjoy that cup of steaming tea in the rain-soaked balcony, cribbing that your prayers to the rain-Gods for this heavenly nectar were not answered earlier, you might want to ponder on the thought that, the delay might just have been caused by the millions, praying harder than you, for the latrines and their contents to be dry so they could easily, 'scoop them up'.

**For those wishing to read more, WaterAid's insightful report, Burden of Inheritance (http://www.wateraidamerica.org/includes/documents/cm_docs/2010/m/manual_scavening_report.pdf) in a hard-hitting tone, analyzes and deconstructs the social conventions that allows this inhuman practice to continue, and pleads for strong action against it. 

Go Travel!

Woke up with this Henry Rollins (The Punk Rock World Traveler) thought today and wanted to share it with everybody! Go Travel!

6 States, 1000 Kilometers, and an Amazing 3 Day Journey

Ferozepur, Punjab, to Babina, Uttar Pradesh. 
A long line on the map....and a longer journey across (the unpredictable) Indian roads!

Starting from Ferozepur, a small city in Punjab, known mostly for its strategic location due to the border that it shares with Pakistan, and ending at Babina, a small city right on the border between Uttar Pradesh and Madhya Pradesh; the journey took us across diverse landscapes, temperatures, and road qualities!


So while the countryside of Punjab offered lush fields and green streams, and roadside eateries with yum food (also called 'dhabas') aplenty; our drive through Delhi and the region surrounding it took us over some of the best roads the country has to offer. 


Agra, and the wondrous Taj Mahal, and hundreds of temples, Gurudwaras, and Masjids, also, luckily, charted themselves on to our course.

However, the thrill of the ride went up a notch, only after we entered the 'not so famous' Chambal region, beyond Gwalior, towards Jhansi. Once the abode of Phoolan Devi and her gang of dacoits, the terrain of this area as seen in the picture below, offers an almost perfect breeding ground for the dacoits to quickly escape and hide from anyone. 

These shallow valley like formations flanked the dusty roads all the way between Gwalior and Jhansi and the driver's constant narration of dacoity stories on these roads did nothing to help us feel more secure!! The windows were securely wound up and nobody asked for a drink or pee break as we negotiated the broken down and in some places made completely of sand, roads, till Jhansi.


The countryside between Jhansi and Babina, where the border between Madhya Pradesh and Uttar Pradesh lazes along like a snake on a hot summer day, has a striking feature. Though mostly barren and with small shrubs as the main vegetation, each hillock in the region has a small temple or sacred rock formation, right on its summit. Whether meant to plead for protection from the dacoits or to please the Gods to ask for rain and less harsh weather, these temples or formations are usually small but stand out due to the barrenness of the area surrounding them, and give the region a surreal feel, especially as the sun sets.

The traveler, having made this intriguing and interesting journey, however, did not lose her focus on health :) The first learning from the journey was that across the 1000 kilometeres traveled, we did not come across a SINGLE trauma center or a medical facility capable of handling road accident victims, or even people with basic medical needs, except within the cities of New Delhi, Agra, and Gwalior. It is scary and surprising that one might be expected to travel 10o-odd kilometers to access even basic health services. 


Another observation is the complete lack of facilities for clean washrooms for women, across the entire distance traveled! So while men attend to nature's calls right at the side of the road even within the cities, women are expected to use only the toilets in restaurants (if any!). A huge problem, especially in the completely barren terrain that offers no huge plants or trees to squat behind safely!!


One striking observation is that the more I travel on, the more I realize that the basic problems plaguing health in our country remain the same, whether it is a Gadchandur, an Ahmednagar, or a Babina. While the public health system of the State is defunct, and completely impotent, the medical practitioners of the government hospitals practice privately offering services inaccessible to almost everybody for whom the State's health system is meant. In addition, quackery, as well as uncontrolled private sector health facilities with almost ZERO quality control are rampant. 


The lack of awareness among people, and an almost God-like respect for anybody with a stethoscope, are exploited beyond imagination to lead to a situation where people reject even the few services which are infact offered by the State's health system, and instead opt for private nursing homes which poison the health of the community while maintaining a vice-like grip on the minds of people through their disinformation, and administration of 'injections' which is considered to be the only effective treatment by many. 


I am sure these issues bring back memories of my stories from Gadchandur. They also apply to the area you live in, and if you ponder a little, they apply to the entire country!! But here, I digress :) 


We are currently writing from Babina, and exploring public health in this part of the country. The stories, hopefully, shall continue. Amen.

We Now Have a Facebook Page

Yes we do! 
We are now also available at https://www.facebook.com/TheObsessiveTravellersScootyDiaries


Let us use this facebook page to connect; and to discuss, argue, agree, disagree, oppose, support, and collectively brainstorm about public health issues. 
Hope to see you there!!

