Healing the heart of India
Dr Abhay Bang and Dr Rani Bang of the NGO SEARCH were given the Spirit of Mastek Award for providing a healing touch to the poor people of Gadchiroli
In recent months, India has attracted a lot of attention in the world’s press because of its growing economic clout. There is a new spirit of optimism in the country, and there is talk about India becoming the next superpower in a couple of decades. While there’s indeed plenty to be proud about, the uncomfortable fact is that in many parts of the country, time seems to have stood still. Grinding poverty is the norm, as is widespread illiteracy, high child mortality and low life expectancy.
Tackling these problems will need much more than governmental effort, and must include widespread grassroots participation from citizens, non-governmental organisations and the private sector. Mastek, on its part, has made active contributions to social causes and supported those who have sought to make a difference to the lives of the underprivileged. Among its efforts is the Spirit of Mastek Award, given to those who have provided inspired leadership to make the world a better place to live in.
At the Mastek monthly meet held in Mumbai in December 2005, Dr Abhay Bang and Dr Rani Bang of the non-governmental organisation SEARCH (Society for Education, Action & Research in Community Health) (http://www.searchgadchiroli.org) were given the Spirit of Mastek Award for their efforts to improve the health of underprivileged people in the impoverished Gadchiroli district of Maharashtra.
The Bangs’ story began more than two decades ago, when they completed their Master of Public Health course at the Johns Hopkins University in the USA. Inspired by Gandhian ideals, the Bangs chose to return to India to use their skills to help the poor. They then set up base in one of the poorest areas of the country – the predominantly tribal district of Gadchiroli. Their dream was not just to look after the health needs of the community, but also to generate knowledge for the global community through research.
Today, SEARCH’s headquarters is Shodhgram, deep in the forests of Gadchiroli. It looks like a cross between a Gandhian ashram and a tribal village, and has a tribal-friendly hospital, a research centre, a training centre, a library and a Bal Bhavan for children. It has become a Mecca for community health research in India.
Reducing child mortality
Among the Bangs’ biggest tasks was tacking the alarmingly high mortality rate in the area. “We were always interested in women’s and children’s health. Also, there wasn’t -- and isn’t – much work done on the causes of child mortality, so we decided to concentrate on infant deaths,” says Dr Rani Bang.
So the first thing they did was to gather evidence about infant deaths. Their work proved to be path-breaking, and was published in the reputed British medical journal Lancet in 1998.
The Bangs’ studies found that pneumonia was the leading cause of infant deaths, along with infections, asphyxia, lack of proper breast feeding etc. Armed with this knowledge, SEARCH designed a Home-based Neonatal Care (HBNC) programme, and conducted a five-year field trial in 39 villages in the district. The trial found that rural mothers and village health workers could be trained to manage most sick newborns at home.
SEARCH went on a drive to educate mothers, their husbands and in-laws on the care needed during pregnancy and after delivery to prevent such infant deaths. In addition, local midwives and village women were also trained to take care of newborn infants.
The measures were extremely effective indeed, leading to a dramatic drop in the infant mortality rate to 30 per 1,000 babies, from 121 earlier. To put this in perspective, the Indian government’s target is to bring the child mortality rate down to 30 by the year 2010 from the current 60-65, says Dr Rani Bang.
Improving the reproductive health of women
The lot of the women of Gadchiroli is a hard one. They have to work long hours in the fields, cope with their husbands’ alcoholism and face frequent beatings. Their health figures very low in the family’s priorities, and the little health care facilities that existed focus on maternity care and family care. The women desperately needed safe abortion services, care for gynaecological and sexually transmitted diseases and sex and reproductive health education.
In their studies, the Bangs presented evidence for the first time that rural women needed gynaecological care in addition to maternal care and family planning. Their studies and advocacy helped initiate the shift in global population policy towards women’s reproductive health.
Apart from research, SEARCH used a community-based approach to tackle women’s health issues. These included organising `jatras’, slide shows, plays and `kirtans’ to educate women. Village female workers were also trained to identify problems and refer ailing women to the SEARCH clinic.
Breaking the grip of alcohol
Another problem was that of rampant alcoholism in the area. SEARCH led a movement against alcohol by mobilising the people of the district, political parties, NGOs and legislators etc. The aim was to change the government policy that encouraged liquor consumption, and to empower women throughout Maharashtra to vote to close down an alcohol shop in their locality if they felt that its sales harmed their lives.
It wasn’t easy going. SEARCH had to face opposition from the strong liquor lobby that included powerful politicians. “It was a long struggle for five years and we faced many threats to our lives. But the backing and faith of the people was our reward,” says Dr Bang.
Eventually, the Maharashtra government came out with rule which stated that if fifty per cent of women from any particular area wanted liquor shops to be closed down, it had to be done by the authorities. Moreover, possession of illicit liquor was made a cognisable offence.
But despite all their efforts, there was no shortage of alcoholics in the area. So SEARCH developed a village-based de-addiction programme; the villagers themselves assumed responsibility for the programme, with volunteers from the NGO visiting once in a while. The programme succeeded in helping many alcoholics break their habit and lead normal lives.
Tackling the scourge of malaria
SEARCH has also trained tribal youth in malaria prevention using a holistic approach that involves taking care of sanitation, hygiene, using mosquito nets etc. It was a matter of satisfaction for the NGO that it was able to rope the village pujaris into the programme, since their word carries a lot of weight among the villagers.
Called Project Ankur, the programme has been implemented not only in Gadchiroli, but also in Meerut, Solapur, Nagpur, Yevatmal etc. What’s more, the government of India has -- with the help of SEARCH -- implemented the programme in Rajasthan, Bihar, Orissa and UP as well. The Indian Council of Medical Research has also given its stamp of approval to this innovative programme.
Still a long way to go
It hasn’t always been a smooth road for SEARCH. But all the hard work and pain has yielded results. Not only has SEARCH achieved a lot of what it set out to do, it has received international recognition as well. The Bangs were named one of the Heroes of Health by TIME magazine for the year 2005. “It’s an honour for all NGOs. Media endorsement helps attract attention to a particular cause and people start feeling responsible,” says Dr Rani Bang.
However, Dr Bang feels that the government needs to pay more attention to rural areas. She feels the government and NGOs can work together to improve facilities, infrastructure, manpower, and the general health of people in rural and tribal areas. “Since we are closer to the community, we can identify their problems and offer solutions. But we don’t have the capacity to meet their requirements, and need government help. There’s a lack of motivation, political will and accountability towards the people on the part of the government,” she says.
She also thinks corporates too can play a vital role. While corporate social responsibility is a welcome concept, Dr Bang says corporates should extend that responsibility to include a wider section of society. She suggests that companies form trusts or foundations for particular causes that would be separate from their economic interests.
To encourage doctors to serve the poor and needy, Dr Bang says, the medical curriculum needs to change to include behavioural sciences. She also emphasises on the need to invest more in public health, in terms of resources and training.
However, Dr Bang feels she and her organisation still have a long way to go. “We need to do a lot more work. We’ve got much more than what we have given the people, and learned a lot from them -- their language, culture and much more. Our challenge is to help the needy and we will always be working towards this,” she says.
|
