A sip of (community) health drink

Training one or more community members to meet the basic health care needs of the community forms one of the central pillars of community health programs. They also serve as resource people who can guide individuals through the public health care system – from the primary health clinic (PHC) to community health centers in the nearest town. The National Rural Health Mission (NRHM), launched in 2005, has led to focus efforts from the govt. to improve access to health care in rural communities across the country.

Community Health Cell (CHC) has been training community health workers (CHWs)in different parts of Karnataka for the past many years. NRHM has allowed CHC to plug into the govt. health care system much more effectively than was possible a few years ago. Jan Arogya Andolana (JAA, People’s Health Movement, Karnataka) has transitioned from a pre-NRHM to a post-NRHM mode of working. In a few places community health workers trained by CHC have been active and practicing in their communities for almost a decade now while in a few others it has been under a year. A two day program was organized in Bangalore by CHC for CHWs from about 8 districts of Karnataka. The program was designed for discussing experiences, challenges and concerns of inidividual health workers and to exchange ideas and tricks they have learnt on the job. Being the spouse of a CHC Fellow, I attended the morning’s proceedings on the first day.

There were resource people from CHC, FRLHT (an organization working on local health traditions), and community health doctors from a couple of different institutions and backgrounds. Almost all the CHW who came to the meeting were women, two men from Northern Karnataka were the exception amongst some 35 or so women. The most impressive in the gathering though, were the CHWs. Many of these women are single, divorced, separated, or widowed. Some of them have some form of disability. They shared their (often turbulent) history quite dispassionately; when they started talking about their work, they were totally transformed. The passion shone through and the energy was really infectious.

The fun part of the discussion I sat through was when they discussed their favorite remedy. Given my inclinations towards ‘kesh seva’ (hair care), I was all excited to note down receipes to some concoctions to improve hair quality and stimulate hair growth. Ground (soaked) methi seeds, egg white, fresh squeezed lime, and coconut oil heated with neem leaves were known ones that came up. Leaves of neem and pomogranate ground with soaked methi and moong seeds was a new one. (Other instructions: work it in to soak the scalp; sit in the sun for about 10 minutes after application; and wash it off with plain warm water.) Apparently it is a treatment for head lice, but even without any un-invited guests, I tried it a couple of times. I can confidently say that my hair felt much better than it did after any other wash I have had since I started growing my hair long. 🙂

‘Inabilities’

It is not very difficult to spot a person with disabilities (PWD). Yes, it is much easier to spot one with physical disabilities, and with a little observation one can spot those with psychological disabilites. Many around us have an inability – they are unable to recognize the rights of PWDs. And almost all of us have an inability to identify our own actions that tread on the rights of PWDs.

The CHC fellows were visiting Community Based Rehabilitation Forum. Thanx to my status as the spouse of a fellow, I joined the group for the day-long program. Mahesh, one of the community mobilizers led most of the discussions and was helped by Nicholas the director of CBR Forum. After many years of working with PWD, ensuring the individual and community rights of PWDs is the direction that CBR Forum is headed in, similar to many other organizations working with other minorities. They work with community based organizations towards increased awareness of the rights of PWDs currently coded in the Indian constitution. They help mobilize and organize capacity building workshops to develop local leadership within these organizations and communities. They work with progressive movements across the country to correct / improve the effect that new laws and rules framed by the Govt. have on PWDs. I found this to be the most impressive part of their work.

An example of this is the text of the National Rural Employment Guarentee Act (NREGA), 2005. Initial drafts of the law considered all able-bodied people in rural districts of the country to be eligible for employment under the act. If one talks about an employment guarentee to revive rural livelihoods and economies, then why should it be restricted to able bodied persons? In fact if one looks at the demographics, the development and health indicies of PWDs are typically worse than that of the community they live in. Lobbying from this perspective, CBR Forum along with other organizations working with PWDs were able to have the drafted appropriately amended.

The inclusivity of a people’s movement or a community based organization when it comes to PWDs in the local community is an indicator of its politics. Though one should be vary of treating it as a litmus test, it is a useful filter to understand the organization. This is especially true when the movement or the CBO claims to work with/for the most marginalized sections of society. Thinking back to our interactions with Sangtin Kisan Mazdoor Sanghatan in Sitapur, I could see the significance of the variety in its leadership. Women play an active and significant role in decision making within the group, and many of them are from dalit families. Tama and Kamlesh are a couple of PWDs that I can identify as those who have stepped up to take up leadership roles within the organization. Equally encouraging is the fact that the group keeps interests and needs of PWDs in focus during its decision making process.

Seeking to correct the condition of PWDs should naturally include working with the community at large, i.e. ‘those with inabilities’ and not just ‘training the disabled’. Even before this is the need for us to identify our own ‘inabilities’. The first step in this direction would be to include PWDs in decision-making processes and encourage them to take up leadership roles.

Lead with slogans

Sangtin Kisan Mazdoor Sanghatan (SKMS) has a presence in some 60 to 70 villages in Mishrikh and Pisawa blocks of Sitapur district. There are village level committees which hold regular meetings to discuss issues of concern and chart a course of action. Once a month, sanghatan ke sakriya saathi (active partners of the Sanghatan) represent their village at a kshetriya baithak (regional meeting) where regional issues are discussed and strategies worked out. At these regional meets there are also people who are just becoming active and / or seeking to know what happens at the regional meetings.

During our 6 week stay earlier in the year (Apr-May) we had attended a few village meetings and two rounds of the regional meets. In June capacity building trainings were conducted for the emerging leadership and after getting to know more about the details of the workshop, Sudha and I were looking forward to see the difference during the regional meetings this time around.