Another Road, Another Journey

Looks like we haven't spoken in a while. 
The adventures however; have continued, on a variety of, smooth and potholed, narrow and six-laned, dusty and freshly-tarred roads; and the diary has only got richer with the stories becoming more vibrant and intriguing along the way.  

Also, while the Gadchandur Chapter continues to offer new knowledge and insights through the rich data collected across the span of the last year, a new Chapter, that of Snehalaya and Ahmednagar, has written itself into this maverick's diary!


Context first. Snehalaya happened almost entirely as a miracle. The block was a requirement, Ahmednagar was just right, and they were happy to have an intern. Thus we traveled, to what is also known as, 'the spiritual center of India', and is the largest district of Maharashtra. 

Ahmednagar.

Most people know it because of its proximity to Shirdi (home of the guru Shirdi Sai Baba), and because it is the hub of sugar factories in the State. Geographically, this map shows where Ahmednagar district is, in the State and in India. 

With a population of about 5 lakhs, Ahmednagar is a developing industrial center, facing many of the problems associated with rapid economic and social change; a huge slum-based population, and aggressive trafficking issues being prominent among them. In other words,  Ahmednagar is another opportunity, for me, you, and for public health and policy. 


This opportunity has been seized by a phenomenal organization called SNEHALAYA (now made famous by the association with the Amir Khan show Satyameva Jayate, read more at http://knowsnehalaya.blogspot.in/2012/05/save-girlsave-world-snehalaya-satyameva.html ), and it is with Snehalaya that this leg of the journey was experienced and lived. 


The call was for more visibility and more public awareness of the substantial work SNEHALAYA carries out, in the district, and we understood what unwavering commitment is, through observation and silent participation in this organization's drive for real social change minus any 'showbaazi' (theatrics). 


I must confess the organization and its people are about as obsessed with their work and its results as I believe myself to be!! In our following series of conversations, I'll tell you stories of how this group of people have brought real change, one step at a time, and how hope for a better world rekindles itself in your heart when you see them at work. 


Till then, keep obsessing over something that you think is important for the world and for you, and thanks for reading!!

The Gadchandur-ed Me

So, field practicum placement over, report submitted, even grade received. 


Back in the campus and in the city that never pauses, Gadchandur seems a far far distance away, another world almost. A world that feels almost like a dream one woke up from...with the edges of detail blurred and smudged a bit. 


And why not, the love and warmth, the endless cups of tea offered and consumed, the innocent, soul-baring smiles and laughter of Gadchandur cannot be in the same age and time as the constant push and pull of life, the mutual distrust of people, and the dirty looks from co-passengers in the local trains of this great metropolis. 


An eye-opener and a turning point, the time spent in and around Gadchandur, is by far, one of the most cherished and most exciting memories of my 28 years on the planet. 


Never once falling short of love or goodwill, cooperation or trust, emotion or friendliness; I was in Gadchandur, happier than I was as a rent-paying vermin in Mumbai, and that changed me forever. I think it messed with my head in ways I don't understand fully now, but that have Gadchandur-ed me in to something better, happier, and more thankful for life and all its myriad and colorful gifts that make my life unbelievably amazing!! 


A supari (betelnut) trader and tobacco products supplier who would hide his 'kharra' (chewing tobacco) packets when he saw me, for a landlord; a Maharashtrian woman, who would cook and relish rajma (kidney beans) for the Punjabi in me, for a landlady;  endless kids with runny noses and ready homework questions for the 'doctor didi' for neighbours; enthusiastic men and women who would drop off food, snacks, and sometimes even me from the bus stand, for colleagues; what a blessed time!! 

Some of the pictures (as uploaded above) manage to just take me back to some place in time that I left a part of me at.....It is difficult to say which one is more difficult..to take away Gadchandur from me or me from Gadchandur but one thing's for sure...some 'jodis' (couples) truly are made in the heavens above :)

A Gadchandur Goodbye

I asked where, they said, Gadchandur,

I stared, thinking, 'must be pretty दूर';

Cribbed all the way, cried and fought,

It was the last place, I expected to be brought;

Language, food, culture, everything was new,

Friends, movies, hanging-out, were bye-bye, I knew;

First few days were all a pain,

Kept wishing I could take the very next train;

One week went by, and then another,

Slowly things became less of a bother;  

Scooty, बैल बंडी, sometimes the walk,

Learnt the world through hearing people talk; 

The stories were crazy, sometimes insane,

Realized the world has so much pain; 

Understood public health like never before,

Found my calling, never gonna run after that crore; 

Laughed, joked, argued, sometimes shed tears,

With the women, men, children, and even the peers; 

Field-work became the reason of my being,

Forgot the wheels of time.........whirring; 

5 months, was it? Went by in a flash,

Just remember the first day, unpacking the stash; 

A cluttered room, half-stuffed still-open bags,

Behind the brain, the heart still lags; 

What to take, what to leave behind,

People, culture, smiles, and love, clogging my mind;

One more photograph clicked, another cup of tea,

Anything to keep the thought of tomorrow, away from me;

Gadchandur has become so much, a part of I, 

It feels almost unnatural to say Goodbye;

But moving on in life is a must,

For what is life, but for newer adventures, an endless lust......

