Humanizing Health Statistics

My main project this year is assessing baseline health statistics of artisans and their families working and living in Kachchh, Gujarat.  I moved to Bhuj in September and dove straight into research for the study.  I formed relationships with artisans, their family members, and NGOs in the area that work with health.  I spent two months just observing, going on site visits, and learning about life in Kachchh before I began designing the study.  After three months of observing, researching, designing, translating, and training an amazing team for this study, I was ready to begin.

At the end of my first day on the field conducting the interviews, something become extremely obvious to me.  This was no longer purely a study on health statistics, but the beginning of a discussion on health information, a forming of a partnership to provide health services, and the first step toward improving livelihoods of people I now consider my friends.  It would be an injustice to my year in Bhuj if my final product was only a report on quantifiable information.  Statistics were not enough information to properly show the intersection of public and health.  During the long car rides back from my field visits, I brainstormed with my health team on how we could humanize the health statistics and properly paint a picture of life in Kachchh.  From my first day on the fellowship I wrote down everything—my diary is how I keep from being lost in my longing to understand.  When we conduct the Focus Group Discussions (FDGs) and in-depth interviews, I sit, watch, and scribble furiously.  I want to make sure I capture every exchange, every hesitation, every moment of humanity.  In an effort to humanize the findings of this study, I want to share excerpts from my field diary- in this blog and in my final report that will be shared with all health related NGOs in Kachchh.

 

December 8th, 2014: Day 1 of Field Work- Khavada, Kachchh
 Khavada is a small leather community just outside the Great Rann of Kachchh.  We turn off the main highway down a dusty, desert road and drive for a half hour into the village.  There are no street signs-no signs of life.  

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The village is made up of 200 households, with brightly painted doorways and ornately dressed women.  I’ve been here once before.  I was part of the Khamir team that interviewed the khumbars on the historical uses of pottery for health.  Some of the families recognized me.  I would like to think it is because I had lunch with one of the families, helped cook rotis, and bought a necklace from one of the girls.  But I think they mostly remembered me because a stray dog chased me through the village.  A white woman running through their village being chased by a dog being chased by men- it was a memorable sight, I’m sure.  They all come over to say hi and to see why I had returned.

Home in Khavada

There was either a miscommunication or information was lost in translation so we (re)inform them of the health surveys and the FGDs we are planning on holding that day.  They ask what they will get in return and then try to sell me more of their jewelry and embroidery work.  Within minutes we are able to effectively communicate why we are there and the men begin to gather for the first FGD.  Because no one previously informed the women of the study, today we are only able to hold a men’s FGD and complete twelve in-depth surveys.  Tomorrow, Geetaben will come back and finish the remaining eight surveys and hold the women FGDs.

The first in depth interview is with one of the female artisans, an embroiderer.  She answers the questions quietly as a group forms outside of her house.  She seems shy, speaking softly so only Geetaben can hear her.  She repeats questions that are not Yes or No to her husband, she says she is not sure of the answers.  She apologizes to me for not knowing the quantities of rice, wheat, and sugar she is given, smiles, and covers her head with a bright green scarf.  

In-depth interview

I sit with Tarnishtaben and Geetaben during the male focus group discussion.  I wrote the questions in English, Tarnishtaben translated them to Gujarati, and Geetaben asks the questions in Kutchi.  Tarnishtaben takes her notes in English so I am able to look over her shoulder and get the gist of the men’s answers.  Once the FGD is over we discuss in full detail all the responses to every question.

The FGD is 9 men and 3 boys.  All the men contribute but there are three that are especially vocal.  From this FGD we learn that the men are becoming more worried about cancer as they become older.  There have been at least 8 cancer related deaths in their village over the past 7 years.  They say they have no transportation to nurses or hospitals and no one ever comes to their village to provide health care.  Anganwadi never comes is a phrase I am all too familiar with.  They tell us this is the first time they have ever had a community meeting to discuss their health.  They ask if Khamir can facilitate more of these, they want to know more about their right to basic health care.

Mens FGD

 

We ask about the future of their craft, if they will pass their techniques on to their children.  They say for now, the kids are in school but they are learning leatherwork and embroidery by nature.  When we press for details about the school they clarify that the girls will only go to school until 5th standard.  The middle school is outside of their village so families do not allow the girls to go.  They believe it is too risky, Tarnishtaben tells me, to have the girls alone that far away from home.  Boys will go to school for as long as the family can afford to send them and for as long as they are interested in going.  They say the girls are not interested in continuing school past 5th standard.   

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After the FGD, Tarnishtaben and I go over the responses and join Geetaben and Martiben at their in-depth interviews.  They are sitting with a group of women under a thatch covering outside one of the houses.  One of the women is breastfeeding her child, he was born eight months ago.  I feel like Kutchi women speak eight octaves higher than voices I am used to hearing.  They yell at each other from house to house with their loud, high pitched, choppy words.  I want to document the interviews, capture the beauty of these women and their clothing, record the piercing almost animal like sounds they make when chatting with each other; but I learned in my previous visit that these women do not like being photographed.  They say it is a point of pride that the only eyes that are able to see them are the eyes of members of their village.  The women here are not allowed to watch TV, look at magazines, or observe any form of media. 

We leave the village by the same dusty road.  When we reach the main part of town just 15 minutes away I see kids of all ages walking home from school.  I notice teenage girls in blue uniforms with books in hand.  These girls come from wealthier families in the more urban part of Khavada.  These girls are interested in going school.

Highlights: Virginia recently graduated from Tulane University where she completed degrees in Public Health, International Development, and Gender & Sexuality Studies. For the past four years, Virginia has been very passionate about work with New Orleans public health involving sex education, reproductive health, and proper nutrition. She was a sex education teacher, a youth mentor, and a global justice intern with a free health clinic where she helped start a farmer's market and led a weekly women's wellness class. She spent her junior year abroad in India living in Delhi and Dharamsala conducting fieldwork on the reproductive health care status of Tibetan refugees.

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