The first regional meeting was in the Aant region. The mobilization in the villages here is still picking up steam and the leadership too reflects its nascent stage. The next meeting in Qutubnagar is almost an exact opposite. The Sanghatan is very strong in many villages here and the local activists are real firebrands. At the Qutubnagar meeting earlier in the week, it was decided that each sakriya saathi who turns up late would get a punishment – to lead the group that had already arrived with slogans and songs. The number of slogans and songs that they would have to lead would be dependent on how late they arrive. (Most of the village activists walk or cycle for a few kilometers to get to the meeting place.)

Sunita from Husseinpur was one of the first late comers. It was decided that she had to lead with five slogans before she could sit down. Hesitatingly she lead with two, Ladenge ! Jeetenge !! (We will fight ! We will win!!) and Kamanewala khayega! Lootnewala jaayega!! Naya zamana aayega !!! (workers will eat; looters will go; a new era is coming). As she tried to sit down, Surbala one of the representatives of the Sanghatan and a regional level mobilizer, stopped her and reminded that she still had three more slogans to go. With just this bit of an extra push was sufficient to melt Sunita’s hesitation and soon she was leading with her full voice and fire. One after the other she lead with not just three but five more slogans ! The effects of the training was right there for all to see.

Words and messages

A team of eleven has been short listed by the core team of Sangtin Kisan Mazdoor Sanghatan (SKMS) for an exposure trip to the Narmada valley. With Sudha and me tagging along, it is a thirteen member team that will be going on this trip. Jagruth Adivasi Dalith Sanghatan and the Narmada Bachao Andolan in the Satpura hills and along the Narmada valley are the main focus of the visit. Due to the long distance from Sitapur and the limited time that the families can go with one less wage earned in the day, I will be visiting the Adivasi Mukti Sanghatan alone.

Not having any training or experience in representing the Sanghatan, I was hesitant to take up the task of contacting these other people’s movements all by myself. Encouragement from the active members, my usual confidence in learning while doing, and time pressure made me go ahead and start making the phone calls and sending out the emails. Needless to say, I made sure I kept the appropriate people in the Sanghatan posted about the discussions and copied them on emails.

The NBA in Khandwa has started ‘Jal Satyagrah’ in different villages along the Naramada. The villages face submergence every rainy season as the water level rises due to the dams being built. The project affected people who have not been rehabilitated or resettled hold out and sit on a satyagrah in the rising waters. While corresponding with the NBA folks in Khandwa, after a lot of thought, I expressed our solidarity with the struggle saying, ‘I am pretty sure that our team will join in the jal satyagrah for the period that we are there.’

After reading the CCed email, I received some much sought after feedback from Richa, one of the representatives of the Sanghatan. While writing the sentence in question I was hesitant to make a statement on behalf of the Sanghatan, and added the ‘pretty’ to the sentence. But Richa had a point about the ‘our team’. The NGO sector, in sustaining its heirarchichal functioning, (ab)uses the phrase to include those working under them, but not those of a higher position than the speaker. And in the eyes of most village and regional level activists it has become a phrase that coopts their work without indentifying or giving due credit to those who worked hard. Further, the objective of SKMS is to build strong individuals and activists in their own right and not to build a team that can be called to action whenever the need arises. Given these two reasons, when talking about someone active in SKMS a phrase like ‘Sanghatan ke saathi’ or ‘partners of the movement’ is more appropriate and conciously employed. And I totally agree with her. Hopefully the wrong impression that the sentence might have created will be corrected during the trip…

Big enough to fight

Involving all affected members of a community in a fight for their rights is a challenge in any struggle. If the threat is as non apparent as an SEZ that has received in principle approval, this challenge is made even more difficult to overcome. The track record of state governments scrapping an in principal approved SEZ is non existent. The one proposed to be set up in Nandigram comes close to being counted as one, but then, it has not really been scrapped. And Nandigram has happened at the cost of the lives lost, the injuries & the sexual, physical and mental abuse suffered by its residents at the hands of govt. sponsored hooligans over many weeks and months.

Fighting for one’s rights is not an easy thing. For a small farmer, often it might be much easier to accept the measly compensation, however inadequate it might be. With a land holding of an acre or less, they would have worked on other’s farms or experienced seasonal migration to make ends meet. The cash compensation might seem to be something substantial enough to allow them to ‘settle down’, though there are very few examples of such sucesses.

Usually one can see that the struggle against an unjust acquisition and an even more unjust compensation is spear headed by those with more than an acre or so and less than 10 to 15 acres of land holding. Having built their farm and family these farmers typically are the most vested in their land and know what they would be loosing in case of an acquisition.

Farmers with relatively larger land holdings are either absentee farmers, or feel that they are too big to be bothered by such minor land acquisitions. More often though, the powers that be do not touch the lands of those farmers strong enough to rock the decision of the acquisition. Even if a significant portion of a large land holding is acquired, the land owner can sit back and see the land value soar as the struggle against the acquisition is fought by others. Rarely can one see a large land owner stand shoulder to shoulder with the few small and many medium land holding farmers and fight against the acquisition.

A typical scenrio seemed to prevail in the area proposed to be acquired for an SEZ in Nandagudi, near Bangalore. It was a short four hour visit and most probably we were not able to capture the details of the community coming together to fight for their rights. But from what we could see, Nandagudi Bhooswadeena Horata Samiti (NBHS) (Anti-land Acquisition Committee of Nandagudi) has an uphill battle in front of them to convince both the small and the large land holding farmers of the threat to their land, their lives and their livelihood.