The 'Gond' way of life & health

'Gonds', the largest tribe of India, are in a majority among the tribal or adivasi groups living in the villages surrounding Gadchandur.

With a unique language(Gondi), an intricate set of socio-cultural beliefs and practices, these 'Hill People' (As 'Kond' in Telugu means Hills), face unique problems when it comes to healthcare delivery in general and Mother & Child Health in particular.

Religion plays a central role in the Gond way of life, and they worship a deity known as Persa Pen. The strong belief that 'spirits are omnipresent & omnipotent' and that all events in the

world are controlled by the spirits underlies all their practices. Worshipers of the 'female life force', the Gonds believe in sacrificial offerings to please their deities for all events, right from the making a of cow shed to the birth of a child.

Ancient shrines like the one in the picture dot the countryside, and all villages as well as fields also have a central shrine.

Girls, upon reaching the age of their first menstrual cycle are considered to be full-grown and the rite of passage is marked by a sacrificial offering. Even though the age at marriage now slowly seems to be increasing, majority of the womenfolk still remember being married at 14 or 15.

The rituals around the entire process of the female reproductive cycle and child-birth are both intriguing and unique. The women in their menstrual periods are supposed to stay in a verandah of the house, on the floor. They are not allowed to go near the kitchen or cook.

The spirits or 'dev' are believed to protect the pregnant woman and the child and thus nothing external is considered good for the woman. This includes immunizations, ante-natal check-ups, and sonography. Deliveries are mostly conducted at home, on the floor, due to the belief that to appease the 'devs' the mother and child cannot use a bed till one month after the delivery.

Also, as seen in the picture the mother and child have a separate area in the house, where a pit is dug for the mother to wash and clean all the clothes she and the baby use including all the clothes which are used for the post-partum bleeding. The baby is not allowed to wear any clothes for 1 month after birth and is bathed twice a day, everyday.

Another very common practice is the application of a paste of turmeric and oil on the baby's umbilical cord stump to make it heal faster. This however causes infections and sepsis, which has been one of the most common causes for neonatal mortality in this area.

Some of the villages that the 'Gonds' live in are extremely remote and the health services in such areas are practically non-existent. Most of the villages are too small to have their own sub-centers. The one village that does have sub-center has an ambulance only on paper, a medical officer that never actually joined work after visiting the sub-center once the previous year, and absolutely no facilities for referring a patient to the PHC.

My visit to this village, "Bhari", shocked me, not only due to the complete lack of health care of any kind, but also due to the the still existing practice of untouchability there. The community health worker as well as the nurse in this village are from a scheduled caste, and not even allowed in to the part of the village which is inhabited by the Gonds.

Believe me when I say this, I was asked my surname before I could visit the mother and the baby, and the health worker and nurse had to sit outside the house boundary, while we were inside.

'India Shining' indeed.

It would, however, be naive to think that the abysmal neonatal and maternal health in these areas is just a 'fault' of people's belief systems.

The following story, of Savita and her baby boy, is a slap in the face for the so called 'referral-system' in the public healthcare delivery that seems to be more a mechanism to keep under check the no. of deaths RECORDED at each service delivery level than to actually offer better health services.

Doing the absolute right thing, Savita took complete ante-natal care, and delivered her 3 kg baby boy at the nearest sub-center. As the boy was unable to breast feed, the referral system kicked in, with Savita and the baby being carted to the PHC at Jeewti, at a distance of about 25 kilometers. Once the mother and baby reached there, the MO realized there was nothing much he could do and he referred both ahead to the Rural Hospital (RH) at Gadchandur in a vehicle (the diesel to be paid for by the family). There was an obvious delay in any treatment being received by the baby. As the family covered the over 40 kilometers distance and reached the RH, there was no doctor available.

In 1 hour's time, the doctor came (this is at 3:00 in the afternoon on a working day), and examined the baby, and decided that the baby needed resuscitation. As he started to resuscitate the baby, the baby died. Upon the death of the child, he told the family to take the child to Chandrapur (District Hospital) as he wasn't a paediatrician and maybe a specialist would be able to tell them something further. The family knew that the baby was dead and refused to go to Chandrapur, instead focusing on Savita's (seen in the yellow sari) health. The MO said, "Fine, but the baby's death wouldn't be recorded here, as I had referred you BEFORE the death of the child."

As an ashamed member of the medical fraternity, all I can do is look away from Savita while her eyes questioningly look at me asking me what she did wrong. And the system for once can't blame this on her being 'tribal', 'uneducated', or, 'careless'. It is time that doctors, and nurses remembered that they are not 'accountants' but 'life savers'; and the health system enabled this transition.