The Midpoint conference was quite eventful, if you couldn’t tell already. Midpoint was followed by the thematic conferences where the fellows were divided into three groups of ten and flew to Rajasthan, Gujarat, and Jharkhand to explore thematic areas like livelihoods, education, and public health respectively.
I was part of the public health conference which was facilitated by AIF’s Maternal and Newborn Survival Initiative (MANSI) program. We were to witness the impact MANSI has had on maternal and neonatal care in rural Jharkhand and also explore those areas where MANSI was planning to scale up.
This experience was unfathomably enriching for me, mostly because I hadn’t experienced any field based exposure into public health in India. As part of the conference, we set off to four different villages in the span of two days where we heard many stories of success when community members are mobilised and trained. We heard stories of community health workers, trained by MANSI, and the impact they saw they were bringing about in their communities and the purpose that brought to their identity as Sahiyyas (ASHA/ community health workers).
I was also struck by what I’ve decided to call, “Schrodinger’s Government”. The government, I came to understand, has several provisions and allowances to ensure maternal and neonatal survival by way of policies and funds. However, the failure (in practice) seemed to be in the implementation of these policies. This failure seemed to be due to two reasons – skewed distribution of knowledge/ information about benefits people are entitled to, and unethical middlemen. I felt that the government couldn’t always by critiqued for being idle, but they still had a long way to go in ensuring that the target populace were benefiting from their policies.
In one of the villages where MANSI’s intervention was being considered, I heard a story that left me quite shattered. A woman who had gone into labour had to be rushed to the hospital immediately. The members of the family attempted to avail a government service provided for them free of charge – an ambulance for pregnant women. The ambulance arrived within half an hour but the driver refused to take them unless the family paid them Rs. 1500. To add to the abhorrence, the local community health worker seemed to have had a commission system with the ambulance driver and insisted that he drive off without helping the family because they wouldn’t be able to pay. The tragic result of this unscrupulousness was the death of the mother.
The solution (or a start, at least) seem to be in programs like MANSI who bridge the gaps in information and skill between people and politics. MANSI trains community health workers, thus augmenting their knowledge of maternal and neonatal care.
This insight was invaluable for me as I drew several lessons that I could apply in my own field site, particularly regarding information sharing, capacity building, and community mobilisation.
All in all, it was an eventful January. As I left behind the warm cacophony of the cohort and made my way to my mountain home, I was swimming in many deep thoughts: the value of empowering women in mobilising communities, my professional trajectory and its state of flux these days, and the unyielding and perennial camaraderie that is fostered by pork induced panic.
