MANSI: The Program

According to CNN, “India still accounts for the highest number of newborn and child deaths in the world” and out of the 2.8 million newborn and child deaths worldwide, 700,000 of those deaths occur in India. Along with the thousands of newborn deaths that occur in India each year, many mothers lose their lives along with their children during childbirth. In order to fully grasp these facts, we need to have a solid understanding of the core problems that are responsible for these deaths. The first reason is that in many rural parts of India, hospitals are very far away from the villages where many of these deaths occur. Additionally, the hospital is not affordable for most families living in these areas and the mother and child are more likely to develop infections from the lack of sanitation in a public hospital than if she delivers at home. Given all of these reasons, it seems logical that a family would choose to have their baby delivered at home. However, this common solution is not ideal. Since most girls in these villages are married at 15 years old, they are expected to have children between the ages of 16 and 20, when their bodies are not yet ready to produce healthy children. Because of this, many babies are born premature and require intensive care from doctors. In the United States, we are very lucky to have Neonatal Intensive Care Units equipped with incubators to keep premature babies warm and mothers are able to tube-feed their babies who are too weak to feed normally. Since many of these mothers choose to give birth at home, they do not have access to these life-saving technologies and because of this, their babies are subject to diseases such as diarrhea, sepsis, and hypothermia, and as a result, have little to no chance of survival.

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The American India Foundation has devoted a branch of their organization to saving the lives of many of these women and their children. In collaboration with the Indian Government and the Tata Steel Foundation, AIF has worked to select and provide intensive training to one woman from each village in the state of Jharkhand. This woman is called a Sahiya, which means “helper” in Hindi, and through AIF’s training, she is equipped with the skills necessary to save and improve the lives of the women and children in her village. The Sahiya plays a large role in her village; she provides monthly home visits and checkups to each woman during their pregnancy as well as health visits for both her and her child until the child is 5 years old. In these villages, pregnancy and women’s health are considered taboo topics and some women may not even understand how or why they became pregnant or know how to care for themselves and their children during and after childbirth. AIF recognizes the importance of female empowerment and giving women control over their own health as well as the health of their children. So, the Sahiya is also in charge of teaching expectant mothers about pregnancy as well as dispelling many harmful myths inflicted on them by society. She talks with young mothers about topics such as anemia, nutrition, and the signs of high-risk pregnancies. Since many of these pregnant women will have complications, the Sahiya is trained to handle almost any emergency situation that may occur during childbirth and advises the woman’s family whether or not she needs to give birth at the hospital. At the hospital, the Sahiya becomes the woman’s biggest advocate and is as knowledgeable about the types of treatment the woman should receive as the doctor. This means that the Sahiya remains in a position of authority and makes sure that the woman is receiving the best care for both herself and her child.

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This summer, I had the privilege to visit five different villages as well as their respective Sahiyas, and I can confidently say that my life was completely transformed. One of my major takeaways from this trip was that it is one thing to see the outrageous maternal and infant mortality rates on a website, but it is a totally different experience to make a connection with the people who are affected by these issues every day.

As my feet navigated their way between chickens and roosters on the dusty roads in the state of Jharkhand, India, my mom and I neared the entrance to our first village. To be honest, I had no idea what to expect. I anxiously adjusted my scarf that was draped around my shoulders and slipped off my sandals as I approached the front porch of the first Sahiya’s house. A young woman greeted us in her late twenties whose name was Babita. She wore a crisp light blue sari and she flashed a smile at me as we sat down on her porch. Babita gave us an introduction to the program and showed us the spreadsheet that she used to keep track of each and every pregnant woman in her village. Next, she opened the tool-kit bag provided to her by AIF and she started to pull out a few items. The first item was a book, which she used to teach the young pregnant women in her village about what to expect during pregnancy and childbirth.

I was impressed by the depth covered by the book and could really see how passionate and educated Babita was about each topic. She discussed topics such as nutrition, high-risk pregnancies, and anemia. Anemia is a disease in which a person does not have enough red-blood cells and usually has iron deficiency. Babita explained that many young mothers don’t know what anemia is because most of the women around them are anemic, so it has become normal for them. However, she told us how critical it is to identify anemia in a woman before she gives birth so that she can be given iron pills, because any bleeding during birth could become fatal for her. She also taught us that many babies are born with mucus clogged in their throat, and as a result, are unable to breathe. This condition can quickly become fatal; however, AIF has provided each Sahiya with a mucus extractor, which is a simple tool that is used to extract the mucus from the throat, saving thousands of lives each year. Babita described to us how she feels empowered because of AIF and how she empowers other women to learn about their bodies and their health, and she is proud to be helping women to learn about topics that before were considered taboo. She described how in the majority of the cases, a woman’s husband makes most of the decisions for her, and sometimes does not know what is best for her health.

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However, women usually have no choice and forced to blindly follow their husband, but this is something that AIF is helping Babita change. Other Sahiyas like Babita have helped their communities come a long way in empowering women to take charge of their own bodies. As Babita showed me around her village, I was amazed by how respected she was by each and every person. As we followed her to one of her home visits, we were in awe at how most of her village came to gather to watch the health checkup. Even the men listened with interest as Babita interviewed the mother, asking her about the health of her child and the woman’s husband proudly stood behind his wife as she answered each question with a confident smile. What started as a private health checkup became a public stage for the Sahiya to educate the rest of the village on proper sanitary procedures before touching a baby and as well as the importance of supporting the baby’s head when holding her. In that moment, I truly realized the power of the Sahiya and even more, the power of a woman. That day, as the Sahiya captured the attention of each man and woman in the village, from young children to great-grandparents, she was ultimately educating a new generation of people who will work hand-in-hand with the Sahiya to ensure the health and safety of every mother and their child in the village. With the help of AIF, the Sahiya will help her village rise along with her to ultimately eliminate infant and child mortality in their village. At the end of our visit with Babita, she placed her hands together and smiled, uttering only a single word, “dhanyavaad”. In Hindi, dhanyavaad means “thank you”, and I can honestly say that “thank you” has never held such a strong meaning for me. I realized how much significance the word dhanyavaad held, it was not simply a polite gesture. It was the sign of true thankfulness for everything that AIF has brought for the other mothers, fathers, boys, and girls living in the 167 villages in Jharkhand whose lives have been saved and empowered because of MANSI. For that, I truly want to say “dhanyavaad” to AIF for providing me with a life-changing experience that I will never forget.

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1 Comment

  1. October 28, 2016
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    Excellent and compelling description of MANSI, Sophia !

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