Ever since I learned about being accepted for the William Clinton Fellowship for Service, I have thought about all that I will gain from this experience: learning how I can contribute to a cause that I deeply care about, developing relationships with my NGO placement’s (Action, Research, and Training for Health) staff to learn about how they are meeting their communities’ health needs, connecting with a new group of dynamic and motivated fellows, and fostering my own personal growth as I gain new perspectives and insights from living in a vastly different culture and environment. But, as my departure date looms closer, I am becoming more conscious of all that I am leaving behind: my terrific friends, loving family, supportive boyfriend, and the comforts, familiarity, and predictability of the US. However, a close family member who experienced a serious accident earlier this year has helped me to focus on what I can do, instead of what I can’t do. I believe that because I am beyond lucky to have grown up with privilege and emotional and financial support, I have the capacity – and the responsibility – to help those who are less fortunate.
When I was traveling in India in 2007, I saw a woman sitting on the porch of a chai shop who had a 6 inch, deep, red, puss-filled gash on her shin. I immediately approached her to offer to take her to the hospital. Incredulously, I learned from the shopkeeper that she always refused treatment because she wanted to use her injury to get money from tourists. This deeply disturbing experience completely altered my understanding of health service delivery. I realized that my assumption that the primary impediment to people’s health was poor access to quality services and providers was incredibly over simplified, and, improvements in health are intrinsically connected with women’s rights and economic empowerment. As I continued my travels and completed a short stint as a volunteer in a leprosy clinic in Kerala, it became increasingly clear how pervasive socio-economic and cultural factors, such as gender inequality, poverty, and lack of education, pose significant barriers to accessing care regardless of the availability and quality of health providers and facilities. This shifted my perspective so that I believed greater improvements in women’s health could be generated through preventative and promotive health care with a focus on raising awareness, changing attitudes about the right to access care, and empowering women with the economic means to seek appropriate services. On the flipside, I also see a major issue in increasing demand for services without improving quality of services and care. It is obvious that both the demand and supply must be equitably balanced in order to achieve sustainable progress in health indicators, I just have yet to determine which side of the coin I will fall on.
I want to make a concerted effort to listen and absorb, and ensure that I am sensitive to the cultural norms that affect the concept of wellbeing in India. My previous travels in India provoked questions about what comprised wellbeing, and made me confront, identify, and sharpen my values, values that I believe are fundamental and transcend cultures and class: living with dignity, choice, and control of one’s body. I anticipate that I will again grapple with and potentially revise my own definition of welfare as I work in a field that involves controversial topics such as abortion, women’s rights, family size, and sexual activity. I hope that my experiences through the Clinton Fellowship will give me greater clarity about what role – clinician, policymaker, or public health professional – I want to pursue to contribute to the wellbeing of underserved women in India.